Next Monday there is to be an Obama administration sponsored Fiscal Responsibility summit in Washington. Obama’s new Director of the Office of Management and Budget, formerly Director of the Congressional Budget Office, Peter Orszag, will chair the summit.
Orszag is not an extremist, and his prior work at the CBO demonstrates care and understanding of varying views and political forces in shaping government economic and tax policies.
Still, when it comes down to it, he along with his boss -- President Obama -- and other Democrats favors more government command-and-control over Americans and their economic sectors, compared to Republicans favoring more competitive forces to steer our courses. (See P.S. below the fold)
Credited by Democrat Senate Majority Leader Harry Reid as “"a hero in all of this” structuring the $1-trillion+ “stimulus”/porkulus legislation rushed through Congress, Orszag told Politico: “What has already been accomplished is a huge start toward a more efficient [health care] system, and I think you’re going to see more in the budget next week.” Orszag is primarily referring to the new federal comparitive effectiveness board to determine which treatments are better. There’s already much such research, much of which is useful and much of which is inconclusive, and its application to specific patients may differ widely. Applied to all, even if statistically conclusive, will cause some to be denied treatment. In the hands of government, it will be used as a tool to ration care to save costs. As this December 2008 report from the then Orszag- run CBO points out: “In considering such changes, policymakers face difficult trade-offs between the objectives of expanding insurance coverage and controlling both federal and total costs for health care.” (The whole CBO report is invaluable reading, especially if you want to get involved in the coming debates over your health care instead of just being on the receiving end.)
Orszag makes his course clearer when he says the next health care measures will be “changes to Medicare and Medicaid to make them more efficient, and to start using those programs more intelligently to lead the whole health care system.” Currently, Medicare is prohibited from considering the cost of a treatment in determining whether it is approved for payment. That will change. Currently, private insurance plans are similarly prohibited. That will change.
Peter Orszag is a 40-year old academic, and an avid runner. His views might be more tempered if he were in lesser health or older, not to mention having more practical experience in medicine.
P.S.: In fairness to Peter Orszag, and demonstrating he knows his numbers, this increase in transparency of the federal government’s budget deficit should be welcome. Seeing how Orszag was instrumental to constructing the Obama-Democrat Congress’ $1+ trillion increase in the deficit for the “stimulus”/porkulus bill, this increase in the “official” deficit seems less of his concern than to likely pressure more fiscally conservative Republicans to go along with his proposals for reshaping other sectors of the economy in the Democrats’ image by cutting spending on areas (e.g., Defense) or in ways (e.g., reducing private competitors to Medicare) distasteful to Republicans.
http://www.nytimes.com/2009/02/20/us/politics/20budget.html?_r=1&partner=rss&emc=rss
For his first annual budget next week, President Obama has banned four accounting gimmicks that President George W. Bush used to make deficit projections look smaller. The price of more honest bookkeeping: A budget that is $2.7 trillion deeper in the red over the next decade than it would otherwise appear, according to administration officials.
The new accounting involves spending on the wars in Iraq and Afghanistan, Medicare reimbursements to physicians and the cost of disaster responses.
But the biggest adjustment will deal with revenues from the alternative minimum tax, a parallel tax system enacted in 1969 to prevent the wealthy from using tax shelters to avoid paying any income tax.
Even with bigger deficit projections, the Obama administration will put the country on “a sustainable fiscal course” by the end of Mr. Obama’s term, Peter R. Orszag, the director of the Office of Management and Budget, said Thursday in an interview. Mr. Orszag did not provide details of how the administration would reduce a deficit expected to reach at least $1.5 trillion this year.
Further evidence of how Democrats and Republicans react to higher deficits comes in a Wall Street Journal editorial:
http://online.wsj.com/article/SB123509103655828373.html
Two weeks after passing a $787 billon economic stimulus plan, Congress returns next week to take up another spending bill, this one with a price tag of $410 billion….
The "omnibus" bill would increase discretionary spending -- funds for programs that aren't benefits like Social Security and Medicare -- by 8.7% over 2008. "This would be the largest increase in discretionary spending since at least 1978 -- with the exception of a 10% boost in 2002, shortly after the Sept. 11 attacks -- according to figures from the White House Office of Management and Budget….
These are funding bills Congress hadn’t passed before because former President Bush promised to veto them for infusing so much “pork” and needless spending. Republican Senate Minority Leader Mitch McConnell comments: "I think Americans would like to know how the administration plans to pay for all these things in the context of all the normal annual spending."
An influential Washington think tank comments: "It's a huge challenge, and that's before you even get to Obama's initiatives for health reform and other things," said Jim Horney, director of federal fiscal policy for the Center on Budget and Policy Priorities, a left-leaning Washington think tank.
Politico has the agenda for the Summit meeting:
http://www.politico.com/blogs/bensmith/0209/Fiscal_summit_details.html
The opening session will be followed by "breakout" sessions of five topics: health, tax policy, Social Security, contracting and procurement, and the budget, each led by senior officials.
The budget director, Peter Orszag, will be leading the health breakout — a policy area on which he's long focused, and one expected to be front and center in the budget.
