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.
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.)
It’s not a minor point. There’s a natural tendency to assume that a new program that involves a lot of money, as health care reform does, is something that will increase the nation’s debt—as it would, if there were no plan to pay for it. Concerns about rising debt are, in turn, a powerful argument against reform. But people in and around Washington have been debating ways to pay for reform all year. That debate has been the subject of plenty of good reporting, much of it in The New York Times, that has explored the justice, wisdom, and effectiveness of various strategies to cover the cost. Now, a number of members of Congress—not all of whom share Coburn’s general far-right politics—are making public statements that suggest a total indifference to or ignorance about that debate, and that reinforce the natural confusion between cost and debt. Their statements should be held up to scrutiny—no matter how well they steer a John Deere.