Mid-Session Review

Today, OMB released the Mid-Session Review (MSR) which updates the Administration’s economic forecast, last done in February, and its budget projections.

Another Look at IMAC

Yesterday, a group of some of the most distinguished health economists in the country sent a letter to the President and Congress in support of the Administration’s proposal for the establishment of an independent board of doctors and health experts to guide Medicare policy. This Independent Medicare Advisory Council (IMAC) would make recommendations on Medicare reimbursement policy and other reforms – playing a critical role in allowing health care policy to adjust flexibly to a dynamic health care market, thereby helping contain costs and improve quality over time.

Werfel Gets the Nod

Today, I am proud to announce that the President will nominate Danny Werfel to be the new Controller of OMB’s Office of Federal Financial Management (OFFM). Danny is currently Deputy Controller and in this capacity has served as Acting Controller during this critically important transition. His leadership in implementing the Recovery Act is just one example of his stellar work over many years – work that led the Administration to recognize what those who have worked with him have known for years: Danny’s an extraordinarily able public servant.

Meeting the $100 Million Savings Challenge

Getting the most from our taxpayer dollars requires ongoing attention and effort. That’s why at the President’s first Cabinet meeting on April 20, he called on Cabinet members to identify at least $100 million in collective cuts to their administrative budgets, separate and apart from those identified in FY 2010 Budget. In a memo that Cabinet Secretary Chris Lu and I sent to the President, we report that agencies have identified 77 cost-saving measures that meet these criteria – amounting to $243 million in savings through 2010 and $265 million including savings in the out-years. Of this, about $102 million would be realized in FY 2009, and about $140 million would be saved in FY 2010.

Closing Lobbyist Loopholes

The President believes that a piece of legislation as important as the Recovery Act must be implemented with an unprecedented degree of transparency. That is why, in March, he imposed substantial limits on lobbyists in their communications with the Federal government about the Recovery Act. He also ordered OMB to evaluate agencies’ actual experiences with the restrictions in the first 60 days and then recommend whether any modifications were needed. That review resulted in a decision to tighten the restrictions and, on Friday, OMB updated the formal guidance on Recovery Act communications with lobbyists.

CBO and IMAC

This morning, the Congressional Budget Office (CBO) analyzed proposals to shift more decision-making out of politics and toward a body like the Independent Medicare Advisory Council (IMAC) put forward by the Administration. CBO noted that this type of approach could lead to significant long-term savings in federal spending on health care and that the available evidence implies that a substantial share of spending on health care contributes little, if anything, to the overall health of the nation.

Data.gov Surpasses 100,000 Datasets

Today, Federal CIO Vivek Kundra announced that the number of datasets on Data.gov has increased from 47 to more than 100,000 – with new sets being added continuously.

A New Foundation

Today, in a speech at the Council on Foreign Relations in New York, I spoke about economic recovery and rebuilding a path towards sustained and broadly shared prosperity. I emphasized two aspects of the Administration’s economic plan: the passage and implementation of the Recovery Act and the need for health care reform this year.

Calendar Clarity

Our upcoming release of the mid-session review (MSR) in August has sparked some speculation. But any speculation about timing games ignores recent history.

IMAC, UBend

Game-changers are appropriately on people’s minds as the work on health care continues on Capitol Hill. By now, close readers of the blog know that the Administration wants to make health care reform deficit neutral and bend the health care cost growth curve down in years to come. Both are critical to our fiscal future, and the latter is especially important in order to put the country on a more sustainable fiscal path.

Airing Differences

Today, the Administration sent a Statement of Administration Policy (SAP) on the National Defense Authorization Act for FY 2010. It emphasizes the President’s commitment to spend taxpayer dollars on what is needed to keep our country safe and secure — and not on programs that are unnecessary or ineffective. To that end, the President made clear that he would veto any bill that supports acquiring more F-22 fighter aircraft beyond the 187 already funded by Congress.

America’s Children

I have written before about the economic and social imperative of expanding access to education and improving the quality of health care while slowing cost growth. Today, a new report, “America’s Children: Key National Indicators of Well-Being, 2009” was issued by the Federal Interagency Forum on Child and Family Statistics. Unfortunately, this report makes clear that more work remains to be done when it comes to children’s well-being in the areas of health care, economic circumstances, and family and social environment.

The Road to Recovery…

Today on Capitol Hill, OMB Deputy Director Rob Nabors testified in front of the House Government Oversight and Reform Committee about the Recovery Act. A major focus at the hearing was a report issued today by the Government Accountability Office (GAO), the non-partisan, independent government watchdog. GAO found that Recovery Act spending was ahead of schedule and was helping to mitigate the economic downturn.

This is IT

Yesterday, the federal "IT Dashboard" went online — a new, one-stop clearinghouse of information that allows anyone with a web browser to track federal IT initiatives and hold the government accountable for progress and results.

A Clean Slate

As the activity around health care reform heats up, I’m participating in a Q&A with John Dickerson at Slate.com. I hope our back and forth is helpful to OMBlog readers and the general public in understanding this important topic and the Administration’s thinking on it.

Welcome to OMB, Jeff!

The OMB team gained another important member today as the Senate confirmed Jeff Zients to be the Deputy Director for Management (DDM). The President’s also asked Jeff to serve as the Administration’s Chief Performance Officer (CPO). I’ve blogged about Jeff before, so I won’t go through his resume again. But suffice it to say, he’s a proven leader who has an impressive record of success everywhere he’s worked. And now, with the Senate’s approval, he’s ready to get to bring his talents to public service.

Rulemaking 2.0

Some of you may be following the public dialogue prompted by President Obama’s Open Government Initiative, which was kicked off on May 21st. Many of the topics discussed have touched on important OMB responsibilities, including oversight of the Federal regulatory process.

CBO Points the Way

Reforms that meet long-term objectives but are not scored as delivering immediate savings are often viewed with an understandable amount of uncertainty and even suspicion. That’s why it was very helpful for CBO to release a letter yesterday afternoon walking through not only some of the challenges of financing major health legislation but also the pathways to a higher-quality, lower-cost health care system over time — the proposals that could help to "bend the curve" on cost growth over the long term. In a section entitled "Policy Options that Could Produce Budgetary Savings in the Long Run," the CBO letter highlights a number of options, nearly all of which were included in the President’s Budget or have been subsequently included as part of his health reform package, that hold promise for reducing costs over the long term.

Filed on Fleet Street

Readers of this blog are familiar with my argument: Our fiscal future is so dominated by health care that if we can slow the rate of cost growth by just 15 basis points a year (0.15 percentage points), the savings for Medicare and Medicaid would equal the impact from eliminating Social Security’s entire 75-year shortfall.

Weekend Reading

If you’re not outside enjoying the nice summer weekend and, like me, you are a health care policy wonk, there are a few important developments to be following.

Debating Health Care

Beginning last week with posts by two bloggers I read regularly and then today with a lengthy editorial in the Wall Street Journal and a blog post by the always provocative Richard Posner, observers are raising some tough and direct questions about health care reform. Some of the pieces were skeptical – and even critical – of our plans. I welcome this debate, and hope to use this blog as a way to foster a dialogue on this vital topic.

Building Rigorous Evidence to Drive Policy

One of the principles motivating the President’s Budget is that, as a nation, we haven’t been making the right investments to build a new foundation for economic prosperity — and we need smarter investments in education, health care, and social services.

McAllen Redux

Last Thursday I blogged on Atul Gawande’s New Yorker essay on McAllen, Texas – the little Texas town with the dubious honor of being one of the most expensive health care market in the country. As Dr. Gawande noted, in 2006 Medicare spent about $15,000 per enrollee here – close to twice the national average, and three thousand dollars more per person than McAllen’s per capita income of $12,000.

Race for the Cure

Transportation Secretary Ray LaHood has organized an Administration team to run in this Saturday’s Global Race for the Cure. I’m joining with Ray and others from the Obama Administration – not only to run with friends and colleagues, but more importantly to remind all of us of the ultimate purpose of health reform: to help people enjoy better health and better lives.

The Budget Director’s Bottom Line: Thank You

Putting together the President’s Budget is no easy task—in a transition year, it’s particularly challenging. Work that is usually done in six or eight months is done in six or eight weeks. That we were able to put together a budget – while also working on the enactment and initial implementation of the Recovery Act – is a reflection of the dedication and quality of OMB’s career staff.

A “Belt and Suspenders” Approach to Fiscally Responsible Health Reform

As the debate about health care reform takes center stage this summer, more and more commentators will be focusing – rightly – on the impact of reform on the federal budget.

Health Care Reform and Fiscal Discipline

When I give public talks on health care reform, the question I receive most often is "given the government’s fiscal situation, how can it make sense for the government to take on new spending commitments as part of health reform?" The answer is two-fold.

McAllen Medicine

As I have written and talked about before, one of the biggest signals of inefficiency in American health care is the massive regional variation in cost and health outcomes. As the Dartmouth Health Atlas has made clear, medicine is practiced differently in different regions across the country, different cities, and even among different hospitals in the same city. And yet the higher cost areas and hospitals don’t generate better outcomes than the lower-cost ones.

Democratizing Data

Today, I’m pleased to announce that the Federal CIO Council is launching Data.gov. Created as part of the President’s commitment to open government and democratizing information, Data.gov will open up the workings of government by making economic, healthcare, environmental, and other government information available on a single website, allowing the public to access raw data and transform it in innovative ways.

Best Places to Work in the Federal Government: Double Bronze!

This morning I was very pleased to speak at the "Best Places to Work in the Federal Government" awards breakfast—an event sponsored by the Partnership for Public Service and American University's Institute for the Study of Public Policy Implementation to honor agencies that have distinguished themselves by excelling at employee engagement and satisfaction. And, I’m happy to report that OMB placed third – tied with CBO.

Misdiagnosis

Despite a media report to the contrary this morning, allowing some time for a ramp-up does not change the fundamental significance of the commitment made earlier this week by health care providers and insurers to reduce the growth rate of health care costs.

Op-Ed in Today’s Wall Street Journal

I have an op-ed in the Wall Street Journal today on a topic of great personal interest and central to the nation’s future: the immense fiscal challenge of rising health care costs, and the opportunity embedded within that challenge to reduce costs in the health care system without sacrificing quality.

Medicare Trustees to America: Bend the Curve!

Today, the Trustees of the Medicare and Social Security Trust Funds released their annual reports detailing the financial operations and long-term positions of the Medicare and Social Security Trust Funds.

Clearing the Air

Media reports today are suggesting that OMB has found fault with EPA’s proposed finding that emissions of greenhouse gases from motor vehicles contribute to air pollution that endangers public health and welfare. Any reports suggesting that OMB was opposed to the finding are unfounded.

Last but Not Least – The Final Installment of the FY 2010 Budget

Today, we released the final volumes of the President’s FY 2010 Budget.

The Health Care Reserve Fund: A Historic Commitment to Reform

As I have said more than a few times before (even on this blog) reducing health care costs is the key to the country’s fiscal future and also to providing relief to American families from rising health care bills.

Using Statistics to Drive Sound Policy

This morning I delivered a speech at a Joint Symposium of the Committee on National Statistics and the American Academy of Political and Social Science on a topic near to my (admittedly wonkish) heart—the role of Federal statistics in developing and executing good public policy.

Determining What Works, Line by Line

We in the Administration have spoken often about the President’s Budget heralding a new era of responsibility—an era in which we not only do what we must to lift our economy out of recession, but in which we also lay a new foundation for long-term growth and prosperity.

This Week in Budget News

This week is another busy one at OMB: we are releasing the full account-level budget on Thursday.

Congratulations to Xav Briggs

Champagne corks are flying (or more accurately, Diet Coke cans are being opened) here at OMB to congratulate Xavier de Souza Briggs for being awarded tenure by the Massachusetts Institute of Technology today.

Congratulations to Emmanuel Saez

My co-author and friend Emmanuel Saez was awarded the John Bates Clark Medal on Friday. The prize, which is awarded to the best American economist under the age of forty, is one of the highest honors the economics profession can bestow upon one of its own.

Nudging Along

One of the most important intellectual developments of the past several years that has had a huge impact on my own thinking has been the rise of behavioral economics.

The Case for Reform in Education and Health Care

This morning I delivered a speech before the Association of American Universities, an association of 62 major public and private research universities in the United States and Canada.

Move Over R2, CPO is Here

Lately, OMB has been consumed with the “B” in our title – the budget – but an equally important part of our mission is the “M” or management of the federal government.

Important EPA Finding

In addition to its other responsibilities, OMB reviews proposed regulations and coordinates an interagency review process. We have now concluded review of the Environmental Protection Agency’s (EPA’s) proposed finding that emissions of greenhouse gases from motor vehicles contribute to air pollution that endangers public health and welfare.

Changing the Game in Health Care

The National Journal blog entry on the Administration’s proposals on health care reform highlights some important issues. But is also contains some red herrings – like the idea the Administration’s proposals won’t reduce costs.

Economic Downturns and Crime

The economic downturn imposes significant costs on families. But does it also increase crime?

New Study on Hospital Readmissions

Estimates suggest that as much as $700 billion a year in health care services delivered in the United States cannot be linked to improved health outcomes – and one reason is that we have incentives for more care rather than better care.

IOU, an Explanation

How much does the federal government owe? It might seem like a simple question to ask those of us wearing the green eyeshades, but there are lots of different concepts used to answer it.

Not Your Reg-ular Blog Post

I know most of OMBlog’s readers are budget wonks – or “propellerheads” to use the now-popular White House term – but OMB also takes a very active and serious role in the management of the federal government, and that includes the regulatory agenda.

Climbing the Hill

Today is a big day in the budget world as the House and Senate Budget Committees kicked off Congressional action on the federal budget with their markups of the budget resolutions.

CBO's New Numbers

CBO released its re-estimate of the President’s Budget today.

Funding for Domestic Programs in the Budget

How much does the Administration’s FY 2010 Budget increase domestic programs this coming year? If you listen to some critics, you would think that the answer is “the biggest increase ever.” But if you approach the question analytically . . .

Fair and Square: NDD Spending to Historic Lows

As I’ve blogged about before, the President’s Budget brings non-defense discretionary spending (NDD) down to its lowest level as share of GDP since 1962.

The Fiscal Impact of Winding Down a War

The President is committed to responsibly winding the war down. I don’t do foreign policy, but I can tell you this: ending wars saves money – and so the Administration’s budget includes savings from ramping down overseas military operations over time.

Notes on the Budget

I am testifying today before the House Budget Committee and wanted to share my notes on the budget.

Economic forecasts and the Budget: Consistency with CBO

During last Thursday’s briefing on the President’s FY 2010 Budget, CEA Chair Christina Romer was asked many questions about the economic forecast underlying the Budget – and since then some news reports have highlighted differences between the Administration’s forecast and the Congressional Budget Office (CBO) forecast.

The Budget and Charitable Donations

Is our budget proposal uncharitable?

Clearing up a misconception: “tax hikes during a recession?”

Peter Orszag: One of the questions I received throughout the day today, as we released the Fiscal Year 2010 budget, is why we are proposing to raise taxes on high-income taxpayers during a recession. And the answer is simple: we’re not.

Discipline, Efficiency, Prosperity

Peter Orszag: I want to open up OMB even more to the public and share with you what we’re doing to address the many challenges that we face as a nation. I know that, for many people, blogs are the easiest way of receiving information – so this blog may prove to be useful even if it simply provides a convenient way of keeping up with information from OMB that is already available in other formats.