• This is IT

    Yesterday, the federal "IT Dashboard" went online — a new, one-stop clearinghouse of information that allows anyone with a web browser to track federal IT initiatives and hold the government accountable for progress and results.

  • A Clean Slate

    As the activity around health care reform heats up, I’m participating in a Q&A with John Dickerson at I hope our back and forth is helpful to OMBlog readers and the general public in understanding this important topic and the Administration’s thinking on it.

  • Welcome to OMB, Jeff!

    The OMB team gained another important member today as the Senate confirmed Jeff Zients to be the Deputy Director for Management (DDM). The President’s also asked Jeff to serve as the Administration’s Chief Performance Officer (CPO). I’ve blogged about Jeff before, so I won’t go through his resume again. But suffice it to say, he’s a proven leader who has an impressive record of success everywhere he’s worked. And now, with the Senate’s approval, he’s ready to get to bring his talents to public service.

  • Rulemaking 2.0

    Some of you may be following the public dialogue prompted by President Obama’s Open Government Initiative, which was kicked off on May 21st. Many of the topics discussed have touched on important OMB responsibilities, including oversight of the Federal regulatory process.

  • CBO Points the Way

    Reforms that meet long-term objectives but are not scored as delivering immediate savings are often viewed with an understandable amount of uncertainty and even suspicion. That’s why it was very helpful for CBO to release a letter yesterday afternoon walking through not only some of the challenges of financing major health legislation but also the pathways to a higher-quality, lower-cost health care system over time — the proposals that could help to "bend the curve" on cost growth over the long term. In a section entitled "Policy Options that Could Produce Budgetary Savings in the Long Run," the CBO letter highlights a number of options, nearly all of which were included in the President’s Budget or have been subsequently included as part of his health reform package, that hold promise for reducing costs over the long term.

  • Filed on Fleet Street

    Readers of this blog are familiar with my argument: Our fiscal future is so dominated by health care that if we can slow the rate of cost growth by just 15 basis points a year (0.15 percentage points), the savings for Medicare and Medicaid would equal the impact from eliminating Social Security’s entire 75-year shortfall.

  • Weekend Reading

    If you’re not outside enjoying the nice summer weekend and, like me, you are a health care policy wonk, there are a few important developments to be following.

  • Debating Health Care

    Beginning last week with posts by two bloggers I read regularly and then today with a lengthy editorial in the Wall Street Journal and a blog post by the always provocative Richard Posner, observers are raising some tough and direct questions about health care reform. Some of the pieces were skeptical – and even critical – of our plans. I welcome this debate, and hope to use this blog as a way to foster a dialogue on this vital topic.

  • Building Rigorous Evidence to Drive Policy

    One of the principles motivating the President’s Budget is that, as a nation, we haven’t been making the right investments to build a new foundation for economic prosperity — and we need smarter investments in education, health care, and social services.

  • McAllen Redux

    Last Thursday I blogged on Atul Gawande’s New Yorker essay on McAllen, Texas – the little Texas town with the dubious honor of being one of the most expensive health care market in the country. As Dr. Gawande noted, in 2006 Medicare spent about $15,000 per enrollee here – close to twice the national average, and three thousand dollars more per person than McAllen’s per capita income of $12,000.

  • Race for the Cure

    Transportation Secretary Ray LaHood has organized an Administration team to run in this Saturday’s Global Race for the Cure. I’m joining with Ray and others from the Obama Administration – not only to run with friends and colleagues, but more importantly to remind all of us of the ultimate purpose of health reform: to help people enjoy better health and better lives.

  • The Budget Director’s Bottom Line: Thank You

    Putting together the President’s Budget is no easy task—in a transition year, it’s particularly challenging. Work that is usually done in six or eight months is done in six or eight weeks. That we were able to put together a budget – while also working on the enactment and initial implementation of the Recovery Act – is a reflection of the dedication and quality of OMB’s career staff.

  • A “Belt and Suspenders” Approach to Fiscally Responsible Health Reform

    As the debate about health care reform takes center stage this summer, more and more commentators will be focusing – rightly – on the impact of reform on the federal budget.

  • Health Care Reform and Fiscal Discipline

    When I give public talks on health care reform, the question I receive most often is "given the government’s fiscal situation, how can it make sense for the government to take on new spending commitments as part of health reform?" The answer is two-fold.

  • McAllen Medicine

    As I have written and talked about before, one of the biggest signals of inefficiency in American health care is the massive regional variation in cost and health outcomes. As the Dartmouth Health Atlas has made clear, medicine is practiced differently in different regions across the country, different cities, and even among different hospitals in the same city. And yet the higher cost areas and hospitals don’t generate better outcomes than the lower-cost ones.

  • Democratizing Data

    Today, I’m pleased to announce that the Federal CIO Council is launching Created as part of the President’s commitment to open government and democratizing information, will open up the workings of government by making economic, healthcare, environmental, and other government information available on a single website, allowing the public to access raw data and transform it in innovative ways.

  • Best Places to Work in the Federal Government: Double Bronze!

    This morning I was very pleased to speak at the "Best Places to Work in the Federal Government" awards breakfast—an event sponsored by the Partnership for Public Service and American University's Institute for the Study of Public Policy Implementation to honor agencies that have distinguished themselves by excelling at employee engagement and satisfaction. And, I’m happy to report that OMB placed third – tied with CBO.

  • Misdiagnosis

    Despite a media report to the contrary this morning, allowing some time for a ramp-up does not change the fundamental significance of the commitment made earlier this week by health care providers and insurers to reduce the growth rate of health care costs.

  • Op-Ed in Today’s Wall Street Journal

    I have an op-ed in the Wall Street Journal today on a topic of great personal interest and central to the nation’s future: the immense fiscal challenge of rising health care costs, and the opportunity embedded within that challenge to reduce costs in the health care system without sacrificing quality.

  • Medicare Trustees to America: Bend the Curve!

    Today, the Trustees of the Medicare and Social Security Trust Funds released their annual reports detailing the financial operations and long-term positions of the Medicare and Social Security Trust Funds.