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There's nothing earth shattering in CBO Director Doug Elmendorf's testimony on the challenges and opportunities facing health reform. What's interesting is what isn't present: The hair-on-fire emphasis on cost containment that his predecessor, Peter Orszag, brought to similar presentations. Orszag argued that health care reform as the One Big Thing in securing a more sustainable path for our budget. He insisted on its urgency. Elmendorf, at least in this testimony, is rather more reserved. Related: My profile of Orszag, which details the changes he made to the CBO and his likely role in health reform.