HEALTH REFORM: Setting the Stage...

A few health tidbits in Washington’s musical chairs before January.

Peter Orszag, the respected head of the Congressional Budget Office, looks likely to head up the White House Office of Budget and Management. Orszag "gets" health care, and he has been extremely effective in his two years at CBO in helping others in Washington "get" it too. He is one big reason why you hear a different dialogue around town these days, a dialogue that reflects understanding of the huge amount of waste and poor quality built into our anachronistic payment and delivery sytem. Orszag appears to live, breathe, eat and sleep Dartmouth Atlas data, and wants us to invest in comparative effectiveness research so we don't deliver and pay for care of  "dubious value."

Orszag understands that health spending—not demographics of aging boomers per se—is the crux of our fiscal challenges. He also built up the health economics expertise at CBO in preparation for Congressional action next year. His likely successor is Doug Elmendorf, according to several news reports. Elmendof who, directs the Hamilton Project at the Brookings Institute, is also no stranger to health care. An analyst at the CBO from 1993-95 he worked primarily on national health care reform.

Over in the Senate, HELP committee chairman Sen. Edward Kennedy said he is divvying up some of the policy tasks among senior committee Democrats  as he puts together health reform legislation. Tom Harkin of Iowa will lead a working group on prevention and public health (including tobacco, a long-time interest). Barbara Mikulski of Maryland will focus on quality. Hillary Clinton gets insurance coverage (unless of course she ends up as Secretary of State..) Noteworthy absence: Chris Dodd, Kennedy's close friend and ally and the second-ranking Democrats on the committee. Dodd is currently Banking committee chairman.