The past week’s debate about health care has shown that in Washington the only things more stubborn than facts are politicians who evade them. In spite of a torrent of independent analyses showing that the so-called health-care “reform” bills moving through Congress will dramatically increase the deficit and cause millions of Americans to lose their health insurance, the politicians leading the effort have steadfastly refused to consider that their ideas and policies, rather than the character of their critics, may be flawed. At the same time, the politicians writing the bill still refuse to answer basic questions about how it will be paid for and how it will affect patients.

The American people have good reason to be concerned. The fact is that President Obama and the vast majority of members who support the reform bills would set up a single-payer health-care system if they could start from scratch. In the meantime, according to their own explanations, they will settle for creating a public, government-run option in the context of our current employer-based health-insurance system. The American people know this because the president and many other Democrats have made this argument many times publicly.

Yet, what matters more than their past statements or current rhetoric is the likely effect of their legislation. According to independent sources, the health-care bills under consideration will dramatically increase the deficit, take away patient choice, and set the stage for a total government takeover of health care — the single-payer model many Democrats have long dreamed of. As the head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, recently said, the bills moving through Congress did not contain “the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health-care costs.” Meanwhile, the independent Lewin Group estimates that 114 million Americans will be forced to give up their current health-care plans as the government-run plan puts everyone else out of business.

Congressional leaders and partisan operatives have responded to these policy indictments by inventing a bizarre conspiracy theory that involves right-wing extremists, the CBO, moderate Democrats, and insurance companies — all of whom are somehow dreaming up “scare tactics” while plotting to disrupt town-hall meetings. This line of attack is troubling because it goes far beyond traditional partisanship and instead indicts millions of hardworking taxpayers who have honest concerns.

For instance, according to a new DNC ad, individual Americans who oppose a government takeover of health care are not acting out of good faith, sound reasoning, and independent judgment, but rather are part of an “angry mob” that lacks the intelligence to think critically and independently. The condescension underlying this claim is breathtaking, particularly when the entire strategy of public-option proponents depends on misdirection and subterfuge. Public-option advocates want the American people to believe — in spite of their past statements — that they aren’t trying to lay the groundwork for a total government takeover of health care, but instead are trying to create new choices. Fortunately, the American people aren’t buying it, and public-option proponents are now attacking the skeptics.

The backers of the public option are concerned because they know that their greatest obstacle is not the small minority of Republicans in Congress but the millions of Americans who will make members of their own party think twice about enacting a government takeover of health care. The budget-reconciliation fallback option — a way to potentially steamroll reform through Congress this fall — is an important clue to their intent. This option wasn’t established because of the Republican minority, which lacks the votes to mount a sustained defense, but because of the likely dissent of moderate Democrats. Public-option advocates know that many Democrats aren’t eager to sacrifice themselves on the altar of single-payer health care.

Individual Americans should view the month of August as their best, and perhaps final, opportunity to alter the health-care bills before Congress reconvenes in September. Citizens should ask hard questions without having their motives questioned. I expect such questions at my town-hall meetings. After all, the greater threat to freedom and liberty is not an informed citizenry but an irresponsible, elitist, and evasive political class that refuses to answer hard questions and make tough choices.


While I have confidence in the American people to come up with their own probing questions, let me suggest a few questions that my own colleagues have been loath to answer:

1. Why do we need to increase spending on health care by at least $1.6 trillion and steal prosperity from our children and grandchildren when we spend nearly twice per person what other industrialized nations spend on health care?

In my view, any bill that increases spending is a failure and not serious reform. The problem is not that we don’t spend enough on health care, but that we don’t allocate resources efficiently and get value for what we pay.

2. What programs will you cut and whose taxes will you raise to pay for health-care reform?

Any politician — Republican or Democrat — who refuses to answer this question or avoids the topic by deferring to the committees of jurisdiction doesn’t deserve to be in office.

3. What earmarks or pet projects that you have sponsored will you sacrifice to help finance the cost of health-care reform?

It is immoral, in my view, to ask taxpayers to make more sacrifices while politicians practice business-as-usual pork-barrel politics.

4. Will you vote for a public option that requires taxpayer-funded abortion?

The current version of the so-called reform bill requires taxpayer-funded abortion. In the House, this fact prompted 19 pro-life Democrats to send a letter of protest to Speaker Pelosi. In the Senate, an amendment by Barbara Mikulski (D., Md.) that would require taxpayer-funded abortion passed in committee. Sen. Bob Casey (D., Pa.) objected and voted no, saying, “The way it [the Mikulski amendment] is written could be interpreted down the road to include something like abortion.” Are these Democrats also part of the right-wing scare-tactic conspiracy?

5. If the public option is so wonderful, will you lead by example and vote for a plan to enroll you and your family in the public option?

I offered an amendment in committee to force members of Congress to enroll in the public option. Nine out of eleven Democrats on the health committee who back the public option refused. If the politicians creating the public option don’t have confidence in it, neither should the American people.

6. Will you vote for a plan that will allow a board of politicians and bureaucrats to override decisions made by you and your doctor?

Both the Senate and House bills set up a government-run “comparative effectiveness” board that will make final decisions about treatment and care. In committee, I gave senators several opportunities to accept language that would forbid this board from denying care. All of my amendments were rejected, which suggests that the intent is to set up a board that will ration care, as is done in the United Kingdom.

7. If you support a “comparative effectiveness” board, what qualifies you, as a politician, to practice medicine? Have you delivered health care to a single person, much less entire classes of people you claim to represent, such as the poor, the uninsured, or children?

I’m one of two physicians in the Senate, along with John Barrasso of Wyoming. I know for a fact that very few leaders in this debate have any firsthand experience or knowledge of health care, which is disturbing.

8. How will a government-run public option perform better than other failing government programs, such as Medicare, Medicaid, and Indian Health Care?

Forty percent of doctors refuse to accept Medicaid patients because the program is broken. Access to a government program — such as the public option — does not guarantee access to health care.

9. If increasing spending on health care was the solution, why hasn’t it worked yet?

The public-option “reform” is not new at all but an extension of 1960s-era public policies that say a little more government spending and intervention is always the answer.

10. Are you more committed to doing reform right or quickly? Would you consider backing a thoughtful alternative to the public option? If so, which one?

I’ve introduced a bill along with Sen. Richard Burr (R., N.C.) and Reps. Paul Ryan (R., Wisc.) and Devin Nunes (R., Calif.) called the Patient’s Choice Act that guarantees coverage and choice for every American without raising taxes or increasing spending. In fact, our bill will save taxpayers at least $70 billion. Many other members of Congress, both Republicans and Democrats, are working on alternatives that don’t herd the American people into a government-run program.

The choice is not between the public option and nothing. The choice is between the public option and an option that can win the support of the public. The future of health care truly is up to you.

— Dr. Tom Coburn (R.) is a United States senator from Oklahoma.