David Gratzer

President Obama’s point person on health care isn’t his point person on health care after all. These days, wherever you’d expect to see Kathleen Sebelius – the respected former Governor of Kansas and newly appointed Health and Human Services Secretary – you’ll probably see the forty-year old Peter Orszag instead. If you’re starting to wonder why the President doesn’t sound like the Barack Obama you remember, it’s because he’s starting to sound almost exactly like Mr. Orszag, the President’s budget director.

Mr. Orszag is in many ways the father of the strange contradiction within the President’s health agenda. President Obama wants to expand government health care and increase government health regulation. At the same time, the White House hopes to cut trillions in future government health costs – or “bend the curve,” to use Mr. Orszag’s most quotable phrase. The President believes in this impossible agenda because he believes in Mr. Orszag, who spent two years as the highly regarded Director of the Congressional Budget Office.

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Mr. Orszag is a proponent of the “game changer” – a big idea that will result in big savings. “Yes, we can” has become “yes, Washington can.” Take the latest government-centered policy solution touted by the White House. It’s called “IMAC,” or the Independent Medicare Advisory Commission, which will have the authority to ration new drugs, tests, and technologies. IMAC will be a new Washington bureaucracy with an “independent” mandate, founded on the fiction that an expensive treatment must be by definition a waste of money.

The Democrats insist they don’t want British health care. We’ve seen this approach before – as it turns out, in Britain, which has employed the IMAC philosophy for more than a decade. There, the Orwellian super-committee is called NICE, the National Institute for Health and Clinical Effectiveness. Courts and patient petitions have forced NICE to repeatedly reconsider its decisions to reject treatments. NICE spent two years restricting a drug to treat blindness arguing that patients could get by with only one good eye. NICE rejected cancer drugs even after certifying their effectiveness solely because they were too expensive.

While Democrats argue they don’t want Canadian health care, Canada’s counterpart to IMAC is the secretive Common Drug Review, or CDR. The CDR has rejected several orphan drugs without public debate, ignoring the fact that these drugs are often the best or even the only treatment for certain diseases.


David Gratzer

Dr. David Gratzer, a physician, is a senior fellow at the Manhattan Institute. David Gratzer's most recent book is Why Obama's Government Takeover of Health Care Will Be a Disaster (Encounter Books, 2009).