I just received a reply back from Senator Coburn from Oklahoma in response to an email I sent prior to the health care being voted on. He makes some good points, but you can still tell these people live in an entirely different world.

Dear XXXXX XXX,



Thank you for taking the time to contact me regarding your concerns with the recent health care reform legislation. I appreciate hearing from you and I welcome the opportunity to respond to your message. Also, I sincerely apologize for the delay in my response. Mail volume has increased dramatically in recent months; however, it was not my intention to keep you waiting.



As you probably know, on Sunday, March 21, 2010, the House of Representatives passed the Patient Protection and Affordable Care Act (HR 3590)-which the Senate previously passed on December 24, 2009-and a reconciliation package (HR 4872) designed to "fix" certain provisions of the Senate bill. HR 3590 became Public Law Number 111-148 on March 23, 2010. HR 4872 was cleared for the White House and President Obama signed it into law on March 30, 2010.



Like you, I had several serious concerns with this legislation. I believe using a government-centered model for health care will be disastrous for this country. Socialized systems stay afloat by rationing care, denying costly treatments, and letting people die before their time. If the United States cancer survivorship rates were as low as Great Britain's- a single-payer health system-one million more Americans could die from cancer each decade. That is unacceptable to me.



The problem with our health care system is not that we do not spend enough money. In fact, the U.S. already spends roughly twice as much money on health care, as a percentage of our GDP, as any other industrialized nation - yet we are not twice as healthy. Rather, the problem is that money in health care is allocated poorly. For example, each year there is approximately $100 billion in taxpayer dollars lost through waste, fraud, and abuse in the Medicare and Medicaid programs. If we were to eliminate waste, fraud, and abuse, we could easily pay to fix Medicare's broken physician reimbursement formula (the sustainable growth rate, or SGR) with existing Medicare dollars. However, the new legislation does not fix these existing problems in the health care industry.



Thousands of my constituents have contacted me with questions about the new health care legislation. If I may, I will take this opportunity to respond to some of the most common issues often raised.



First, the only health care plans the Federal Government may make available to members of Congress and congressional staff under the new law are mandated health plans that are offered through an exchange established under this bill. Unfortunately, we know from the Congressional Budget Office and various private sector estimates that this new law will increase premiums higher than the current status quo.



Second, I am deeply disappointed and gravely concerned that the new health law will use taxpayer dollars to fund abortion on demand. The new health law requires that the federal government create health insurance exchanges for those states that do not establish them. States that prohibit abortion coverage in their insurance exchanges will see their citizens' federal tax dollars used to subsidize insurance plans that cover elective abortions in other states.



As a physician, I share many of my fellow Oklahomans' disappointment that cost-containment measures put in place by federal bureaucrats would interfere with the unique and trusting relationships between patients and their physicians. Time and time again, I pointed out to my colleagues the fundamental problem consisting of the fact that when the government is in charge of health care, federal bureaucrats will restrict care based on costs instead of focusing on what is best for the patient. The payment schedule from Medicare amounts to governmental price fixing; there is almost a 300 percent payment disparity between primary care and specialists, which contributes to the shortage of primary care physicians.



Tragically, the single group who will pay the most for the recently passed health care bill is America's senior citizens, who will face about half a trillion dollars in dramatic cuts to the Medicare program. These cuts are being made to finance an expansion of Medicaid and a brand new entitlement that goes directly from the federal treasury to insurance companies to help people buy mandated health insurance. Changes to Medicare are necessary, but Medicare dollars should be used to preserve Medicare or reduce the deficit, not fund a new entitlement program.



Americans who are currently insured will pay higher indirect taxes on medical devices, pharmaceuticals, and their health insurance plans. The bill imposes a 40 percent excise tax on family health insurance plans that cost more than $27,500 a year. Further, the Congressional Budget Office (CBO) shows that premiums for Americans in the large group market will continue to rise $1,000 a year under the health care bill, no different than the estimate without reform.



Under the new health law, insurance carriers will not be able to vary premiums by age by more than 3 to 1 (i.e., charge older individuals no more than three times what younger, lower-risk applicants would pay). While this concept sounds appealing, it will push up prices for young people in order to cut premium rates for older Americans. Average premiums for individuals aged 18-24 are currently nearly one-quarter the average premiums paid by individuals aged 60-64. As a result, the very narrow age variations allowed under the new law will function as a significant transfer of wealth from younger to older Americans-and by raising premiums for young and healthy individuals, may discourage their purchase of insurance.



Another concern I have is for small business owners. Many small business owners who offer affordable health insurance today may not be able to afford government-approved health insurance in 2014 and will drop coverage and be forced to pay the mandate tax. For two years, small businesses could receive a complicated and temporary credit to cover 50 percent of the premium costs of their workers. This credit is no longer available after 2016, but some business owners would face the fine in perpetuity. CBO has said that costs associated with the employer mandate will be shifted to workers in the form of lower wages, fewer jobs, or more part-time jobs at the expense of full-time jobs.



Finally, I have major concerns regarding other policies advanced by President Obama's Administration. I know our President to be a good man personally, but I believe his policies are increasing every American's dependence on the government and moving this country toward socialism at an alarming pace. In fact, I believe President Obama has accomplished the most significant shift toward collectivism, and away from capitalism, in the history of our republic. The President is accurate in his assertions that we can drastically improve every aspect of our nation. I am convinced, however, that positive change can be accomplished only when the federal government gets out of the way and allows individual Americans the freedom to make those changes. I can assure you that I will continue to support and pray for President Obama as he carries out the enormous responsibility of leading our nation, but I will also continue to fight for the principles and truths for which I have always labored. I strive every day to actively support policies that adhere to our Constitution and that help all Americans; and I will continue to do so.



Thank you again for taking the time to contact me. Please feel free to write again if I may be of further assistance to you. Best wishes.



Sincerely, A

Tom A. Coburn, M.D.

United States Senator