Conservative ire about White House "czars" covering various policy areas (health, environment, recovery, etc.) misses the big point. Nixon appointed such "czars"--but clearly with the intention of centralizing power over bureaucracies he regarded as lawless, constitutionally dubious, and opposed to his policies. That is altogether legitimate.
Obama's czars would also police policy as he understands it. The issue is not that such appointments are "undemocratic"--that is, not subject to Senate confirmation--but that they represent a further growth of the bureaucracy, not a limitation of it. For the distinction, see John Marini's classic account of the growth of bureaucratic government. This is another example of conservative politicos' failure to hit the central issue, the return to self-government.