Coburn says committee bill will do harm

 (WASHINGTON, D.C.)   U.S. Senator Tom Coburn, M.D. (R-OK), a practicing physician, member of the Senate Health Education Labor and Pension (HELP) committee, and co-author of the "Patients’ Choice Act" along with Senator Richard Burr (R-OK) and Representatives Paul Ryan (R-WI) and Devin Nunes (R-CA), released the following statement today after the HELP committee passed a health reform bill by a party-line vote of 13-10. 

"This legislation will do grievous, and perhaps irreparable, harm to patients, families and our economy. Congress is missing an historic opportunity for true reform by repeating the failing policies of the past.    If more government spending and control was the answer, our health care system would have been fixed long ago. This bill will increase unemployment by punishing small businesses, take away patient choice by forcing everyone into a government-run plan, and ration care for those who don’t pass tests administered by the politicians and government bureaucrats," Dr. Coburn said. 

"Any American who is concerned with this plan should make their concerns known now because Congress and the White House are committed to forcing this plan on the country before taxpayers have a chance to understand its consequences. The administration doesn’t want to talk about the process because the process has been a charade. The administration and congressional leaders want a single payer system controlled by the government but they lack the political courage to say so. We know they want a single payer system controlled by the government because that will be the effect of this legislation, according to independent reviews," Dr. Coburn said.  

According to the Lewin Group, 120 million Americans lose the insurance they currently have because the  public option will drive private companies out of business. Also, this bill still leaves 34 million Americans without health insurance.    The administration and congressional leaders will not argue for what they want  ‘a single pay system’ because they know the American people will reject this approach. They are obviously worried about a repeat of 1993 when their detailed plan was roundly criticized and defeated.

"While artificial deadlines might be politically expedient, a plan of this magnitude that can’t survive public scrutiny does not deserve to become law," Dr. Coburn said.   

Finally, this $2 trillion bill is reckless from a fiscal standpoint. Moreover, proposed funding mechanisms for this plan are laughably inadequate. Class warfare ‘soaking the rich’ approaches combined with taxes on the very ‘sugary beverages’ we hope to minimize through sound prevention programs will never cover the costs of this plan. The problem in health care is not that we don’t spend enough, but that Americans aren’t getting enough value for their dollars.

On a per capita basis, America spends nearly twice what other industrialized nations spend. Our responsibility is to make better use of existing resources. "This bill does little to fix the perverse incentives in the current system that drive up costs and instead adds to the already crushing burden of debt awaiting future generations," Dr. Coburn said.   

Other serious flaws with the HELP bill:    

Imposes new taxes and regulations that will increase unemployment and depress wages NFIB has estimated more than 1 million jobs will be lost due to the employer mandate. Small businesses, the engine of economic growth, will be disproportionately impacted.   If employers who did not offer insurance were required to pay a fee, employees’ wages and other forms of compensation would generally decline by the amount of that fee from what they would otherwise have been. (CBO report, 7/13/2009, page 3)  

In particular, a play-or-pay provision (employer mandate) could reduce the hiring of low-wage workers, whose wages could not fall by the full cost of health insurance or a substantial play-or-pay fee if they were close to the minimum wage. (CBO report, 7/13/2009, page 4)  

One program that creates work disincentives for its recipients is Medicaid. That program is structured so that eligibility for benefits is completely eliminated at a specified income for most eligibility categories (a cliff) creating a disincentive to work more. (CBO report, 7/13/2009, page 6)  

Similarly, firms might take steps to become smaller (or avoid actions that might expand their workforces). For example, firms could outsource –  that is, lay off employees and contract with other smaller companies for the same services. (CBO report, 7/13/2009, page 7)

Rations and denies care based on costs rather than what patients need and doctors prescribe The comparative effectiveness research section of this bill sets up a bureaucracy to perform similar cost-effectiveness measures that have led to the denial of care to people in need in Great Britain.   Rather than let patients and doctors make medical decisions, this bill will ensure that Federal bureaucrats are making decisions based on costs   rather than what  medically necessary. Wastes billions on sidewalks, playgrounds, and streetlights, instead of focusing health care dollars on health care.  The prevention and wellness section appropriates $10 billion annually for every year in to the future. The section is another mandatory spending program that, unfortunately, includes substantial funding that has nothing to do with health care. The section creates a  public health investment fund, which is nothing more than a slush fund for the appropriations committee to spend on any project they choose.   An example of a program in this bill that will receive billions includes  community transformation grants, which are intended to build bike paths, gyms, playgrounds, street lights, and parks.  

The Congressional Budget Office has determined this spending will not lead to future health care savings. Taxpayers might question why a health care bill borrows $10 billion annually of mandatory spending in the midst of an economic recession   that will not lead to any future savings. Dramatically increases Federal workforce programs and spending, but actually changes current law to discourage serving in primary care or in medically underserved areas.  The authorization levels for workforce programs represent a 400 percent increase over current law   $5.4 billion as compared to 1.3 billion currently. That  a 4.1 billion dollar annual increase.  

Overall, there are 20 new programs authorized, and every existing program is increased anywhere from 30-730 percent over current law.   This bill softens the penalties for breaching a contract to serve in primary care or rural areas, making it easier for individuals to get Federal funds and scholarships without fulfilling the purposes of the programs. Includes an entire title on  Fraud and Abuse that increases government bureaucracy and regulation of the private health insurance industry — while doing nothing to eliminate the real problem: Medicare and Medicaid fraud.  Title V relies on increased government bureaucracy and regulation of private plans (including problematically opening up ERISA preemption), despite the fact that private fraud is considerably lower than fraud in public programs.   This title completely ignores the fact that the real culprit for fraud and abuse is the government-run health programs. Medicare fraud is estimated to be up to $80 billion annually (15-20 percent), and Medicaid improper payment rates are estimated to be as high as 13.5 percent annually.

Creates a huge new long-term care entitlement that promises to place unfunded liabilities on the Federal government Actuarial analysis of the long-term care program in this legislation finds that over the next 40 years this program will create $2 trillion in unfunded liabilities   benefits promises that the program can’t pay for that taxpayers will be on the hook for.   Democrats claim that this program saves money, because it collects premiums for the first 5 years (with the intention of paying them out in benefits in the future). This is disingenuous at best, disastrous accounting at worst. The bill assumes a new expansion of Medicaid up to 150 percent of the Federal Poverty Level.  The Medicaid expansion will cost the Federal government at least $500 billion over the next 10 years, according to CBO Director Elemendorf.   At a time when States are writing IOU  and facing increasingly large budget deficits, this will create enormous new and unsustainable costs.