Obamacare

Early Obamacare Advocate Goes Missing as Program Flounders

Peter Orszag is strangely silent since the reforms he wanted have been made.

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Where is Peter Orszag now?

Orszag was the director of the White House Office of Management and Budget for the first year and a half of the Obama administration. Other than President Obama himself, he's the person most identified with the argument that health reform was necessary to save the government money.

"Reducing health care cost growth is the key to our fiscal future," Orszag wrote in one White House blog post back in October of 2009. "As the President has repeatedly emphasized: Doing nothing is the surest way to fiscal failure, while reform is the best path for fiscal responsibility."

Or, as Obama himself put it in an address to a Joint Session of Congress in September of 2009: "Our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close. "

President Obama is emphasizing the cost-control aspect of his health-care overhaul less these days. In his talk the other day to the Wall Street Journal CEO Council, Obama said, "With respect to the Affordable Care Act, I think people are legitimately concerned because we have a major problem with health care in this country — 41 million people without health insurance, a lot of people underinsured."

The two sales pitches for the law — helping the uninsured, and saving the taxpayers money — are not mutually exclusive. But it's a lot harder to go around claiming that ObamaCare is necessary to save taxpayers money when the law's most visible signature achievement so far is a Web site on which the government spent hundreds of millions of dollars, a site that does not work.

The HealthCare.gov debacle sure makes it look like rather than saving taxpayer money, the Patient Protection and Affordable Care Act is wasting taxpayer money. It's an impression only furthered by reports like one in today's Boston Herald, which brings in the news that "A stunning 40 percent of the staff at the state agency that oversees the glitch-plagued, befuddling $69 million Obamacare website earn six-figure salaries."

As a kind of fallback, Obama has resorted to arguing that somehow, the Affordable Care Act is controlling health care costs even before many of its key provisions have taken effect. "We also have seen health care costs growing at the slowest rate in 50 years. Employer-based health costs are growing at about one-third of the rate of a decade ago, and that has an impact on your bottom line," Obama said to that same Wall Street Journal CEO Council audience.

There, Obama is trying to take credit for something that was happening before his health care law was passed. A 50-year low in growth of health spending was back in 2009 — before the Affordable Care Act was passed in 2010. As Charles Blahous points out in a commentary for Economic Policies for the 21stCentury, the effect of the health reform law, at least in the short term, has been to increase costs, not to decrease them; Blahous calls the cost reduction claim about as credible as the "if you like your plan, you can keep your plan" claim that has become a late-night laugh line.

Speaking of comedy, that's where some of the most incisive commentary on ObamaCare is coming from these days. Bartley's, a hamburger restaurant in Harvard Square, has added to its menu the ObamaCare burger: "Nobody knows what's in it!…Ask the liberal sitting next to you." (Cost: "$ Trillions.") Even the liberal New Yorker magazine's resident humorist, Andy Borowitz, jokes that Ayatollah Khamenei, "told reporters today his nation agreed to a deal on its nuclear program in the hopes that it would distract attention from the trouble-plagued rollout of Obamacare."

"It's true, we've resisted any deal on nukes for over three decades," the Ayatollah said, according to the humorous dispatch in the New Yorker. "But when we saw how much trouble Obama was having with his Web site, we realized it would be uncaring of us not to try to help him out."

As for Orszag, his usually weekly Bloomberg View column has gone on what the columnist described in an email to me as a "quick sabbatical." His only column since October 7 was one about a housing bubble in New Zealand. Orszag, now a Citigroup executive and newly returned from a three-week trip to Asia, says he will address the issues with Healthcare.gov in a future column.