The front page of today’s New York Times features a profile of Tom Coburn, the proudly obstructionist Republican senator from Oklahoma. Though Coburn is a staunch social conservative (according to the story, he favors the death penalty for abortion doctors), he seems to be less an ideologue than a crank, a stance that has a long tradition in American politics. The article gets a lot of mileage out of Coburn’s status as the “Dr. No” of Capitol Hill, even quoting a Rutgers professor who deems him “part of a very tiny pantheon in the history of the Senate” when it comes to obstructing legislative proposals. We also hear about Coburn cutting “a determined swath” on his John Deere mower, “just as he does in the Senate,” decapitating snakes with a shovel, and generally being a royal pain to the leadership of both parties.
All of which is entertaining enough; there is a strong element of sport to politics, after all, and if Coburn relishes the role of third-line defenseman who aggravates his opponents and picks fights, that makes for a fine story. But since the ostensible news peg for this story is the debate over health care—which Coburn, a family physician, identifies as his foremost priority—the merits of his case against reform deserve at least passing attention. Coburn, after all, apparently sees himself as a lonely truth-teller; his colleague John Barrasso, with whom he hosts a weekly Webcast on health policy, says the pair will act as “a kind of truth squad” during floor debate. On the opposite side, an aide for Democratic leader Harry Reid says Coburn commonly uses “specious arguments” to obstructionist ends. Which characterization is more accurate when it comes to health care reform?
The story doesn’t seem too interested in answering that question; in fact, it doesn’t spend much time actually outlining Coburn’s argument (as opposed to the tactical maneuvers he will use to frustrate the opposition). But here is what it does say:
“My mission is to frame this health care debate in terms of the fiscal ruin of this country,” said the 61-year-old Mr. Coburn, who recently railed on the Senate floor that the federal debt was “waterboarding” his five grandchildren.
And later:
These issues remain deeply meaningful to him personally, but “none of these things are important right now,” he said, compared with the “fiscal ruin” he sees the country facing.
“If you look historically, every great republic has died over fiscal issues,” he said. “That is the biggest moral issue of our time.”
So: Will an expansion of health care swell the federal debt? It all depends on the details of the program, of course—details that have been the subject of months of negotiation, much of which has been focused on this very point. One significant result of those negotiations is the health care reform bill that was unveiled yesterday in the House of Representatives, and which the very same New York Times reports on today (emphasis added):
By the most commonly used yardstick, the bill would cost $1.05 trillion over 10 years, roughly $150 billion more than President Obama had said he wanted to spend on the legislation.
Even so, the budget office said that the costs would be fully offset by cuts in the growth of Medicare and by new fees and taxes on individuals, families and businesses. Thus, it said, the bill would reduce projected federal budget deficits by $104 billion over 10 years.
In other words, Coburn is—at least on this point—full of it. There’s inherent uncertainty when making projections about the future, of course. But by the widely accepted standards used to measure all actions of Congress, health care reform, as currently proposed, will not add to the deficit. (And the bill set to be introduced in the Senate, where Coburn serves, will likely have some cost-control measures that are stronger than those found in the House version.)
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In other words, Coburn is—at least on this point—full of it. There’s inherent uncertainty when making projections about the future, of course.
Is there an example, even one, where the long term budgetary projections for new entitlements have come in under or even for a new entitlement?
Yeah, that’s kind of what I thought too.
#1 Posted by Mike H, CJR on Fri 30 Oct 2009 at 01:32 PM
Mr. Marx tries to base his political commentary on his notion that the Times report did not try to evaluate the truth or falsity of Dr. Coburn's judgment that the new program will further beggar the republic.
Mr. Marx might believe the CBO projection, at least for the purpose of achieving the Democrats' claimed reform, but no reasoning adult should. Beside erring in believing unrealistic cost and revenue projections, Mr. Marx also errs in inferring that opponents oppose reform per se. That is false.
With the baby-boom generation entering their Medicare years, Medicare spending will increase. The weasel words here, new to me, are "cuts in the growth of Medicare spending." So spending will move up, say, by 5% per annum. Perhaps the "cuts" would shrink that to 4%.
But the cuts would involve payment cuts to hospitals and physicians, already underpaid by Medicare. (Higher charges to others are used to offset the undercharges.) Physicians don't roll off clients previously on private insurance, but they are not eager to add new Medicare patients, preferring not to operate at a loss. Other assumed cuts would limit care to the elderly. In the words of one of the Administration people the MSM has ignored, they would have fewer "chances" at care.
Democrats might be eager to offend the elderly and most in the medical community; as an elderly voter, I know they are achieving the former. Their transparent effort to provide public funding of abortions alienates yet other groups. Perhaps the leftists who push Democrats’ policies favor all three results.
Two reform essentials that the Democrats are not touching: enacting tort reform and enabling private insurance to cross state lines. I know a New York State physician who quit practice because of high malpractice insurance fees, a result of high tort payments. Tort lawyers help to fund the Democratic party and one does not cross donors, but any alleged reform that does not reform the tort system, a major cause of defensive medicine and higher medical casts, is no reform at all.
Democrats and some mistaken Republicans, including Gov. Bobby Jindal, also want to end coverage bars to people with pre-existing conditions. Companies bar such people to keep premiums down and thus to stay competitive and to earn a buck (and profit is not as great as the President has alleged). A reasonable solution would be some means of following auto insurance’s “high-risk pool” system or perhaps federal funding, where federal spending makes sense.
Much else in his commentary is false, absurd, or insulting, e.g., the claim that opponents of the Democrats' scheme (a word Democrats used against Republicans a few years ago) have "a total indifference to or ignorance about" the debate. Baloney. And Mr. Marx further weakens his argument in calling Dr, Coburn as 'far right." perhaps from the position of Mr. Marx, that is true, but not to others. And would he ever describe such as Sen. Charles Schumer as “far left”? (He is that, from my perspective, but the description is tantamount to name-calling.) Mr. Marx also wrote that the physician and senator “seems” to be a “crank.” I respectfully consider Dr. Coburn a principled and courageous advocate for better government policies.
#2 Posted by Alfred J. Lemire, CJR on Fri 30 Oct 2009 at 02:02 PM
OK, we now know how Greg Marx feels about those strange people from weird places like Oklahoma - a state which, like Texas, seems to be rather more sophisticated than its liberal state brethren in handling little things like the present recession, if one is looking at actual statistics. Instead of celebrating the 'dissenting' position of expressing skepticism (based on the past history of the explosion of entitlement costs), Marx sides with - the 'ins'! And criticizes a report which doesn't crack the party-line whip! Is Navasky editing CJR's writers directly now?
#3 Posted by Mark Richard, CJR on Fri 30 Oct 2009 at 03:08 PM
Mr. Marx claims that Sen. Coburn is "full of it" because the CBO thinks the House bill could trim the federal deficit in the long term.
So.... Where has Sen. Coburn commented on the CBO's assessment of the House Bill? Huh?
Mr. Marx is playing fast and loose with the facts here. He is misusing Sen Coburn's statements regarding the Senate debate over health care (where the bill has has not yet been scored by the CBO).. Mr. Marx is deliberately ridiculing Sen Coburn's concerns regarding the Sentate Bill by falsely comparing them to the CBO's assessment of the House bil.
This is sleazy yellow attack journalism.
#4 Posted by padikiller, CJR on Fri 30 Oct 2009 at 03:49 PM