Waste, Fraud and Abuse


Mickey Kaus liked the speech better than I did, but wonders about this:

Orszagism:  Still there, but gets an image makeover. In it's new, airbrushed form, we're told that "our health care problem is our deficit problem" (which it is) but not that Obama's reforms are necessarily the solution to the deficit problem (which they aren't, even if they'll work--you could also raise taxes or cut spending elsewhere). The content of those long-term structural reforms is redefined along free-lunch, no-grandiose lines: only "waste and abuse" that does "nothing to improve your care" will be targeted. That's a relief! Only "common sense best practices" will be encouraged by the new cost-cutting panel. All building up to the central iffy policy pitch

[W]e've estimated that most of this plan can be paid for by finding savings within the existing health care system

Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan ..

a) Does anyone really believe this--that is, if you define waste and inefficience as things that don't actually help improve your health, as opposed to things that might improve your health marginally but aren't worth the cost? b) Specifically, does the average Medicare recipient feel that the system that he enjoys is rife with waste, inefficiency, fraud, and abuse? I suspect not. This seems like the greatest point of vulnerability in the speech;

Ah, our old friends, waste, fraud, and abuse, the bane of politicians everywhere.  Based on the number of politicians I have heard during my adult lifetime promising to generate massive savings from cutting waste, fraud, and abuse, I estimate that this diabolical trio accounts for approximately 113% of all Federal spending.  The percentage may be even higher at the state and local levels.

It was not actually a bad speech, and no more than ordinarily filled with political fairy stories.  But it wasn't a good speech, certainly not good enough.  I don't think this speech persuaded many people not to worry about the health care plan:  it made it sound complicated, wonky, and uncertain.  And it is people's worries that need to be overcome more than their hopes need to be stoked.  People who already loved Obama, and his health care plans, whatever they were, still love Obama, and his health care sort-of-plans.  But I just don't see this massively shifting the game.

Meanwhile, I'm not sure that WF&A really cuts it any more.  As Mickey Kaus says, I doubt most people consider Medicare to be full of fraud.  But more to the point, politicians have been promising to pay for their programs, or their tax cuts, with our old friends for a long, long time.  Has everyone really failed to notice that the savings never materialize?

Well, hell, maybe.  Hope springs eternal and all that.

Update:  Arnold Kling asks the real question

He said,

Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.
And if we don't pass this plan, does he intend to keep the waste and inefficiency, out of spite?
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Megan McArdle is a columnist at Bloomberg View and a former senior editor at The Atlantic. Her new book is The Up Side of Down.

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