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PETER ORSZAG TO BE HEAD OF OFFICE OF MANAGEMENT AND BUDGET.
If you're interested in health care reform, the appointment of Peter Orszag to be director of the Office of Management and Budget is second only in importance to the the elevation of Tom Daschle to health czar and HHS secretary. OMB is a strange place. It's incredibly important, but also somewhat amorphous. It's a cabinet level agency that offers policy recommendations to the president, scores programs, builds the yearly budget. It is how the executive branch imposes empirical rigor on its agencies, and coheres their work into a single budget. In that way, it is the connective tissue of the federal bureaucracy. And the director sits atop all that, sets many of the agency's priorities, and is, generally, one of the president's top policy advisers.
Orszag will be coming from the Congressional Budget Office, OMB's legislative cousin. There, he's shown an almost single-minded focus on health care reform. He's added dozens of health care analysts to the staff, reconstructed the health policy division's management structure, and is readying to release two major books on health policy options and CBO's health care scoring models that will be extremely central in how Congress looks at building a health care bill. Amidst all that, he's toured the country giving a slide show about the problems of the health care system, the overwhelming danger it poses to our fiscal condition, the incredible inefficiencies that beset the delivery, and the research that suggests reform could not only save money but also improve care. He's also acted as a powerful and credible counterweight to those who counsel incrementalism, or delay, on health reform. Indeed, when it became common to suggest that the bank bailout should displace ambitious agenda items like health care reform, Orszag took to his blog -- yes, he has a blog, did I mention that? -- to write:
Many observers have noted that addressing the problems in financial markets and the risks to the economy may displace health care reform on the policy agenda...Although it may not seem immediately relevant given our current difficulties, it will be crucial to address the nation’s looming fiscal gap — which is driven primarily by rising health care costs — as the economy eventually recovers from this current downturn. Indeed, our ability to address our current economic difficulties (through both financial market interventions and potential additional fiscal stimulus) would be severely impaired if investors were not so willing to invest substantial sums in Treasury securities without charging much higher interest rates. That willingness reflects the (currently accurate) view among investors that Treasury securities are extremely safe investments.In other words, one of Obama's top economic advisers will be an economist who has clearly stated that he thinks health care reform central to our fiscal future, who has said that he considers delay or denial a dangerous impulse, and who has proven himself willing to leverage his position and agency to argue that position. That's important, as it assures that there will be voices around Obama arguing that health care is more than simply another item on the lengthy liberal wish list. Orszag also has a smart and innovative take on how to approach health reform, but for more on that, you'll have to wait for the next issue of The Prospect...If we fail to put the nation on a sounder fiscal course over the next few decades, though, we will ultimately reach a point where investors would lose confidence and no longer be as willing to purchase Treasury debt at anything but exorbitant interest rates. If that were to occur, we would lack the kind of maneuvering room that we currently enjoy to address problems in the financial markets and the economy. So if you think the current economic crisis is serious, and it is, imagine what it would be like if we didn’t have the ability to undertake aggressive and innovative policy interventions because creditors were effectively unwilling to lend substantial additional sums to the Federal government…
COMMENTS (13)
Do you mean that he has an article forthcoming in TAP? The fact that the key administration point person is writing in TAP is reassuring for progressives.
Posted by: gobama | November 21, 2008 6:50 PM
gobama: I think Ezra will be providing the article.
I like this choice lots of ways, not just for the health care stuff - although that will be key on the budget issues associated with reform.
But OMB has becomes (since Reagan) that deathstar that looks over every damn program in the gov't to see if it can't be made conservative friendly or utterly cynical or both.
Oh, and the Kuttner/Scheiber articles on Tim Geithner make me welcome Tim as the new Treasury Secy. too. I'm practicing my "Mikey likes it" delivery in front of the mirror daily.
Posted by: JimPortlandOR | November 21, 2008 8:12 PM
Awesome, can't wait for your profile/interview. I hope he won't lose his mojo.
Posted by: alexk | November 21, 2008 8:56 PM
The combination of Daschle (with his history as Senate Majority Leader) and Orszag (with his sociological insights, and his understanding of the cost-benefit side of health reform as well) should be a formidable one. These kinds of appointments honestly get me pumped on a daily basis. I expect the volunteers from the election will also be willing to make time sacrifices to inform and influence the public via grassroots means as well. Things are shaping up. I don't foresee progressives and the Obama admin. making the same mistakes we did in the early 90s. We might get caught up in not finding the votes for reform, the institutional barriers will always be there, but it looks like the foundation is much more fertile this time around. EK, I love your emphasis and reporting on this most important issue.
Posted by: Matt | November 21, 2008 10:15 PM
I like Obama, voted for Obama, and then steeled myself for disappointment as things would--inevitably, I thought--unravel into the same old Washingtonianism (see, for example, this week's fine work of lauding Ted Stevens while not acting on the Big Three). But when I read that the cabinet is being built with this level of care and thoughtfulness, it gives me hope.
Posted by: Winslow | November 22, 2008 9:16 AM
Seriously, Orszag is the most overrated act in washington right now. The guy reads the dartmouth atlas on health once or twice and deems himself an expert. And the liberal blogger fascination with him is downright peculiar. Methinks cocktail parties must be involved.
This guy is good on a soapbox but his ability to run a bureaucracy is seriously in doubt. I hope they have good career staff unwinding the Bush regulations because Orszag is not the guy to do it.
Posted by: senatorwho | November 22, 2008 10:53 AM
What, if anything, does this mean for the CBO (and by extension the legislative process).
Posted by: AlanSP | November 23, 2008 12:44 AM
Here's the key question (in my mind)
Is Orszag calling for universal coverage in 2009
or the beginnings of reform?
"Reform" and "universal coverage" are not synonymous. So far, Obama has talked about "reform" in terms of
Medicare and SCHIP expansion,
and beginning to contain Costs--eliminating hte windfall bonus for Advantage insurers, bringing down the price of drugs (by importing form Canada or negtiating) and, most imoprtantly, asking about the comparative benfits of the treatments we are paying for , , ,
All of this would pave the way for universal coverage, Obama doesn't seem to be talking about univeral coverage in 2009 . . .
Meanwhile although everyone around him (or at least the pundits) seems to be predicting "universal coverage" in 2009, Orszag never uses the phrae.
What do you think?
Posted by: Maggie Mahar | November 23, 2008 1:39 PM
All of this is moving beyond just what Obama may or may not want to do. Hence the Baucus/Kennedy document from a week or so ago. So the question about how big is becoming moot. It will be big. Its also clear, at any rate, that Obama is leaning int hat direction on several fronts. An FDR Big approach rather than incrementalism.
Posted by: akaison | November 23, 2008 3:05 PM
Thing is, akaison, that crises beget opportunities for real change. Even if people are resistant to a particular idea or uncomfortable with the ideological implications, the simple fact that it's SOME kind of action will help pull people along.
Posted by: Demosthenes | November 25, 2008 2:43 PM
Love his haircut!!!
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