Who Is This Guy? (The Health Care Side)

The third part of the approach President Obama outlined in his fiscal policy speech on April 13 addressed health care costs.  He first contrasted his approach with his characterization of the Republican plan.  He said Republicans intended to reduce health care costs in the federal budget by “asking seniors and poor families” to pay the health care costs, whereas his approach would “lower[] the government’s health care bills by reducing the cost of health care itself.”

How to do so?  First, by reducing “wasteful subsidies and erroneous payments,” cutting “spending on prescription drugs by using Medicare’s purchasing power to drive greater efficiency and speed generic brands of medicine onto the market,” and working with governors “to demand more efficiency and accountability from Medicaid.”  Next, the government will “change the way we pay for health care” with “new incentives for doctors and hospitals to prevent injuries and improve results.”  Finally, “we will slow the growth of Medicare costs by strengthening an independent commission of doctors, nurses, medical experts and consumers who will look at all the evidence and recommend the best ways to reduce unnecessary spending while protecting access to the services that seniors need.”  These initiatives, the President said, will save $500 billion over the next 12 years.  And if those savings don’t materialize, “then this approach will give the independent commission the authority to make additional savings by further improving Medicare.”

This part of the speech seems completely inconsistent with a prior part of the same speech.  The President earlier observed:  “So because all this spending is popular with both Republicans and Democrats alike, and because nobody wants to pay higher taxes, politicians are often eager to feed the impression that solving the problem is just a matter of eliminating waste and abuse.  You’ll hear that phrase a lot.  ‘We just need to eliminate waste and abuse.’  The implication is that tackling the deficit issue won’t require tough choices.”

The clear implication of that passage is that promising savings from eliminating “waste, fraud and abuse” is not a serious approach to solving budget problems.  Yet isn’t that all that the President’s health care approach does?  Look again at the President’s proposed approach, and you’ll see plans to eliminate “wasteful subsidies and erroneous payments” (end waste), to demand more “efficiency and accountability from Medicaid” (prevent fraud), and to “improve results” while “reducing unnecessary spending” (avoid abuse).  It’s as if the two parts of the speech were written by two different speechwriters — or as if President Obama thinks that, just because he is the one making the proposal, the tired “waste, fraud and abuse” mantra has actual validity this time.

So, again, I am left to wonder what this President actually believes.  Does he believe that a deficit reduction plan that focuses on eliminating purported “waste, fraud, and abuse” is really no plan at all?  Or, does he truly think there is $500 billion in waste, fraud and abuse to be wrung from our health care spending — and if that is the case, why has that waste, fraud, and abuse been allowed to continue unabated during the first two years of his Presidency?

While we are asking questions, another fair question is whether the President honestly thinks that there is any real value in blue-ribbon commissions, when the political landscape is littered with the reports of prior blue-ribbon commissions that have been happily ignored by those in power.  And if the President does think such commissions are a powerful answer to problems, why does he hold that belief when he has pretty much ignored the recommendations of the Bowles-Simpson budget commission that he himself appointed?

Who Is This Guy?  (The Defense Side)

Who Is This Guy?  (The Spending Side)

The Tao Of Hotel Room Ironing

You awaken in a strange, darkened room, perhaps to the shrill jangling of the unfamiliar alarm of a clock-radio that you don’t know how to turn off.  You stumble to the bathroom, hoping that you do not crash into furniture that is not where you expect it to be.  Moments later, as you check your iPhone or Blackberry, you become dimly aware that you need to get ready for the morning meeting.  This necessarily means your shirt must be ironed, because it is impossible to pack a man’s dress shirt in a suitcase without the shirt become wrinkled, and wearing a wrinkled shirt to your meeting would be . . . unseemly.

You must use the iron and ironing board squirreled away in the hotel room’s closet.  You fumble with the ironing board, lifting it from the hooks that allow it to hang suspended against the closet wall.  You open it and hear that high-pitched screeeel of metal on metal, a sound that is made only by the act of setting up a hotel room ironing board.  Perversely, you are comforted by the annoying, yet familiar, noise.  You retrieve the iron from its slide-in storage rack and plug it in, perhaps struggling with either the miles of cord found in half of American hotel irons or the balky, push button/feed out/scroll back cords found in the other half.  As you slowly, clumsily perform these simple tasks, you realize that the morning fog is beginning to lift from your slumbering brain.

You check the temperature of the iron, and the sizzle of hot metal against your wet index finger feels good.  You place your shirt on the ironing board, dragging it so that the collar and shoulder of the shirt are hard against the squared end of the ironing board.  You iron the plain fabric of the back of the shirt first, your ironing strokes becoming more assured as you progress.  You move the shirt around the board as you go along.  By now, the cranial synapses are engaged.  Be careful you don’t plunk the pointed end of the iron into the row of buttons with too much force!  Snap that sleeve and smooth it to make sure that the act of ironing the top fabric doesn’t leave unwanted creases on the bottom side!  You’ve done this hundreds, perhaps thousands, of times before.

And then you are finished.  You confidently snap the shirt as you remove it from the ironing board and place it back on its hanger.  It looks fine.  You unplug the iron, and as it cools you close up the ironing board, anticipating that sound yet again, and lift it back onto its inner-closet hooks.  Finally, the iron is snapped back into its closet holder.

You have successfully completed the morning’s first chore.  The hotel room shower beckons.