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After the Director of the Congressional Budget Office, Doug Elmendorf, delivered a serious blow to President Obama's credibility on health care when he testified that none of the current Democratic bills does anything to control costs -- the stated goal of reform -- the White House responded with a novel idea: create a commission! The new Independent Medicare Advisory Council would be for a panel of experts chartered to make recommendations on how to contain costs in Medicare. But when Obama was asked about it during yesterday's AARP townhall, he backtracked that cost-containment actually the point of the commission. Er, maybe he didn't. Okay, let's just look at the relevant portion of the transcript (with emphasis on my part):

Q    Hello, Mr. President.  My question is some concern we have about the possibility of a cost containment commission.  If you could comment on that.

THE PRESIDENT:  The idea is not the cost -- it's not a cost containment commission that's been proposed.  It's been what I just described -- an independent medical advisory committee modeled on the kind of committee that is called MedPAC right now.  It's got people who are health care experts, nurses, doctors, hospital administrators.  The idea is how do you get the most value for your health care dollar.

Now, the objective is to control costs.  But it's not cost containment by just denying people care that they need.  Instead it's reducing costs by changing the incentives and the delivery system in health care so that people are not paying for care that they don't need.  The more we can reduce those unnecessary costs in health care, the more money we have to provide people with the necessary costs -- the things that really pay high dividends in terms of people becoming healthier.

Got that? It isn't a cost-containment commission even though its objective is to control costs. I can think of no more concise demonstration of Obama's double-speak on health care. The problem Obama faces is that he wants to push the idea that he's going to reduce Medicare spending to satisfy the CBO and those concerned about exploding deficits, but he doesn't want senior citizens to think any of the cuts will affect the care they currently receive. And this gets to the heart of his failure as a leader -- his inability to acknowledge that tradeoffs exist. This has been the case no matter the issue. He wants to drastically increase spending and reduce the deficit while maintaining that he'll cut taxes on 95 percent of Americans and only raise them a slight amount on the very wealthy; he claims he'll rein in entitlement spending by creating a massive new entitlement; he argues that a national energy tax (which he won't admit is a tax on energy) will help the environment and improve the economy at the same time; and he says that we can give health insurance to 46 million more people, save money, improve the quality of care, and avoid rationing.

But for a moment, let's take Obama at his word. Let's say that the $622 billion in Medicare cuts he's proposed would merely eliminate waste, fraud, abuse and inefficiency and would not affect care. And let's say that the proposed Medicare panel finds that billions more are being thrown away by Medicare, and simply paying for services that patients don't need. Uh, doesn't that kind of undermine Obama's case that we need to create a new government-run health care program because it will be efficient and have low administrative costs?