Out-going Governor and Democratic presidential candidate Tom Vilsack says it’s time for major changes in the way the president and congress draft the federal budget.
Vilsack says “specific investments” should be tied to “specific results” and he suggests that’s one way to cut wasteful spending.

He’s also calling for an end to the congressional privilege of “earmarking” which let’s members of congress insert their pet projects into spending bills. “That’s wrong,” Vilsack says. “That’s gotta go.”

In a subtle dig at likely rivals for the Democratic presidential nomination like Hillary Clinton and Barak Obama who are members of the U.S. Senate, Vilsack points to his eight years as governor and his record of balancing the State of Iowa’s budget. “Governors know how to balance budgets. We’re forced and compelled to balance budgets,” Vilsack says. “We have to make tough choices.”

Vilsack says better oversight would save millions, particularly in the Medicare program which is the government’s system of providing health care to the elderly. “Let me give you an example,” Vilsack says. “…I’ve been told that there’s a community in Iowa where you have an eight-times greater likelihood of being operated on for back surgery than any place in America.”

According to Vilsack, it’s time to start rewarding “efficiency” in the Medicare system rather than paying the most to hospitals, clinics and doctors who provide the most services to patients.

Vilsack says curing the nation’s deficit problem would be a top priority if he’s elected president. “Here’s the problem: people talk about the death tax and the estate tax in Washington, D.C. all the time. Hardly anybody pays that,” Vilsack says. “We should be talking about eliminating the birth tax. That’s what the (federal budget) deficit is.” Vilsack made his comments during an appearance on Iowa Public Television.