In both conventions these past few weeks, Republicans and Democrats have been guilty of talking about their dreams and ideology versus getting into the specifics of what they'll do to introduce revolutionary reform in the areas that need it most from a Federal Spend Management perspective. Specifically, these are entitlement programs such as social security and Medicare/Medicaid, which are growing at uncontrollable (and unsustainable levels). So far, I've not heard either candidate talk about how they plan to make hard (and/or creative) cost cutting decisions in these areas. It's important to point out that policy reform and cost cutting are two different platforms. I'm focusing on the latter here.
Some suggestions? For one -- especially when it comes to Medicaid/Medicare spending -- the Federal government should develop strict guidelines when it comes to their share of reimbursements around states back-office staffing, systems and processes. By forcing Six Sigma rigor on the State level, there are undoubtedly billions to cut from budgets due not only to inefficiencies but also fraud that still goes undetected. While this is easier said than done, it would have a huge impact. Perhaps an easier approach might be to mandate private-sector style strategic sourcing for the operational costs within the entitlement programs versus forcing these programs to use Federal standards that place equal and more emphasis on soft-factors such as small/minority business status rather than cost.
- Jason Busch