Fiscal Realities

We are mere feet from the finish line to passing into law historic, fiscally responsible health insurance reform that will give more choice and security to those with health insurance, provide access to coverage to those without, improve the quality of health care for us all, and provide the most deficit reduction of any bill in over a decade.

Responsible and Paid For

Today’s Congressional Budget Office (CBO) estimate of health insurance reform legislation reaffirms what we have said for the past year: that fiscally responsible health insurance reform is not only possible, but also is an important step toward long-term fiscal sustainability.

Taking On Earmarks

Yesterday, House Appropriations Committee Chairman David Obey announced a major step forward in earmark reform, banning earmarks that go to for-profit companies. He also announced that the House would post every earmark request on a single website — right in line with what the President called for in his State of the Union address. These actions will help to reduce abuses and bring more transparency to earmarks.

Show-Me Savings

Before he became President, Harry Truman made a name for himself by heading a commission that looked into waste in contracting during World War II. So it is only fitting that in Truman’s home state of Missouri today, the President announced a new initiative to go after the $100 billion in improper payments made by the federal government each year.

Salary Statistics

At a Government Executive breakfast meeting yesterday, I was asked about salaries for federal employees – an issue that has received some attention lately in the popular press.

No Gimmick

The President has insisted since day one that health insurance reform should not add a dime to the deficit. In keeping with this commitment, the President has put forward a health plan that would reduce deficits by roughly $100 billion over the next ten years and by roughly $1 trillion in the decade after that.

Education: The Wind at America’s Back

Today, I spoke to students at the Georgetown University Public Policy Institute, where I discussed the Administration’s efforts to promote short-term economic recovery, put the nation on a sustainable fiscal trajectory, and make investments to bolster long-term economic growth. I have written here on many occasions about the first two topics covered in today’s talk, so I’ll use this post to delve a bit more into the final topic of making new investments to promote growth —and, in particular, by expanding access to and the quality of education.

Welcoming the National Commission on Fiscal Responsibility and Reform

This morning, the President signed an executive order establishing a new, bipartisan National Commission on Fiscal Responsibility and Reform. The Commission’s co-chairs – former Clinton White House Chief of Staff Erskine Bowles and former Republican Senate Whip Alan Simpson – will bring Republicans and Democrats together to help tackle one of our looming fiscal challenges.

OIRA Dashboard Goes Live

Last week, as snow forced federal offices to close, OMB was hard at work opening up more of the Federal government – at least online. Today, we are debuting the OIRA Dashboard, an easy-to-use website that will allow people to track the progress of federal rules and regulations that have been submitted for interagency review and find other relevant information about the Office of Information and Regulatory Affairs (OIRA). Putting this information online and in an accessible format is one of the ways that OMB is applying the principles of the Open Government Directive to rulemaking and regulatory policy.

A Short History of Deficit Reduction

It’s been a day since the 2011 Budget was released, and analysts and journalists have written about what it means for individual agencies, specific issues, and states. But let’s not lose sight of the big picture. The President’s Budget represents an important step towards fiscal sustainability: it put forward $1.2 trillion in deficit reduction over the next ten years, even excluding savings from the assumed ramp-down in war funding over time. Including these war savings, the deficit reduction proposed in the President’s Budget rises to $2.1 trillion.

A Dialogue on the Recovery Act

Nearly a year ago, the Congress and the President joined together to enact the American Recovery and Reinvestment Act, one of the most sweeping economic recovery efforts in our nation’s history. Since then, and although more steps can and should be undertaken to promote job growth, the Recovery Act has spurred economic activity and thereby helped to avert a depression.

Introducing the 2011 Budget

Today, the President transmitted the FY 2011 Budget to the Congress. In about an hour, he will deliver remarks about the Budget, and after that I will be taking questions from the press with CEA Chair Romer. This post gives readers of OMBlog a brief overview of the document.

Facing the Fiscal Facts

A Wall Street Journal op-ed today by the prior Administration’s CEA Chair, Edward Lazear, observes that the ratio of federal spending-to-GDP has risen by 14 percent since 2008—and that the transition from 2008 to 2009 saw the greatest annual increase in spending in the last 30 years.

The First Cuts Are the Deepest

In May, we released our Terminations, Reductions, and Savings volume. It put forward more than 120 cuts and reductions, totaling $17 billion, to programs that were duplicative, ineffective, or outdated. At the time, cynics said that we’d never be able to eliminate these programs – some of which had been around for decades. And it’s true that every one of the programs has a supporter, and there have been – and will continue to be – vocal and powerful interests that oppose almost any budget cut.

Modernizing Government

This afternoon, I will participate in the White House Forum on Modernizing Government. More than 50 of the nation’s leading CEOS are attending today’s forum, bringing their ideas for how the government can use technology to save money and improve performance.

No Illusions

We are closer than ever before to passing fiscally responsible health reform legislation. So it’s not a surprise that the most reflexively and ideologically partisan commentators are lashing out. Today, it’s the editorial board of the Wall Street Journal.

And the winner is...

Congratulations, Nancy Fichtner, on becoming the first-ever winner of the President’s SAVE Award — a contest for Federal employees to come up with the best idea to save taxpayer dollars and make the government perform more effectively and efficiently. Since voting began on Monday, OMB received 84,670 and her idea was picked from the “final four” as the winner. On Monday, December 21, Nancy will present her idea to President Obama at the White House.

Voting Ends Tomorrow!

As many of you know, earlier this year, President Obama launched the SAVE Award — a program that offered every federal employee the chance to submit ideas about how government can save money and perform better. Over the course of three weeks, federal employees submitted more than 38,000 ideas. Staff at the Office of Management and Budget (OMB) assessed the submissions and narrowed them down to the final four ideas presented below.

From the Banks of the Danube to the Banks of the Potomac

During the first decade of the last century when Theodore Roosevelt sat in the Oval Office, my great-grandparents emigrated from Hungary to the United States. On Friday, in the first decade of this century, I sat in the Roosevelt Room – adorned with a portrait of the Rough Rider – for a fascinating meeting with the Prime Minister of Hungary.

Promoting Transparency in Government

On his very first day in office, President Obama signed a memorandum to all federal agencies directing them to break down barriers to transparency, participation, and collaboration between the federal government and the people it is to serve.

Health Care Reform as a Journey, not a Destination

Atul Gawande — surgeon and journalist — once again writes a trenchant article examining a key question about health reform: in particular, how can we improve care and reduce costs? Gawande’s answer: there is no single, right answer.

The SAVE Award Final Four

At the end of September, OMB launched the President’s SAVE Award – a contest for federal employees to come up with the best idea to save taxpayer dollars and make the government perform more effectively and efficiently.

CBPP: Savings Will Stick

One of the criticisms leveled by skeptics of health insurance reform is that the hundreds of billions of dollars in Medicare savings being proposed won’t actually be implemented since efforts to cut waste never stick. "Congress is notorious for passing Medicare savings, and then after the cuts take place and the political groups get activated, we restore all the money," one Republican congressman told the Wall Street Journal last month.

An Insightful Article on Health Care Costs

For those skeptical about the ability to restrain health care cost growth in heath reform, read Ron Brownstein’s latest article on how the bills now being considered in Congress would transform the health care system so that it delivers better care to more Americans at far less cost.

The Team Is Set

This weekend, the Senate completed the OMB team when it confirmed Dan Gordon to lead the Office of Federal Procurement Policy (OFPP). Dan brings more than two decades of professional contracting experience to OMB, having most recently served as Acting General Counsel at GAO. He understands the President’s goal of improving the contracting system in order to provide the best value for taxpayers. Dan will be at the center of this effort to deliver better value to the American people at a lower cost to the government’s bottom line.

A Washington Post Post

In today’s Washington Post, I have an op-ed that lays out the four key pillars of fiscally-responsible health reform as endorsed by a group of the nation’s leading economists: deficit neutrality, an excise tax on high-cost insurance plans, a Medicare commission, and delivery system reform. As we move closer to a final bill, I argue that the greatest risk we run is not completing health reform.

Reducing Improper Payments

Each year, taxpayers lose billions of dollars in wasteful improper payments by the federal government to individuals, organizations, and contractors. "Improper payments" is an umbrella term that covers a number of financial transactions — overpayments to individuals or firms is one example; benefit payments to ineligible program participants is another. In 2008, improper payments totaled $72 billion; in 2009, they totaled $98 billion — an increase driven by improved detection and the significant increase in federal outlays associated with the economic downturn. These errors and mistakes are unacceptable. Taxpayers deserve to know that their dollars are being spent wisely and effectively.

Fiscally Responsible Health Reform Redux

Every two weeks or so, there seems to be a story ringing the alarm bells over the fiscal dimension of health reform. As I've said time and again, the President is committed to signing a health reform bill that is deficit neutral in the first decade — and deficit reducing thereafter. The legislation under consideration in the Senate and the bill passed Saturday by the House both meet these tests.

Step Right Up

Last Friday marked the end of the first month of the OMB pedometer challenge. As a team, we took a whopping 51,337,900 in the first month. This is equivalent to walking almost 26,000 miles — over a thousand miles more than walking the full circumference of the earth. Quite an accomplishment.

Rescue, Recovery, and Reining in Deficits

I delivered a speech today at New York University about the Administration’s efforts to jumpstart the economy and to build a secure and prosperous recovery by putting the nation on a path to fiscal sustainability — issues that are especially important to the students of today and generations to come.

Improving our Performance

Today on Capitol Hill, OMB Deputy Director for Management Jeff Zients testified in front of the Senate Budget Committee about the Administration’s efforts to improve the performance of the federal government so that it is more efficient and effective.

Missing the Boat on Cost Containment

As I have said repeatedly — and as my colleague, Christy Romer, is discussing today at the Center for American Progress — reducing health care cost growth is the key to our fiscal future. To anyone who has studied our fiscal facts, this central conclusion seems indisputable.

Birth date, business cycles, and lifetime income

We often hear about people who are unlucky in love, but what of those who are unlucky in the business cycle? What is the impact of being born two decades before a significant economic downturn, such that you graduate from college and enter the labor force in the middle of a period of high unemployment? As the class of 2009 is keenly aware, entering the labor market during a recession has immediate negative effects. Job offers are harder to find: according to the National Association of Colleges and Employers, less than 20 percent of the class of 2009 graduated from college with a job offer in hand, compared to 25 percent in the class of 2008 and more than 50 percent in the class of 2007. Whereas year to year starting salaries on average tend to increase, with the tough competition in this year’s labor market, average starting offers for the class of 2009 are slightly down.

Better than the Heisman

Tonight, the Senate confirmed Danny Werfel as Controller, Office of Federal Financial Management (OFFM). This is great news for OMB, as Danny brings broad experience and financial acumen to the table. His skills will be tested, as there are serious challenges facing the federal government to improve transparency and drive better results for the American people.

Bending the Curve in More Ways Than One

Over the past few days, a number of news articles about health reform have suggested that efforts to control the growth of health care costs are in jeopardy. Great strides to control long-term health care costs have been made in both the Senate and the House — fulfilling a key goal of the President’s health reform effort.

Score One for Senate Finance

This afternoon, the Congressional Budget Office (CBO) released its estimate of the budgetary and coverage effects of the Senate Finance Committee health reform legislation. The bottom line is that this mark demonstrates that we can expand coverage and improve quality while being fiscally responsible. It does not add one dime to the deficit over the next 10 years and, according to CBO, reduces deficits significantly thereafter.

Valuing Evaluation

Especially in these difficult economic times, it’s critical that taxpayer dollars are used wisely. We can’t just keep continuing with business as usual in Washington where programs get funded because they always have – even if they may be ineffective, duplicative, or outdated. That is why the President has made changing how the federal government does business and how taxpayer dollars are spent a top priority. And, as I have written about before, it’s why we are putting an emphasis on objective, rigorous evaluations to help drive funding decisions across the government.

Removing Barriers to College

This weekend I read a fascinating new paper about the impact of providing a simplified approach to financial aid for prospective college students.

A View from the Institute of Medicine

The need for health insurance reform just became clearer with the release from the non-partisan Institute of Medicine (IOM) of an estimate that the health care system contains over $800 billion in excess costs, a number consistent with previous studies. In other words, according to this new estimate, we spend more than $800 billion a year on health care that does not make us healthier. The result is higher premiums for us all and higher costs for the government — but it also means you may receive tests and procedures that you do not need, putting your health at risk.

A Real Pro for Procurement

Today, the President announced his intent to nominate Dan Gordon to serve as the Administrator for Federal Procurement Policy – a key member of the management team here at OMB. Dan is a career contracting professional who understands that the top goal of our procurement efforts is to use taxpayers’ dollars smartly and effectively – that we get the most value for every dollar we spend. Dan will bring a fresh approach to procurement policy, but he also will rely on the expertise of the career procurement workforce to improve our procurement processes.

Fiscal Fitness

October 1st marks the beginning of a new fiscal year. At OMB, that coincides with an increased pace as we begin to put together the Fiscal Year 2011 Budget. This year, as part of their budget submissions, federal agencies have been asked to report on their efforts to improve the health and wellness of their employees. I want to make sure that the staff at OMB doesn’t just talk the talk on wellness, but that we also walk the walk — literally.

Going the Distance – 10K ideas

Last week, OMB launched the President’s Save Award, a contest for federal employees to come up with the best idea to save taxpayer dollars and make the government perform more effectively and efficiently. Today, we received the 10,000th submission and we now have 10,266 entries (to be exact!).

Why Are Older Workers Working Longer?

One of the most significant repercussions of the economic downturn has been its effect on the labor market. It goes without saying that too many Americans are out of work. And as you dig deeper into the data, it becomes evident that the age pattern of changes in labor force participation rates is different now than during past downturns.

Enhancing Performance

Last night, I attended the Service to America Medals ceremony, where I joined in honoring the outstanding performance of a number of federal civil servants. Their accomplishments are inspiring—including establishment of a national suicide prevention hotline for veterans; cutting-edge discoveries that have led to effective treatments for multiple sclerosis and forms of cancer; and development of a loan modification program that kept thousands in their homes.

Introducing the SAVE Award

Some of the best ideas come from those working on the frontlines, so today OMB is launching the President's SAVE Award, a contest for federal employees to come up with the best idea to save taxpayer dollars and make the government perform more effectively and efficiently. Federal employees will be able to submit their ideas, securely and confidentially, at www.SaveAward.gov. The deadline for submissions is Wednesday, October 14. The winner will meet with President Obama and have his or her idea incorporated into the FY 2011 Budget. (We also will recognize the agency with the highest participation rate so make sure your co-workers enter too!).

Regulatory Mussel

Many things come across my desk at OMB. To offer a flavor: the Office of Information and Regulatory Affairs (OIRA) at OMB just completed review of a proposed rule from the U.S. Coast Guard that would establish a new, protective standard for ballast water discharge from vessels in U.S. waters. The rule would represent a significant step toward protecting our waters from the spread of invasive species.

Marshalling Memories

18 years ago, I was given the opportunity of a lifetime by the Marshall Commission to study at the London School of Economics. Tonight, I was able to meet the extraordinary group of this year’s winners as well as the American winners of this year’s Gates scholarships. It was a great reception at the British Embassy (hosted by Ambassador and Mrs. Sheinwald), and for those interested in how my Marshall interview went and my advice to this year’s winners, my remarks are here.

On Norms

I have spoken in the past about the often substantial role of social norms and "contagions" in our health and other behavior. This week’s New York Times Magazine has a fascinating article summarizing the research debate about the role of friends and family in affecting our behavior.

The Head of the Cass

Just a few minutes ago, the Senate confirmed Cass Sunstein to serve as the Administrator of the Office of Information and Regulatory Affairs (OIRA) at OMB. All of OMB and the rest of the Obama Administration appreciates the Senate’s support and for securing smart, effective leadership at the top of our regulatory division.

Counting the Uninsured: 46 Million or “More than 30 Million”?

Last night, President Obama stated: "We are the only democracy—the only advanced democracy on Earth—the only wealthy nation—that allows such hardship for millions of its people. There are now more than 30 million American citizens who cannot get coverage."

The Ingenuity of the American People

On May 21, 2009 the Administration launched data.gov to drive transparency and innovation by making federal data easily accessible. This was immediately followed by the Apps for America contest, challenging the American people to develop innovative solutions using data.gov. The contest was run by the Sunlight Foundation, a non-profit, non-partisan organization focused on “using the revolutionary power of the Internet to make information about Congress and the federal government more meaningfully accessible to citizens.”

Banneker students: A shining example

Today as the President delivered his back to school message to students, I had the privilege to meet with students at Benjamin Banneker Academic High School, a public high school here in the District. (The school is named after a famous African American astronomer and mathematician, who published a series of almanacs in the late 18th century and corresponded with Thomas Jefferson about the cruelty of slavery.) Banneker has an impressive 100 percent graduation rate and college enrollment rate – and thus offers an inspiring example of overcoming multiple barriers to educational success.

Saving for Retirement – Making It Easy and Simple

One of the most compelling examples of the explanatory power of behavioral economics is the sometimes dramatic effects of small changes in making it easier to save for retirement. In this morning’s weekly address, the President highlighted four proposals to do just that.

The Recovery Act at 200 Days

The American Recovery and Reinvestment Act marked its 200th day on Tuesday. What are outside analysts saying about its impact?

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.