Returning once more (at least!) to Barack Obama’s speech last Wednesday on entitlement reform, reader Bob R pronounces himself a little puzzled by one promise Obama made. He claimed that his ObamaCare program would help keep health-care costs from rising and push down deficit spending, mainly through the actions of the Independent Physicians Advisory Board (IPAB), which would have the power to, er, “make additional savings” …. but how?

Now, we believe the reforms we’ve proposed to strengthen Medicare and Medicaid will enable us to keep these commitments to our citizens while saving us $500 billion by 2023, and an additional $1 trillion in the decade after that. But if we’re wrong, and Medicare costs rise faster than we expect, then this approach will give the independent commission the authority to make additional savings by further improving Medicare.

“Make additional savings by further improving Medicare”?  Well, why wait?  If we can “further improve Medicare” and at the same time “make additional savings,” why not just make those changes and cost savings right up front?  Obama makes it sound as if he’s sandbagging us on cost savings, perhaps to have a handy little reserve in case the rest of his budget falls on its face, so that he can have a “Eureka! Cost savings!” moment when he most needs it.

Or, more likely, Obama doesn’t have a clue about how to cut the budget and figured this made it sound as if he had a Plan B.  Shouldn’t cost reduction and service improvement really be Plan A, though?

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