Monday, March 2, 2009

A Commission on Entitlement Reform--A Good Idea

The Kaisernetwork reported the following today:
On Sunday, White House Office of Management and Budget Director Peter Orszag during an appearance on ABC's "This Week" said that Obama might establish a commission on entitlement reform, or broader health care reform, to take some of the authority over the development of legislation from Congress. Under such a commission, the Obama administration and lawmakers would reach an agreement on legislation, and Congress would vote on the bill without amendments. Such a commission "would move a lot of the decision-making away from ... Congress ... towards a group of more politically insulated and technically skilled people," Orszag said, adding, "We will be exploring all of these ideas with the Congress"
This is a good idea.

As I have posted, when they released their budget last week it was clear to me that the Obama Administration was not able to make the "hard decisions" the President himself has called for in order to reform entitlements.

That is not to say this administration does not know what needs to be done--starting with their very competent budget director.

But the Obama health care budget cuts hardly make a dent.

In 2012, the Obama "down payment" on health care reform only reduces Medicare and Medicaid spending by 2% of what it would have been without their proposed cuts. In 2019, with the proposed reductions "all in," the federal health care bill for these entitlements would still be more than 96% of what it would have been anyway. The Obama budget didn't even attempt to deal with the huge challenge of reforming physician payment. Half of these cuts alone come from one place--cutting the Medicare HMOs--and spreads the rest across a number of health care providers.

For the Obama administration to essentially punt the big and politically problematic health care spending decisions to the 535 disparate members of Congress isn't going to get us sustainable health care reform.

Health care reform is unlikely if the process is left to the traditional Capitol Hill "sausage factory" because the special interests would cut good policy to pieces.

The commission on entitlement, or overall health care reform for that matter, idea Orszag has floated is the best chance we could ever have
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