Commentary Magazine


Topic: Doug Elmendorf

Flotsam and Jetsam

Not what he had in mind when he signed the “historic” health-care bill: Obama hits a new low in the Fox News/Opinion Dynamics poll, at 43 percent approval. Only 38 percent of independents approve of his performance. Still, it’s better than Congress, which manages only a 21 percent approval.

Not what Democrats were predicting when Obama won Colorado in 2008: now all the potential Republican Senate candidates lead all the possible Democrats, and Obama’s approval is down to 43 percent.

Not what Arlen Specter was hoping for when he switched parties: “Republican Pat Toomey is back on top 46 – 41 percent over Sen. Arlen Specter in Pennsylvania’s seesaw U.S. Senate race, while Attorney General Tom Corbett, the leader for the Republican gubernatorial nomination, remains ahead of each of the three top Democratic contenders by double digits, according to a Quinnipiac University poll released today. Gov. Ed Rendell’s job approval rating is 45 – 45 percent, up from a negative 43 – 49 percent last month, the independent Quinnipiac (KWIN-uh-pe-ack) University survey finds. But President Barack Obama’s approval is a negative 45 – 49 percent, down from 49 – 46 percent.”

Not what is helpful in defeating “Islamic radicalism“: taking out any mention of that phrase from the National Security Strategy document. “But some fear sanitizing the NSS may actually confuse our allies; those within the Muslim world who oppose violent jihad and expect the US to very clearly and very publicly do the same. Elliot Abrams, Former Bush Deputy National Security Advisor says, ‘One of the things we are doing there is we’re not really helping moderates in the Islamic world. They have a fight against Islamic extremism, we’re on their side and when we are afraid to even discuss the problem we look fearful and weak.'”

Not what Obama wants to hear: Joe Lieberman wants to carefully review the START treaty: “My vote on the START Treaty will thus depend in large measure on whether I am convinced the Administration has put forward an appropriate and adequately-funded plan to sustain and modernize the smaller nuclear stockpile it envisions. I also remain deeply concerned that — regardless of the merits of the NPR and START on paper — we are losing the real world fight to prevent rogue regimes like Iran from acquiring nuclear weapons. If Iran continues on its current trajectory and crosses the nuclear threshold, it will inflict irreparable harm on the global nonproliferation regime.”

Not what Michael Steele wanted to hear after he played the race card: “For the first time since revelations that the RNC had spent some $1,946 at a risque L.A. nightclub, a member of the national body has called on Steele to step aside. In a letter to Steele dated today, NC GOP chair Tom Fetzer asks the chairman to step aside for what he says is the good of the party.”

Not what anyone has been waiting to hear: “Spitzer: I’ve got the urge to run again.” Free advice — stay away from words like “urge.”

Not what most Americans, I suspect, believe Congress should be spending its time on: “A Democratic member of Congress next week is holding a hearing into baseball players’ use of chewing tobacco.”

Not what Congress is spending its time on: “The nation’s fiscal path is ‘unsustainable,’ and the problem ‘cannot be solved through minor tinkering,’ the head of the Congressional Budget Office said Thursday morning. Doug Elmendorf, best known for arbitrating the costs of various health care proposals, added his voice to a growing chorus of economic experts who predict dire consequences if political leaders don’t scale back spending, increase taxes or both — and soon.”

Not what he had in mind when he signed the “historic” health-care bill: Obama hits a new low in the Fox News/Opinion Dynamics poll, at 43 percent approval. Only 38 percent of independents approve of his performance. Still, it’s better than Congress, which manages only a 21 percent approval.

Not what Democrats were predicting when Obama won Colorado in 2008: now all the potential Republican Senate candidates lead all the possible Democrats, and Obama’s approval is down to 43 percent.

Not what Arlen Specter was hoping for when he switched parties: “Republican Pat Toomey is back on top 46 – 41 percent over Sen. Arlen Specter in Pennsylvania’s seesaw U.S. Senate race, while Attorney General Tom Corbett, the leader for the Republican gubernatorial nomination, remains ahead of each of the three top Democratic contenders by double digits, according to a Quinnipiac University poll released today. Gov. Ed Rendell’s job approval rating is 45 – 45 percent, up from a negative 43 – 49 percent last month, the independent Quinnipiac (KWIN-uh-pe-ack) University survey finds. But President Barack Obama’s approval is a negative 45 – 49 percent, down from 49 – 46 percent.”

Not what is helpful in defeating “Islamic radicalism“: taking out any mention of that phrase from the National Security Strategy document. “But some fear sanitizing the NSS may actually confuse our allies; those within the Muslim world who oppose violent jihad and expect the US to very clearly and very publicly do the same. Elliot Abrams, Former Bush Deputy National Security Advisor says, ‘One of the things we are doing there is we’re not really helping moderates in the Islamic world. They have a fight against Islamic extremism, we’re on their side and when we are afraid to even discuss the problem we look fearful and weak.'”

Not what Obama wants to hear: Joe Lieberman wants to carefully review the START treaty: “My vote on the START Treaty will thus depend in large measure on whether I am convinced the Administration has put forward an appropriate and adequately-funded plan to sustain and modernize the smaller nuclear stockpile it envisions. I also remain deeply concerned that — regardless of the merits of the NPR and START on paper — we are losing the real world fight to prevent rogue regimes like Iran from acquiring nuclear weapons. If Iran continues on its current trajectory and crosses the nuclear threshold, it will inflict irreparable harm on the global nonproliferation regime.”

Not what Michael Steele wanted to hear after he played the race card: “For the first time since revelations that the RNC had spent some $1,946 at a risque L.A. nightclub, a member of the national body has called on Steele to step aside. In a letter to Steele dated today, NC GOP chair Tom Fetzer asks the chairman to step aside for what he says is the good of the party.”

Not what anyone has been waiting to hear: “Spitzer: I’ve got the urge to run again.” Free advice — stay away from words like “urge.”

Not what most Americans, I suspect, believe Congress should be spending its time on: “A Democratic member of Congress next week is holding a hearing into baseball players’ use of chewing tobacco.”

Not what Congress is spending its time on: “The nation’s fiscal path is ‘unsustainable,’ and the problem ‘cannot be solved through minor tinkering,’ the head of the Congressional Budget Office said Thursday morning. Doug Elmendorf, best known for arbitrating the costs of various health care proposals, added his voice to a growing chorus of economic experts who predict dire consequences if political leaders don’t scale back spending, increase taxes or both — and soon.”

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What Happened to Bending the Cost Curve?

Megan McArdle has a typically thoughtful post on bending the cost curve, or not, through the Democrats’ health-care reforms. She explains:

What passes for delivery reform consists mostly of slashing reimbursement rates to providers, and then putting Medicare Advantage on the same plan. There are two problems with this.  The first is that there’s no reason to believe that providers will find ways to efficiently provide care at the new, lower rates, rather than just stop serving Medicare patients. That was the core point of the recent report from the Centers for Medicare and Medicaid Services — and though a lot of bloggers developed sudden suspicions about the integrity of government reports, in fact, this pretty much jibes with the warnings that Doug Elmendorf has been issuing, and also, reality. . . The second is that the treatment cuts — and any further cuts recommended by the cost effectiveness commission — can be undone by Congress.

Well what about the tax on so-called Cadillac plans? Maybe that’s going to discourage overspending, but as McArdle points out, it’s also quite possible that it “ends up just being a heavy tax on a random group of people who happen to have expensive health insurance, [and] then it won’t cut health care costs, and also, will probably end up being repealed.”

There’s really nothing in sight that will influence the cost of health care, because the Democrats refuse to address two issues: tort reform (with the ensuing problem of defensive medicine and unneeded procedures) and expanding markets (e.g., interstate sales, changing tax treatment of individually purchased plans).

What we are doing here is spending gobs of money, raising hundreds of billions in taxes, slashing Medicare payments, and empowering government bureaucrats to influence health-care treatment all in the name of expanding coverage. It isn’t remotely what Obama promised, and it’s not what voters seem to want. But we may get it anyway.

Megan McArdle has a typically thoughtful post on bending the cost curve, or not, through the Democrats’ health-care reforms. She explains:

What passes for delivery reform consists mostly of slashing reimbursement rates to providers, and then putting Medicare Advantage on the same plan. There are two problems with this.  The first is that there’s no reason to believe that providers will find ways to efficiently provide care at the new, lower rates, rather than just stop serving Medicare patients. That was the core point of the recent report from the Centers for Medicare and Medicaid Services — and though a lot of bloggers developed sudden suspicions about the integrity of government reports, in fact, this pretty much jibes with the warnings that Doug Elmendorf has been issuing, and also, reality. . . The second is that the treatment cuts — and any further cuts recommended by the cost effectiveness commission — can be undone by Congress.

Well what about the tax on so-called Cadillac plans? Maybe that’s going to discourage overspending, but as McArdle points out, it’s also quite possible that it “ends up just being a heavy tax on a random group of people who happen to have expensive health insurance, [and] then it won’t cut health care costs, and also, will probably end up being repealed.”

There’s really nothing in sight that will influence the cost of health care, because the Democrats refuse to address two issues: tort reform (with the ensuing problem of defensive medicine and unneeded procedures) and expanding markets (e.g., interstate sales, changing tax treatment of individually purchased plans).

What we are doing here is spending gobs of money, raising hundreds of billions in taxes, slashing Medicare payments, and empowering government bureaucrats to influence health-care treatment all in the name of expanding coverage. It isn’t remotely what Obama promised, and it’s not what voters seem to want. But we may get it anyway.

Read Less




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