Dr. Orszag, the President’s budget sets forth a very ambitious policy agenda, while simultaneously adhering to an honest and sobering accounting standard that realizes incredible fiscal challenges.  It has become clear that in order to rebuild our economy, we are going to have to make significant investments in key priorities like energy, education and health care while sacrificing in some others.  One of the priorities highlighted in the budget outline is a reserve fund of more than $630 billion over 10 years to finance health care reform.  As a strong advocate for health care reform, I am very interested in hearing more about this initiative.

1. It is stated that the reserve fund will be financed in part by new revenue and in part by savings proposals that promote efficiency and accountability.  Can you please elaborate on that?  What specific budgetary and policy changes need to be made to fully fund this reserve?

2. As you know, priorities often shift as Congress and the Administration attempt to address competing goals and challenges that change from year to year.  What guarantees will be made to ensure this fund isn’t utilized or redirected for other purposes?

President Obama’s reserve fund obviously represents the beginning of a long-term path to reform.  I would appreciate if you could highlight some of the other immediate funding investments made in the President’s budget to address health care in FY2010.  Specifically,

3. What role will community health centers play over the short term in providing health care access to the uninsured and underinsured?

4. How will their role and funding change as we move towards a system of universal health care?

Many policy experts agree that investing in the health of our citizenry now will yield tremendous savings later.  In other words, by increasing quality and efficiency in our health system today through innovations in health information technology and early access to preventative care, we can ultimately reduce health expenditures over the long term, but it is often difficult to account for these savings under the House “pay as you go” rules:

5. To what degree are savings from these investments currently incorporated into the budgetary outlook?

6. If they are not incorporated, why not?

7. Can we expect unrealized budgetary savings not incorporated into current health care modeling?