Alice Rivlin says she's a generally optimistic person but admits the current situation in the nation's capital is trying her patience.
"It's nice to get out of Washington in this crazy time," Rivlin said Tuesday at a meeting of the World Affairs Council of Jacksonville. About 180 members of the council and The Gate Governors Club attended.
"Oh boy, just this last week has strained my optimism to the breaking point. But I think we'll make it," she said.
Rivlin, who has spent many years studying and working on federal budget issues, was speaking about the future of health care spending. She's even optimistic that politicians from both sides can get together to improve the nation's health care system.
"I'm actually going to make the case that we're not so deeply divided about health care," she said.
Rivlin has served in many roles both inside and outside of government over the last four decades.
She served as the founding director of the Congressional Budget Office from 1975 to 1983 and later was director of the White House Office of Management and Budget under President Clinton. She was then appointed by Clinton as vice chairman of the Federal Reserve Board.
She currently is a senior fellow in the Economic Studies Program at The Brookings Institution and is a visiting professor at the Public Policy Institute at Georgetown University.
However, Rivlin still is involved in government policy. In 2010, she was named by President Barack Obama to serve on the Simpson-Bowles Commission, a bipartisan group formed to study ways to resolve the nation's budget problems.
Baptist Health CEO Hugh Greene, who introduced her at the meeting at The River Club in Downtown Jacksonville, called Rivlin "one of the most influential policymakers in Washington today."
Rivlin said the recent election clouded the debate on health care issues because both sides were trying to demonize the other's views.
The 2010 Affordable Care Act, commonly known as "Obamacare," is not socialized medicine and is not a government takeover of the health care system, as some Republicans charged, Rivlin said.
"It's complicated not because it was radical and transformational but because it's marginal and incremental," she said.
Meanwhile, Democratic charges that Republican Vice Presidential candidate Paul Ryan's Medicare reforms would take away benefits from senior citizens were also untrue.
"Democrats really succeeded in scaring a lot of seniors," Rivlin said.
"The political debate does not reflect the real discussion at all," she said. "What we are talking about is how to tweak the system."
Rivlin said the U.S. health care system starts from a position of "incredible strength," so nobody in government wants to make major changes.
"Most people trust their doctor and hospital," she said.
However, something must be done to control Medicare costs as more baby boomers enter the system.
One issue that Rivlin hopes will be addressed is changing from the current fee-for-service system, which encourages doctors to perform more services to make more money. She is hoping that will change to a system in which payments reward effectiveness and patient outcomes.
"Medicare is in a position to change its reimbursement rules," Rivlin said.
"We've got all the pieces in place. Now let's make it work better," she said.
Beyond health care, Rivlin said after the meeting she is hopeful government officials will get together and compromise on upcoming issues such as spending cuts and the federal debt ceiling.
"I'm an optimist by nature so I'm always hopeful. But it doesn't always turn out so well," she said.
"I think cooler heads will prevail," she said.
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