Peter R. Orszag
Director,White House Office of Management and Budget
For The Wall Street Journal
This week confirmed two important facts - that health-care costs are the key to our fiscal future, and that even doctors and hospitals agree that substantial efficiency improvements are possible in how medicine is practiced.
The numbers speak for themselves. The Medicare and Social Security trustees' reports released this week show that health-care costs drive our long-term entitlement problem. An example illustrates the point: If costs per enrollee in Medicare and Medicaid grow at the same rate over the next four decades as they have over the past four, those two programs will increase from 5% of GDP today to 20% by 2050. Despite the attention often paid to Social Security, spending on that program rises much more modestly - from 5% to 6% of GDP - over the same time period. Over the long run, the deficit impact of every other fiscal policy variable is swamped by the impact of health-care costs.
Spiraling health-care costs are not just some future abstraction, however. Right now, families across America who have health insurance are seeing their take-home pay reduced and their household budgets strained by high costs and spiraling premiums. State and local governments also are feeling this pinch. And the growing weight of health costs on state budgets translates into an inability to make investments in areas such as education, hindering our overall economic growth.
In his book The Audacity of Hope, Barack Obama offered a paean to the glories of flying on private jets. He lovingly described his first trip on a Citation X: "The plane took off, its Rolls-Royce engines gripping the air the way a well-made sports car grips the road ... I could see how people might get used to this." The punch line of the story was that Obama's staff asked him to give up the practice, which was legal, because he was the Democrats' Senate point man on ethics reform. "It was the right thing to do, but I won't lie," he admitted. "The first time I was scheduled for a four-city swing ... flying commercial, I felt some pangs of regret." The traffic was awful. His plane to Memphis was late. But then he found himself in an intense conversation about stem-cell research with a man suffering from Parkinson's. "These are the stories you miss, I thought to myself, when you fly on a private jet," he concluded.
Despite his past denunciations of the “perpetual campaign” — and “political hacks like Karl Rove” — President Barack Obama’s version of change doesn’t include banishing hardball politics from the environs of the Oval Office.
Like presidents before him, Obama has imported pieces of his campaign into the White House, ranging from his own Rove, David Axelrod, to two dozen campaign staffers who will serve as liaisons with agencies. A top Iowa aide, for instance, is moving to the Environmental Protection Agency.
David Gewirtz | BIO
Editor-in-Chief, ZATZ Publishing
The Bush White House email story just gets weirder and weirder. In his inauguration speech, President Barack Obama told us, "The time has come to set aside childish things." Within the United States Government, apparently old habits die hard.
Apparently, even though the Bush administration is now out of office, the Bush administration's legal team responded late last week to a federal judge's emergency order as if they were still representing the Executive Office of the President.
For those keeping track, this was just a few days after telling the Judge there was no "there is no distinct entity known as the 'Executive Office of the President'."
Program Note: Tune in tonight to hear more from David Gergen on AC360° at 10pm ET.
David Gergen | Bio
CNN Senior Political Analyst
In his first three working days in office, Barack Obama has seized the reins of presidential power in smooth, almost flawless fashion. Whether that will be enough to conquer the forces arrayed against him, however, remains very much open to question.
On the economy, his most urgent challenge, he has followed up quickly on transition planning by bringing in bipartisan leaders of Congress today and will soon hold a special meeting with Congressional Republicans alone. One of the first mistakes of some past presidents has been to dismiss the concerns of the opposition. Because Obama has gone far beyond tradition, GOP leaders left the White House this morning endorsing his call to have a stimulus bill by the President’s Day recess in February.
Even so, chances remain high that the President’s economic plans will hit serious snags in Congress and even if passed, may not work. Democrats in the House, where partisanship has been rancorous, seem little inclined to seek a truly bipartisan stimulus bill, as Obama has wanted. And while some Senate Democrats are trying to re-craft the House bill to make it more pleasing to Republicans, others like Dick Durbin are now airily saying that it makes little difference how many Republicans sign on. (Perhaps they are taking a cue from Obama himself, who reportedly made it clear to the GOP at the White House today that he was in charge of negotiations because “I won”.) If partisan attitudes take hold on both sides, Obama can kiss off his hopes of getting dozens of Republicans on board in the House and more than 20 Republicans in the Senate – and in turn, the bipartisanship he needs on TARP, Detroit, and many other bills to come will be progressively tougher.
[cnn-photo-caption image=http://i2.cdn.turner.com/cnn/2009/POLITICS/01/22/clinton.state/art.clintongreet.gi.jpg caption="Secretary of State Hillary Clinton is welcomed to the State Department on Thursday."]
CNN State Department Producer
Richard Holbrooke and George Mitchell are both here – in the Secretary of State's outer offices.
Holbrooke was working the crowd of State Department staff who turned out to welcome Secretary Clinton, shaking hands and doling out hugs to everyone, including administration heavywieghts of presidents past–former Deputy Secretaries of State John Negroponte and Strobe Talbot and former Defense Secretary William Cohen.
Mitchell smiled politely but stayed close to the senior State Department officials handling Middle East issues.
Update 2:29 p.m.
President Obama is here at State Dept., meeting with Secretary Clinton and other senior state dept staff, as well is the two senior envoys he is going to name – George Mitchell and Richard Holbrooke.
Some color: there is a packed, standing-room-only crowd of approximately 500 - senior staff, a group of lucky civil and foreign service employees are here. Deputy Secretary Designate James Steinberg is here too, fresh from his conformation hearing this morning.
Samantha Power, a close confidante and foreign policy aide of Obama's who resigned from the campaign after calling Clinton a monster, is in the front row – apparently they have kissed and made up. Martin Indyk, who reportedly was inching for some Mideast envoy role but didn't appear to have gotten one is here, along with a group of middle east experts.
The one person who is noticeably absent is Dennis Ross – who was widely expected to take a senior role in the administration dealing with Iran but rumors are circulating that it may not be the plum role he was looking for. Stay tuned.
[cnn-photo-caption image=http://i2.cdn.turner.com/cnn/2009/images/01/20/rahm.jpg caption="White House Chief of Staff Rahm Emanuel."]
From Senior White House Correspondent
Another sign of transition - According to White House officials, White House Chief of Staff Rahm Emanuel this afternoon signed a memorandum sent to all agencies and departments to stop all pending regulations until a legal and policy review can be conducted by the Obama Administration.
[cnn-photo-caption image=http://i2.cdn.turner.com/cnn/2009/POLITICS/01/15/holder.hearings/art.holder.gi.jpg caption="Attorney General designate Eric Holder will likely face tough questions during Thursday's nomination hearing."]
Arlen Specter and Edwin Meese III
For The Wall Street Journal
The Senate Judiciary Committee hearing on Eric Holder's nomination for attorney general has failed to focus on the threat to constitutional rights posed by what is known as the "Holder Memorandum." Near the end of the Clinton administration, this memo changed Justice Department policy regarding the formerly unquestioned right to counsel and to confidential communication with one's counsel.
The Holder memo allowed federal prosecutors to demand waiver of these rights in exchange for characterizing a corporation as "cooperating in an investigation" so that it would not be charged with a crime itself. It thus handed prosecutors a powerful weapon in white-collar criminal investigations.