Obama’s Dreaming

From Obama’s speech tonight:

I will not sign a plan that adds one dime to our deficits – either now or in the future. Period. And to prove that I’m serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don’t materialize. …

We’ve estimated that most of this plan can be paid for by finding savings within the existing health care system – a system that is currently full of waste and abuse. … We will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead. …

Because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody. We have long known that some places, like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania, offer high-quality care at costs below average. The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.  Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. …

Add it all up, and the plan I’m proposing will cost around $900 billion over ten years.

So he’s going to save $500+ billion over ten years by having an independent commission “encourage best practices”?  Actually doing that would require this commission to have enormous power and be willing to use it to create many politically powerful enemies.  I see no sign whatsoever that they are actually willing to do this, nor any sign that they would actually be willing to cut medical spending if “spending cuts” somewhere were required by law.  So far this still looks like the usual empty campaign promise to pay for spending deficits by “cutting waste and abuse.”

Added: The Post fact-checker agrees on Obama’s cost-cutting claims: “This is, at best, wishful thinking.”  The White House website elaborates that the Commission will not ration or cut benefits or access:

An independent Commission, made up of doctors and medical experts [will] make recommendations to Congress each year on how to promote greater efficiency and higher quality in Medicare.  The Commission will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care.

So they will cut vast waste without ever telling anyone they can’t get a treatment they want?  Fantasy.