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Bisignano (above center) is poised to run a highly complex federal agency of immense size, with 1,200 field offices and around 60,000 employees. He has done no work in the field of social services or public policy. “What he has done,” Altman continued, “doesn’t give me any confidence — because he’s overseen what they would call ‘efficiency,’ and what I would call ‘cutting off the workers at the neck.’” It is additionally difficult to imagine that Bisignano, a man who earns tens of millions of dollars a year (and reportedly has a net worth of almost $1 billion), would understand the needs of elderly retirees in a nation where around half of senior Americans struggle to afford basic living expenses.