J.C. Moore Online

Current events from a science perspective.

Integrity in Politics: It is the purpose of this site to apply observation and reason to current events. Good government depends upon our Legislators and our voters having up-to-date and accurate information. Senator Tom Coburn is considered to be the best informed of the Oklahoma Legislators. However, some things he presented at his town hall meeting, though they play well with his base, are not supported by research. We feel that Senator Coburn should thoroughly research the topics upon which he votes and speaks and that he should provide his constituency with accurate information.

Supreme Court: When asked about the recent court appointments, Senator Coburn disparaged the latest Supreme Court Justice, Sonia Sotomayor, by claiming she had lied, a very serious accusation to make against a Supreme Court Justice – especially when wrong. Coburn said that Sotomayor had reneged on a promise made during her confirmation hearing not to use foreign law to interpret the Constitution of the United State. He used as evidence the ruling of the Supreme Court on the case of Graham v Florida, in which a juvenile offender had been sentenced to life in prison for nonhomicidal crimes.

After reading the Supreme Court response which was actually presented by Justice J. Kennedy, not Justice S. Sotomayor, it appears that Senator Coburn was actually not being honest in his presentation of the information. As shown in the section of the Supreme Court brief below, the only reference to foreign anything is that the practice has been rejected the world over. This does not refer to any foreign laws but merely reflects on our standing in how humanly we treat juvenile offenders compared to the global community to which we belong and by whom we are scrutinized and in no way reflected that any foreign law was used to interpret the United States Constitution.

This misleading charge by  Senator Coburn raises a concern about any information he uses to support his views and whether he is just another typical politician trying to manipulate his constituents with “smoke and mirrors”.  Additional support for the Court’s conclusion lies in the fact that the sentencing practice at issue has been rejected the world over: The United States is the only Nation that imposes this type of sentence. While the judgments of other nations and the international community are not dispositive as to the meaning of the Eighth Amendment , the Court has looked abroad to support its independent conclusion that a particular punishment is cruel and unusual. (See, e.g., Roper, supra , at 575–578. Pp. 29–31, 982 So. 2d 43, reversed and remanded. )

Elena Kagan: Senator Coburn also said he could not support the appointment of Elena Kagan to the court because she considers the Constitution to be a living document. Senator Coburn believes that the Constitution should be interpreted as the Founding Fathers meant it. That, however,  has been as an excuse used by some politicians and judges to interpret the Constitution as they wish and claim it is what the Founding Fathers actually meant. The Founding Fathers were wise enough to give us a mechanism for amending the Constitution and there are now 27 Amendments. The Constitution is alive and better for it.

Recess Appointments: When asked about President Obama’s recess appointment of Dr. Berwick to head the Center for Medicare and Medicaid Services (CMS), Coburn emphatically declared that it was wrong and  illegal. Yikes! Coburn should polish up on his history of the much-used recess appointment. By this same point in his Presidential career, George W. Bush had used this technique to make 15 appointments and he used it 179 times during his career. Where were those Republicans then? The last group of appointments will bring Obama’s total to 18. It has been noted that Bush was not facing the same level of obstruction.Currently, Obama has 189 nominations pending before congress and 28 have been on the floor for more than three months. Bush only had six nominees that had been waiting that long. It might also be an interesting FYI to note that even George Washington used the practice to appoint the then controversial judge John Rutledge to the Supreme Court after he had failed to be confirmed by the Senate.

Reccess Appointments are a legal practice granted to the President of the United States by the Constitution of the United States in Article II, section 2.

Some have indicated that they feel this power should only be used when the position becomes vacant during a recess but this has been adjudicated by The Eleventh Circuit, in an en banc decision in Evans v. Stephens which held that the Constitution permitted both intrasession recess appointments and recess appointments to fill vacancies that existed prior to the congressional recess.( Evans v. Stephens, 387 F.3d 1220 (11th Cir. 2004). ) Since the position filled by Dr. Berwick has been vacant since 2006 it fulfills the courts requirements and is clearly legal.

Health Care: Senator Coburn said he  objected to the appointment of Dr. Don Berwick to head the CMS as Dr. Berwick  promotes medical rationing. Coburn’s basis for this premise uses “cherry-picking“, a technique which picks out a quotation and presents it out of context. A statement that Dr. Berwick made in 2008 in an interview with the respected publication, Biotechology Healthcare has been “cherry-picked” and this partial quote has been publicized many times by zealous Republican in order to create the specter of medical rationing. Here is the partial quote Senator Coburn refers to: “The decision is not whether or not we will ration care. The decision is whether we ration care with our eyes open.”  But, here is the actual quote in context, “We make these decisions all of the time. The decision is not whether or not we will ration care. The decision is whether we ration care with our eyes open. And right now, we are doing it blindly.”

Despite what Senator Coburn might claim, that statement isn’t particularly radical. Rationing currently occurs in our health-care system as resources are limited, and medicine and medical procedures are approved or disapproved by insurance companies regardless of whether that system is privately or publicly funded. “Blindly” as used by Dr. Berwick indicates we are currently doing it badly and not with an eye to the best practices to be used for the good of the patient; and not with an eye to which practices are unnecessary and therefore unnecessarily costly; and not with an eye to what medicines, tests and equipment are provided unnecessarily and sometimes even to the detriment of the patient.

“Ezra Klein, a blogger for the Washington Post, notes that Berwick’s statement is no different than a statement from Republican Rep. Paul Ryan of Wisconsin (seen as an up-and-coming leader within the GOP), who said with respect to health care, “Rationing happens today! The question is who will do it?” www.cbsnews.com/8301-504763_162-20009880-10391704.html.
Here is another more honest Republican’s statement on Berwick’s appointment. Tom Scully, who ran the CMS under President George W. Bush, noted, “You could nominate Gandhi to be head of CMS and that would be controversial right now.” http://www.newsweek.com/blogs/the-gaggle/2010/07/07/don-berwick-appointed-to-drive-health-care-changes-sidestepping-congress.html

With the use of the “cherry-picking” technique, some Republicans appear to be using medical rationing as a scare tactic to gain support in the up-coming elections without regard for what is actually good for the patient, I mean constituents. And to make matters even worse, Senator Coburn is a doctor. He also  said that other countries have national health care at lower cost because they ration health care. He says you and your family are responsible for paying for your own health care. Isn’t that just rationing health care by using money. If you, or your family can’t pay, would he just let you die?

By Guest Author: Barbara Moore

The proper role of government in health care has been the source of many recent arguments on health care reform.  A similar argument has been going on at the state level in Oklahoma. According to a recent Tulsa World article¹, “Workers comp proposal mulled “ , Oklahoma State Rep. Dan Sullivan wants to privatize CompSource Oklahoma because: “It’s a fundamental issue of what is the proper function of government . Is it to compete with private enterprise? We think not.”   According to Sullivan, the incentive behind the privatization is to lower workers’ compensation insurance rates as rates should fall because of increased competition.

 That rationalization seems weak. It would seem that providing workman’s comp to state workers is a proper function of  the state government.  CompSource Oklahoma  has been doing so for 76 years – apparently successfully. Many private businesses use CompSource. Why would they do so if private insurance companies can provide better service and lower rates?

 According to an expert in comp insurance ²: “ CompSourse  is an insurance carrier of last resort when all other insurance companies turn down a company for coverage.  If they privatize, the competing insurance companies cannot just dump the employers over to Compsource. I think there will be an overall price increase. Instead of having CompSource as a safety net, more companies will be put into the risk pool. The risk pool forces carriers to insure the higher risk employers.  This sounds good, except the downside is the rates are 40% -70% higher than the regular insurance market. “

 There you have it. If CompSource is privatized, it will cost the companies it now insures  and the State of Oklahoma more  to provide workman’s comp. That sounds like a bad idea. 

Privatization for ideological reasons often fails as a practical way to lower costs. Privatizing Social Security increased the cost to the government by 14% and created the infamous “donut hole“ that costs seniors an additional $25 billion annually. After the recent economic downturn, we should all be grateful that the plans to privatize Social Security failed.

Finally, Sullivan doesn’t know who would get the proceeds from the sale of CompSource. He says he plans to file a bill that its assets belong to the state in the hope that it will result in a lawsuit which will let the courts decide the matter. That seems like a stange plan from Sullivan, who promoted Tort Reform to end frivolous lawsuits.

(1)Tulsa World , August 7, 2009

(2) James Moore at J&L Risk Management