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Children's Health Insurance Program Reauthorization Act of 2007

Floor Speech

Location: Washington, DC



Mr. COBURN. Mr. President, I thank the leaders of this bill for the time to speak.

I am kind of flabbergasted at the last talk. I am one of the physicians in this country who has cared for kids on Medicaid. I have actually delivered over 2,000 babies on Medicaid. I have actually done well-child exams.

We have the Senate lecturing the President, and we should be lecturing ourselves. The debate on this bill is not about children. There is not anybody in the Senate who does not want to cover and continue the present SCHIP.

What this debate is about is how do we move toward national health care. That is what this debate is. So immoral? Is it immoral to spend $3,000 to buy $1,500 worth of care, like we are going to do in this bill? Is it immoral for the Senate to say it only costs $35 billion and then totally take a program that is costing $12 billion a year 5 years from now and cut it down to $700 million and say we met the budget rules, when in fact we did not? That is immoral. What about the children who are going to pay for the deficit associated with this bill?

I have actually cared for these kids. My practice has been a Medicaid-based practice and a SCHIP-based practice. The holier-than-thou attitude that if you oppose this bill, you do not care about children is completely disrespectful to those of us who happen to disagree, who maybe think a better way to cover children would be the Burr-Corker bill, which gives a tax credit to every kid in this country that covers enough to give them insurance and takes that Medicaid stamp off their head, since only 40 percent of the doctors in this country will cover SCHIP kids and Medicaid kids.

So the debate is not about the President being immoral. It is not about tax cuts. The real immoral fact of this bill is we are winking and nodding again to the American people that we are going to spend $121 billion over the next 10 years--not $60 billion over the next 5 years--$121 billion, and we have no way to pay for that. We had a $444 billion deficit last year. We could have paid for the war and decreased the deficit if this body would have had the courage to eliminate duplicative and fraudulent programs. There is no holier-than-thou attitude to go after those programs because they have an interest. As politicians, we do not want to upset anybody.

So it is easy--the greatest pleasure in the world is to spend somebody else's money and to claim it is in the name of children. I have been on the ground with children. I have taken care of the poorest of the poor. We have a pregnancy component in this bill. Title 19 now is at 300 percent of the poverty level in this country. We have people dropping their insurance to qualify for title 19. We do not need pregnancy covered in the SCHIP bill. It is already covered. But we claim that to rationalize to make the bill better.

I have no disrespect for people in this body who claim they want national health care, government-run national health care. Well, American public--guess what--if you think health care is expensive now, wait till it is free. Wait till it is free. That is exactly what we are doing with this bill.

We can reauthorize SCHIP, and we can make it higher than a $5 billion increase to truly cover those kids who need it. This body rejected an insurance contribution component amendment I offered that would actually expand further the number of kids.

The other point that is not being made is, for every kid you cover who does not have health insurance today, you are going to drop another kid from health insurance that is being paid for by their parents, and they are getting no benefit in terms of a reduction of their health insurance. So what we are doing is shifting taxes to those same parents to pay for a program, twice as much money for the benefit we will get for the kids.

I am not against well-child exams. I am not against immunizations. I give them out of my pocket of my own practice now for free. They cost me an average of $146 a kid.

The claim of superiority that somehow if you do not want to have this bill you do not care for children is gobbledygook. What about the kids in the future who are going to pay for the mistakes we are making? What about the kids who are born today who owe $400,000 on our unfunded liabilities? We have done that. If we care so much about kids, why aren't we fixing that problem? They are never going to get a college education or own a home, and they are never going to have health coverage because we will have bankrupt this country by the way we do not control how we spend money.

So to be lectured and lecturing the President because, finally, he is exhibiting some fiscal responsibility into the future, and us to play games on the true cost of this program, that is what is immoral. It is not the President being immoral. The fact is it is not our money, it is the money of the people of this country, and we are going to decide we are going to spend money and not tell them what it is really going to cost because that is what this bill does in the outyears, the 6th through the 11th year of this bill if we cut this program to $700 million a year.

Now, nobody in their right mind will honestly say we are going to let that happen. So if we are not going to let that happen, how about being honest with the American people about the true cost of what we are doing? It is $121 billion. It is not $60 billion. Even the staff admits that. Both the Democratic and Republican staff admit that.

For us to sit up here and claim it is only a $35 billion increase--well, only a $35 billion increase is a 120-percent increase in the program, just a 120-percent increase in the program.

We ought to have a debate about national health care and how we solve the problems of health care in this country. There is a way to solve it. It is to make sure everybody in this country has access and give them the freedom and the power to choose what is best for them rather than us tell them what they have to have. That is the debate we ought to have.

This is a farce. This debate is a farce. It is a farce about saying we want to cover more children, when we are really taking children who are already covered and putting them under a government program and then charging those children's kids for the cost of the program. That is what we are doing. It is not about caring for kids. It is about lying to the American public about what this program does.

So I do not have any hard feelings about the fact that people want to have national health care and a government-run program, but let's have the debate about what it really is and not have a debate demeaning the President when he finally stands up and says we have an obligation, for the next few generations, to start doing it right, and finally he is starting to do it right. And now we are saying he is immoral. Of the 10 million kids, 5 million already have coverage. We are going to ask the American taxpayer--in spite of what we are doing, in spite of the fact we borrowed $434 billion--we are going to load that on them.

They already have coverage. They already have immunization. They already have well-child care, and we are going to add that cost to the American taxpayer. Do you know who that taxpayer is? That is that child's child because we are not going to pay for it. We are going to refuse to be responsible. We played the game of pay-go on this, the great pay-go rule, where we now bastardize our own ethics to say we paid for something, knowing we did not. Because nobody in this body believes this is going to go to $700 million 5 years from now. Nobody believes that. Everybody knows that. So everybody knows we are telling an untruth to the American people about the true cost of this program.

I care a ton about my patients. But I also care enough about this country to be able to speak the truth about what we are doing. And what we are doing is absolutely untruthful in how we characterize the spending on this program. You can debate that. I will debate that all day with anybody up here. This body knows I know our numbers, and the numbers on this bill are untruthful.

So what we ought to say is, we think we ought to expand the SCHIP program, and it costs $121 billion. Let's have a debate about what it really costs. That is why the President says we should not do it. And we should not go to 300 percent, and we should not have adults on a program where in many States it consumes 75 percent of the dollars.

I will readily grant you, we have a big problem with health care in this country. One of the major reasons we have a big problem with health care in this country is government-run health care programs that drive the cost and the overutilization in many areas where we cannot function properly.

What is happening today in our country with quality of care is because we have so much government run. We have physicians trying to see too many patients. The one thing we are taught in medical school is, if you will listen to your patients, they will tell you what is wrong. Right now, 8 percent of the cost of health care in this country is associated with tests we order that no patient needs. It is because this body will not look at the malpractice situation we have in this country and the liability situation and fix it to where it truly represents a system where people who are injured are taken care of. What we have is a system that games it. So consequently we are all paying 8 percent more for health care because providers have to order tests to cover their backside.

The other thing we know is another 3 percent of the cost of health care is associated with tests that doctors are ordering because they are not listening well--$50 billion worth of tests that people do not need because we will not take the time to listen to them.

I will summarize and finish my point with this: Washington has an 11-percent approval rating for a very good reason. Because we do not deserve to be trusted, because we do exactly what we are doing on this bill. We are lying to the American people about what it costs, who it will cover, and how it will be delivered.

Now, some other details of the bill are debatable, but those facts are not debatable, and the American people, hopefully soon, are going to wake up to the dishonesty and the farce that we perpetrate on them as we debate those issues.

Let's have a debate about national health care. Let's really debate it. Let's look at the options. Our bill, in several other places--the Burr-Corker bill, the Universal Health Care Choice and Access Act--gives everybody in this country an equal tax credit. Everybody gets treated the same. You want to punish the millionaires? Take away some of their tremendous excess tax benefits from health care. But we would not do that. We do not have one person who will come forward and say: Let's equalize the Tax Code on the other side. Let's equalize the Tax Code so everybody has the same shot. Let's let a market help us access that. Let's make sure it is 100 percent access. If you do not have access, you cannot have care.

This bill is not going to provide that much access. Fifty percent of what it does has to do with people who already have access. Those are not my numbers. Those are Congressional Budget Office numbers.

So let's be honest about what we are doing. Let's talk about health care. If we want to go to national health care, if we have the votes to do it, then let's do it. But let's do not, under the guise of helping children, expand national health care.

This Senator will vote to reauthorize a higher level of funding for SCHIP to cover kids who are truly poor--those who don't have access. I will help anytime, any way to do that. That has been my practice. That has been my heritage. That has been my history in caring for poor folks in Oklahoma. But I am not about to go along with a lie, that what we are doing is something different than what we say we are doing.

With that, I yield the floor.


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