Elmendorf vs. Orszag: A “Teachable Moment”… for Geeks and Nerds

July 29, 2009

This week a bitter confrontation between individuals from two distinct social groups offered our nation a rare and precious “teachable moment,” an opportunity to grow beyond those things which divide — or unite — us as a people.

Those individuals, of course, are OMB Director Peter Orszag — a geek — and the CBO Director, ubernerd Douglas Elmendorf. Their struggle is our struggle. Through it we can learn not only about ourselves, but about how to understand and talk about … numbers.

That’s right. I said we can talk about numbers. Wait! Don’t go. This doesn’t have to be boring! Numbers can be exciting!

First, the conflict. As NBC’s First Read reported: “Peter Orszag accused Congressional Budget Office Director Doug Elmendorf of ‘overstepping’ in a Web post Saturday … Orszag, a former CBO director, accused Elmendorf of playing into a stereotype that the CBO often overestimates cost and underestimates savings.”

This is war … between two analytical types whose names sound like characters in a Tolkien novel.

And they didn’t just throw down. They did it on blogs. The conflict began when Elmendorf blogged that the new Medicare advisory panel charged with reforming payments was likely to generate a paltry $2 billion in savings over the next ten years. Orszag replied by saying, in effect, that short-term savings was never the point, adding for good measure that the CBO had “overstepped.”

While it ain’t exactly rival rap entourages exchanging gunfire outside a radio station, it’s pretty badass stuff for number-cruncher types. Orszag’s post also suggests that the CBO would be wise to restrict itself to “qualitative” and not quantitative projections over longer periods of time – a polite way of say “you can’t touch – or quantify – this.” (His “qualitative” comment even includes a hyperlink … back to the very post it’s embedded in. Is that kind of head trip? Some ultra-hip, self-referential “meta” critique of the blogging medium itself?)

“Playing into a stereotype”? Those are fighting words in any context. The stereotyping in this case is between Orszag as geek and Elmendorf as nerd. While people consider the two terms interchangeable, here’s the difference: A ‘nerd’ is conservative, number-fixated, and highly rational. A ‘geek,’ while equally bookish and intellectual, is more given to flights of intellectual fancy and wild imagination.

A nerd can count. But a geek can dream.

Each of us can be a nerd or a geek at different times of our lives, of course, or even at different times of the day. But in this fracas, that’s how the social divide breaks down. Why? Perhaps it’s because Elmendorf’s job is to calculate the bottom-line effect of any program on the government and its coffers, while Orszag (who once held Elmendorf’s job) is allowed to project the long-term and systematic change that new ideas (like advisory panels) might have. There may be bigger savings in Orszag’s vision (I think there are), but dreaming those sweet dreams isn’t in Elmendorf’s job description.

For those of us who love our policy by the numbers, it’s heady stuff. It’s hard dollars vs. soft. It’s expenditures vs. imagination. Elmendorf is the stone-faced banker who won’t lend the money, while Orszag’s the inventor holding a prototype of the hula hoop. Elmendorf’s the dour landlord who says “Sorry, kids – the theater’s closed,” while Orszag is Mickey Rooney and Judy Garland saying “Hey, kids! Let’s put on the show right here!”

Orszag is the right brain and Elmendorf is the left. Orszag is the … oh, you get the point.

Does any of this matter? Actually, it does. We need to apply both types of rigor, but policy analysis is no different from judicial analysis. Numerical impartiality can be a mask for ideological leanings and other assumptions. Both Elmendorf and Orszag have important roles to play, but I think Orszag is right to look at a larger and more quantitative picture. Real “healthcare reform” will come in ways we can’t quantify yet.

I was also surprised by the ideology that seemed implicit in Elmendorf’s recent testimony about health reform. It was striking that he noted simply the cost to the Federal government, and not the potential for overall savings. Even more noticeably, according to the Wall Street Journal, he commented on the support many health policy analysts have expressed for taxing health benefits (an idea I’m not crazy about). The vast majority of health analysts believe there are great savings to be had, along with improved health outcomes, from structural reforms of the very kind that the Medicare panel represents. Elmendorf’s selective use of health analysts’ thinking reflects either ideology, a mode of thought, or (to be fair) simply his necessary focus as the “expenditure and revenue guy” on Capitol Hill.

It’s not up to me to adjudicate between these two analysts, whatever my biases. I do think Orszag has the cooler job, and perhaps as a result has a broader outlook. But that may only prove that I’m a geek. As for resolving this throwdown, maybe the President can invite the two of them over for a beer. Or an Ovaltine. They can watch sci-fi movies, chill out, and resolve their differences.

In the end, however, health care isn’t about the numbers at all. It’s about human lives. Numbers are only tools to help us achieve the right ends. If those of us who love numbers remember that, this will have been a true “teachable moment.”

About these ads

2 Responses to “Elmendorf vs. Orszag: A “Teachable Moment”… for Geeks and Nerds”

  1. brs Says:

    Throwing up costs is frequently a smokescreen put up to block a policy for personal or ideological reasons. Did Elmendorf (or Orszag for that matter) throw up a huge red flag about costs of the bankster bailout? I thought not. Have they objected to the cost of the Iraq occupation let alone the Afghan or Pakistani wars? Have they done a cost benefit analysis of these wars? Have they done one of the bankster bailout? If we were able to make a true cost benefit analysis most wars would be quietly shelved. The only reason they continue is that the costs fall on one group and the benefits on another.

    This is not about geeks vs nerds. It is about social class. Both of these guys are upper social class. Is either one of them willing to trade his taxpayer funded health plan for what we are stuck with in private industry?

    It is the old aristocrat structure continuously trying to assert itself. They are trying to roll back the overlay and appearance of democracy. They want the heathen unwashed to acknowledge the aristocrats superiority for once and for all.

    This discussion is not about making the system work. It is about goals and creating a system where the bread of one class is smeared with caviar and pate de foie gras and the other class is assumed not to have earned luxuries like bread (or health care).

  2. Amir Says:

    I really enjoy reading this blog. I have put together a website on health reform that touches on many of the issues on this site. I would love for any or all of you to visit and both enjoy its content and let me know what you think.

    The ads for all visits go to charity to fight Ulcerative Colitis too!

    http://www.satvathealthcare.com

    Best,

    Amir

    Thanks in advance.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Follow

Get every new post delivered to your Inbox.

%d bloggers like this: