(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.  

 (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.  

The U.S. Department of Justice’s Bureau of Alcohol, Tobacco, Firearms & Explosives’ Dallas Field Office issued the following news release:  

The National Response Team (NRT) of the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), along with ATF special agents from Lubbock Field Office, Dallas Field Division, have entered the investigation of a large fire that occurred July 9 at the Cal-Maine Foods egg production plant in Farwell, located in far West Texas.  "The fire occurred at approximately 5:30 p.m., and it is estimated that 800,000 chickens were killed.  The NRT arrives at the scene today. The fire destroyed four of the nine laying houses at the site, as well as killing some hens at a fifth house. Damages are estimated at $20 million," said Ken Chisholm, assistant special agent in charge of ATF Dallas Field Division.

ATF is working with the Texas State Fire Marshal’s Office and the Parmer County Sheriff’s Office in the joint investigation.   The NRT is being brought into the fire investigation because of the difficulties presented when investigating a fire of this size.    

Five separate buildings, each approximately 24,000 square feet, were destroyed; and four fire fighters were injured from heat exhaustion and smoke inhalation during suppression efforts.  

In 1978, ATF developed the NRT to bring its expertise to federal, state and local investigators in meeting the challenges faced at the scenes of significant arson and explosives incidents. The NRT consists of four teams organized geographically to cover the United States. Each team can respond within 24 hours to assist state and local law enforcement/fire service personnel in onsite investigations.    In addition to investigating hundreds of large fire scenes, the NRT has also been activated to scenes such as the 1993 World Trade Center bombing, the Oklahoma City federal building bombing and the Sept. 11, 2001, Pentagon crash site, as well as blasts at explosives and ammunition manufacturing plants, legal fireworks factories and illegal explosive device manufacturing operations.   

The teams are each composed of veteran special agents who have post-blast and fire origin-and-cause expertise; forensic chemists; explosives enforcement officers; fire protection engineers; accelerant detection canines; explosives detection canines; intelligence support, computer forensic support and audit support. The teams work alongside state and local officers in reconstructing the scene, identifying the seat of the blast or origin of the fire, conducting interviews, and sifting through debris to obtain evidence related to the bombing/arson.   Further complementing the teams’ efforts are technical, legal and intelligence advisers. Moreover, a fleet of fully equipped response vehicles strategically located throughout the United States is available to provide logistical support.   This investigation will be the 20th activation for fiscal year 2009 and the 678th activation since the inception of the program.  

ATF is the federal agency with jurisdiction for investigating fires and crimes of arson. More information on ATF can be found at http://www.atf.gov/

President Barack Obama released an official statement this morning regarding his appointment of Judge Sonia Sotomayor.

It states: "Yesterday, Judge Sonia Sotomayor made her opening statement to the Senate Judiciary Committee and moved another step closer to taking a seat on the United States Supreme Court. As President, there are few responsibilities more serious or consequential than the naming of a Supreme Court Justice, so I want to take this opportunity to tell you about the qualifications and character that informed my decision to nominate Judge Sotomayor.  

Judge Sotomayor’s brilliant legal mind is complemented by the practical lessons that can only be learned by applying the law to real world situations. In the coming days, the hearings will cover an incredible body of work from a judge who has more experience on the federal bench than any incoming Supreme Court Justice in the last 100 years. Judge Sotomayor’s professional background spans our judicial system – from her time as a big-city prosecutor and a corporate litigator, to her work as a federal trial judge on the U.S. District Court, and an appellate judge on the Second Circuit Court of Appeals. And then there is Judge Sotomayor’s incredible personal story. She grew up in a housing project in the South Bronx – her parents coming to New York from Puerto Rico during the Second World War. At the age of nine, she lost her father, and her mother worked six days a week just to put food on the table. It takes a certain resilience and determination to rise up out of such circumstances, focus, work hard and achieve the American dream. This character shined through in yesterday’s opening statement.  In Judge Sotomayor, our nation will have a Justice who will never forget her humble beginnings, will always apply the rule of law, and will be a protector of the Constitution that made her American dream and the dreams of millions of others possible. As she said so clearly yesterday, Judge Sotomayor’s decisions on the bench  have been made not to serve the interests of any one litigant, but always to serve the larger interest of impartial justice.  In anticipation of today’s first round of questioning, I hope you’ll share this email widely, because Judge Sotomayor’s confirmation is something that affects every American. It’s important for these hearings to be about Judge Sotomayor’s own record and her capacity for the job – not any political back and forth that some in Washington may use to distract you. What members of the Judiciary Committee, and the American people, will see today is a sharp and fearless jurist who does not let powerful interests bully her into breaking from the rule of law."    

Thank you,  Barack Obama    

Addendum to article: Judge Sonia Sotomayor Opening Address Transcribed  

Yesterday, the Senate Judiciary Committee kicked off the confirmation hearings for Supreme Court Nominee, Judge Sonia Sotomayor. In her opening statement, Judge Sotomayor pledged a  fidelity to the law:  "In the past month, many Senators have asked me about my judicial philosophy. It is simple: fidelity to the law. The task of a judge is not to make the law — it is to apply the law.   And it is clear, I believe, that my record in two courts reflects my rigorous commitment to interpreting the Constitution according to its terms; interpreting statutes according to their terms and Congress’s intent; and hewing faithfully to precedents established by the Supreme Court and my Circuit Court.    In each case I have heard, I have applied the law to the facts at hand."   

Judge Sotomayor’s confirmation hearings continue today with the first round of questioning.         

 Kroll, the world  leading risk consulting firm, is warning that worldwide more than $500 billion in economic stimulus spending could be lost to fraud.  

For more information on bribe warnings, click here for more information.  In the full global fraud report, it says "stimulus spending  creates a once-in-a-generation opportunity for corruption."   Let’s hope the Obama Administration won’t be asleep at the switch.  

But we don’t have to project into the future to see where waste, fraud and abuse could be happening. All we’ve got to do is look back and see how the failures of the U.S. military and civilian investigators and prosecutors to act when crimes occurred right under their noses have already cost the American taxpayer millions.

Two cases-in-point arise from the events surrounding the handwritten  bribe ledger of Major John Cockerham, first described in this space last month.  In the case of the Kamal Mustafa Sultan Company, listed as  KMS in the ledger, the government should have been paying prompt attention to the December 2003 arrest of the company operations manager for theft of U.S. military fuel, and the May 2004 formal notice that the company had to pay more than $500,000 in restitution. (View full report)   

It’s not at all clear why the U.S. commander, Lt. Gen. David McKiernan, felt he could just seek a token restitution and fail to refer the matter to the military  system of justice. If handled properly and the company dealt with then, almost surely it would not have shown up in the Cockerham ledger.  The failure to act was even more acute when it came to Future Services. Prompt action when its initials were discovered in the ledger in December 2006 would have cut it off from a scheme resulting in the theft of more than $40 million worth of U.S.fuel in Iraq, with two Future Services employees as "ringleaders." 

The two affidavits from the case repeatedly name Future Services.

If investigators and prosecutors had moved swiftly when they saw the initials of Future Services in the bribe ledger it would have saved millions of hard-earned tax dollars.   And if General McKiernan had acted properly regarding KMS the company would have been cut off from contracting. Let  hope their successor will be faster off the mark, and that the Obama Administration starts to match some of its campaign rhetoric with action.      

About the author:   An award-winning journalist, Pat McGuigan is a longtime contributor to Tulsa Today, and now serves as our contributing editor. He is also managing editor of a weekly newspaper in Oklahoma City.