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RealClearPolitics - Articles - Tom Coburn





Last Build Date: Thu, 02 Apr 2009 07:30:00 -0600

Copyright: Copyright 2009
 



Budget Debate Shows Washington Politicians in Denial

Thu, 02 Apr 2009 07:30:00 -0600

Finally, in this script, the congressional majority has no real responsibility for any of the fiscal mess in which we find ourselves. Anyone who counters this script is merely recycling old ideas and old talking points. In the minority war room, aides are arguing that the president's budget taxes, borrows and spends too much. All of this is true but the minority can best demonstrate its commitment to limited government by leading by example. We can do far more in this respect, first by limiting our own earmark requests and by identifying specific areas of the budget that need to be scaled back. Doing anything less will reduce these legitimate claims to partisan chatter. What the American people want, and what they voted for in November, is an end to the petty, partisan and pre-scripted exchanges in Congress. The American people want a real debate and a fair fight between competing philosophies. What they detest from both sides is hypocrisy and partisan gamesmanship. The challenges facing our country are too great for Congress to continue business as usual. Our task is urgent not just because we are in the midst of a financial crisis but because we are on the cusp of an even more severe crisis when baby boomers retire en masse in the next few years. Even before Congress contemplated this current budget that runs $1 trillion deficits every year we knew that the impending bankruptcy of Medicare and Social Security would create deficits of the same size. Yet, instead of having an honest conversation with the American people about the need for restraint we are continuing to indulge in the bad habits of the past. President Obama was elected on pledges to go through the budget line by line, eliminate failing programs and end the abuse of earmarks and no-bid contracts. Congress, however, has little interest in change, unless it comes from the taxpayer's pockets. In this Congress' first ten weeks it has spent more than $2 trillion and funded more than 8,000 earmarks. Congress continues to do the easy work - nothing unites politicians more than the pleasure of spending other people's money - and still refuses to do the hard work of setting priorities and living within our means. With this budget the perfect political moment for fiscal responsibility continues to be a mirage just beyond the horizon of the next election. As a first step, Congress should drop its intellectually dishonest and hypocritical rhetoric. President Obama, is not merely part of some "clean-up crew," but, as President of the United States, has offered a sweeping and bold budget. I believe President Obama has proposed the most significant shift toward collectivism and away from capitalism in the history of our republic. I believe his budget aspires to not merely promote economic recovery but to lay the groundwork for sweeping expansions of government authority in areas like health care, energy and even daily commerce. If handled poorly, I'm concerned this budget could turn our government into the world's largest health care provider, mortgage bank or car dealership, among other things. I recognize that others have a different view and sincerely believe these policies are investments. That is the debate we should be having. But, as we do so, we should remember what the late Senator Daniel Patrick Moynihan of New York said, "Everyone is entitled to their own opinions, but not their own facts." The fact is, we are on an unsustainable course and have been for many years. The American people want us to take the long view. History does not begin and end with each president, each election cycle, or each news cycle. It's time we look at the policies of the past 80 years, not eight years, because the challenges before us have been brewing for decades. Claiming that one president is the focus and genesis of all that is irresponsible and dysfunctional in government is asinine, particularly when this claim comes from members of Congress from either party who so strenuously defend their so-called constitutional right to spend m[...]



Senate Leaders Holding Doctors Hostage

Wed, 09 Jul 2008 08:30:39 -0600

The real debate, then, is not about reimbursement rates, but government-run health care vs. individually-controlled consumer driven health care. If that is the debate Senate leaders wish to have, they should have that debate directly - not stage a diversionary hostage-crisis that harms doctors and patients. As a doctor, the hostility toward private plans among some of my legislative colleagues is confounding because private plans have a proven record of better benefits and quality, superior clinical expertise for coverage decisions, and increased access for vulnerable and minority populations. Medicare Advantage offers seniors personal choice and control over their health care decisions. More than one out of every five seniors rely on their Medicare Advantage plans to provide an alternative to government-run Medicare. Yet, the Democrats' plan would inexplicably limit the availability of these options for seniors. This misguided position is not based on any empirical data, but pure ideology and hostility to individual freedom and choice in health care. The irony of this debate is that the so-called "crisis" in sustainable Medicare reimbursement rates is caused by policies that lead to unsustainable increases in costs. Medicare was designed so physician reimbursement rates would keep pace with costs. Yet, this broken payment system predictably leaves doctors facing a larger cut every successive year - hence the annual crisis that requires difficult maintenance. Instead of fixing this problem once and for all, Senate leaders, and presumptive Democratic presidential nominee Barack Obama, want to not only enshrine this dysfunctional model in Medicare but apply it to the entire health care system. As a doctor, I know first-hand that the result of such a scheme would be not merely an annual crisis, but a permanent crisis in which even more of my medical colleagues would leave the profession rather than contend with ever-shrinking reimbursement rates and intractable bureaucrats in Washington. Senate leaders seem oblivious to the fact that this is an immediate - not far off - problem. Physicians across the country are increasingly refusing to treat Medicare (and Medicaid) patients because Washington's manipulation of the health care market is failing. Expanding Washington's lordship over health care would only reduce the number of doctors in the system as the number of seniors seeking to access Medicare swells. Regardless of the outcome of the doc fix bill, this debate is a reminder of why physicians must get engaged in health care reform. Once we pass this 18-month patch, we will have to come back and figure out how to prevent a 21 percent cut in 2010. Doctors should make no mistake that the underlying problem is that bureaucrats and politicians in Washington are telling them how much they can charge to see their patients. If our health care system turns single-payer - as it eventually would under an Obama Administration - we won't be fighting cuts to care for our over 65 patients, but cuts over reimbursements for all of our patients. After a compromise is passed and the phony theatrics end, Congress should immediately begin working on comprehensive reform. We can solve today's health care crisis by turning to a single-payer system - where care will be rationed and physicians will have to fight for perpetual reimbursement rate fixes for all of the patients they see - or we can solve that crisis with solutions that rely on American ingenuity and individual choice. My experience as a physician and legislator has taught me that the latter is the only long-term solution that will work. In any event, our goal must be results for seniors and patients - not election-year posturing. Physicians want to care for their patients and receive a fair wage. Beneficiaries want the security of knowing medical care will always be available to them. We can achieve both if [...]