President-elect Barack Obama reportedly plans to name Congressional Budget Office Director Peter Orszag as director of the White House Office of Management and Budget, the AP/Miami Herald reports (Taylor, AP/Miami Herald, 11/19).

As CBO director, Orszag "has focused on health policy since growing costs for Medicare and other federal programs are driving projections of unsustainable future budget deficits," but "with the economy in crisis, he has been dealing with economic stimulus proposals before Congress," according to the New York Times (Calmes, New York Times, 11/18). His health care "expertise could help Mr. Obama, who has promised to expand health care insurance to more Americans while containing costs," the Times reports.

During the Clinton administration, Orszag served as a staff economist for the Council of Economic Advisers and the White House National Economic Council. Orszag also has served as a senior economics fellow at the Brookings Institution, where he directed the Hamilton Project, and is a member of the Institute of Medicine at the National Academies of Sciences (Calmes, New York Times, 11/19).

Orszag "has been reluctant to leave Capitol Hill's budget agency in the middle of his four-year term, but Democratic aides said Tuesday that Orszag seems likely to accept the job if it is offered," as Orszag "would find it virtually impossible to turn down a request from Obama," according to the AP/Herald (AP/Miami Herald, 11/19). According to CongressDaily, possible replacements for Orszag include Doug Elmendorf, a former staff member at the Federal Reserve, the Department of Treasury, CEA and CBO (CongressDaily, 11/19).

Emanuel Cites Need To Support Health Insurance Expansion
At a business leaders conference on Tuesday, Rahm Emanuel, chief of staff to Obama, called for their support to expand health insurance to all U.S. residents, the Detroit Free Press reports. During the conference, sponsored by the Wall Street Journal, Emanuel said, "I'm challenging you today; we're going to have to do big, serious things." Emanuel also said that the Obama administration will make the enactment of an economic stimulus package the "first order of business" (Detroit Free Press, 11/18). In addition, he said that the Obama administration would take advantage of the current economic downturn to pass broad health care and other proposals (Weisman, Wall Street Journal, 11/19).

Health Care for Veterans
House Appropriations Military Construction, Veterans Affairs, and Related Agencies Subcommittee Chair Chet Edwards (D-Texas) this week asked Obama to reconsider a promise to sign an executive order that would allow more veterans with nonservice-related disabilities to seek care at Department of Veterans Affairs medical facilities, CQ Today reports. Since 2003, VA has not allowed "Priority 8 veterans" -- those who have nonservice-related disabilities and annual incomes more than $28,430 -- to seek care at department medical facilities as part of an effort to reduce patient backlogs and reduce costs. Obama has said that he would revise the income eligibility requirement to allow more veterans with nonservice-related disabilities to seek care at VA medical facilities.

Edwards said, "Even if we had unlimited dollars, it would take time to hire all the doctors and nurses," adding, "We don't want to double, triple, quadruple the wait times. I would urge the administration to maintain the goal but spread it out equally" (Johnson, CQ Today, 11/18).

Opinion Pieces

• Rep. Michael Burgess (R-Texas), Washington Times: The Republican Party needs to "reflect upon the central idea of freedom that drives America and allow it to influence our actions on a whole host of issues," such as health care, Burgess writes in a Times opinion piece. According to Burgess, the "idea of government-run health care sounds appealing to many Americans," but such a system would result in "limiting freedom -- the freedom to choose a doctor, to take your health care with you when you switch jobs, to make personal medical decisions." In addition, such a system "presents a host of problems for the health care sector of our already lagging economy," Burgess writes. He writes that "a massive campaign is under way to nationalize health care" and that "many believe the 2008 election provides them the mandate to do just that." In response, Republicans must "offer a clear and credible alternative to a one-size-fits-all system that puts bureaucrats in charge of health care decision-making," Burgess says, adding that the Republican proposal "should squeeze the greed out of the health care system, put the money back in the hands of patients, protect choices and options and make the system more transparent and understandable" (Burgess, Washington Times, 11/19).
  
  
• Merrill Matthews, Washington Times: Obama "says his plan to ensure universal health insurance coverage will lower family premiums," but the source of that proposed savings remains undetermined, Matthews, executive director of the Council for Affordable Health Insurance and a resident scholar at the Institute for Policy Innovation, writes in a Times opinion piece. Obama has proposed to save $77 billion through the implementation of electronic health records, $46 billion through a reduction in administrative costs and $81 billion through improvements in prevention and disease management programs, but Matthews questions whether Obama is "inflating those numbers." Matthews writes, "What Mr. Obama's plan really lacks -- and why it will certainly fail -- is a way to get the economic incentives aligned correctly so that consumers have a reason to be value-conscious shoppers in the health care marketplace," adding, "Instead, he distorts incentives even more than they are by imposing more mandates, regulations and price controls." Matthews concludes, "We probably can cut health insurance by $2,500 a year, as Mr. Obama suggests, but only by giving consumers, not bureaucrats, more control over their health care dollars" (Matthews, Washington Times, 11/19).

--------------------------------------------------------------------------------------

© 2008 MediLexicon International Ltd