put at risk, you're never going to go bruptd, you're not going to lose your job because you didn't have health insurance. and all of those policies cover screening and prevention outside of the deductible. so what we're doing is trying to accomplish it. i think his idea of the kitchenin sink, you can't believe the amount of time, 20 or 30 of us in the senate, both sides of the aisle, have spent listening to experts, listening to how they do it in other parts of the world, listening to new ideas. and we all the want to get the health care cheap fixed. the question is, it's really very important, is how we do it. and the one place write really disagree with president obama is we don't need to raise taxes on anybody to fix health care. we don't need another $2 trillion in the health care. what we need is better value for what we're getting today. host: in that theme the president calling for a pay-as-you-go rule in order to control spending.

guest: well, i want to be nice. the fact is, it's 15 times already this year and the last year we exempted pay-go rules. pay-go doesn't work. because anytime there's a tough cheap some members of congress, republicans and democrats alike, say, oh, let's -- time-out, let's make pay-go counted so that's why we've spent $3.6 trillion in the last nine months in this country. and every time we've said pay-go, we're going to have the war supplement, we're going say pay-go. we don't have to make choices. time-out, pay-good doesn't count. so every time there's a tough vote what do people do? override pay-go and say it doesn't count so pay-go doesn't work. what has to happen is there has to be members of congress that are willing to make tough choices based on what's the most important priority. and disappointingly, the congress refuses to do that. it's not going to do that until we change the members of congress. because members of congress are

more interested in their next election than they are the next generation. and they don't want to do anything that is a hard choice that causes them the political difficulty. host: our guest is senator tom coburn with us about another half-hour. pentagon city, virginia. john on our republican line. caller: good morning, senator. guest: good morning. caller: a colonel in the air force. you mentioned a lot of lessons learned and things you've looked at. following desert storm we realized we had some very serious problems in 100% government participation cradle-to-grave system that is military medicine. we implemented a number of reforms including what we thought were small things like outsourcing a bid for family care and then adding small copays, as much as $5, and found that the lines for service decreased by as much as 80% when people had to simply make the choice to pay a little bit. you mentioned safeway. i believe that reform was driven largely by a grocery worker's

strike years ago that paralyzed the industry out there because of a proposed change in health care benefits that add a co--pay feature. and the unions rebelled against it because of a simple copay. in the end that's proven to be a big feature that's worked. my question, sir, is what have you done to look at what's going on with the military model, a model that has succeeded in the sense that our readiness to support these wars over a sustained period of time was achieved and for reforms that were started? about 18 years ago. thanks. guest: well, we have looked at it. there's a lot of criticism of the military health care, especially for the families in terms of availability. it's essentially quasi h.m.o. system that limits access in certain areas. the question i would have for you is, why shouldn't we allow our military to have the same thing everybody else has? as a provider in oklahoma which

has minimum military people but has a lot of military families who reside there, who have family members serving, they market lid decreased the access -- marketedly decreased the access under the military. my clinic wasn't and available to treat patient we wanted to treat for years because they wanted to control it. the point is, we can do a lot of things to incentivize better behavior both in terms of prevention and wellness but also incentivize economic choice. the military has given us some. but i think the military is far from where -- what i would like to have for our military. i would like for military families to be able to go wherever they want and choose the provider that they want and nobody say here's the list. and i agree that there ought to be some economic skin in the game for every decision you make in health care as far as purchasing. but at the same time there ought

to be transparency in terms of quality and price. we don't have price transparency and we don't have quality transparency. fact is, the doctors know who the bad doctors are but everybody else disnltd. why should that be? why should you not be able to have transparency in terms of being able to judge the quality of the provider that's giving you some very significant care for you and your family. host: we have an e-mailer who asked about hospitals saying how your play would impact hospitals. they say i would like to know how the republican mantra of everybody has access is any different? if people cannot afford to see a primary care physician for routine care, how can they afford an e.r. bill of thousands? guest: everybody under our plan would see the physician of their white house, number one. number two, we save $200 billion a year in cost shifting. we will make under this plan, the e.r.'s would become ghost rooms. they'll be back to just truly for emergencies and not the

primary care. so i would dispute the fact that we actually -- if you go to our website and look at the patients choice act, you'll find in that act access for everybody that doesn't have insurance today at a primary care. part of our cheap is if we get all 46 million enrolled, we don't have the primary care doctors to care for them. because we have incentivized through medicare and medicaid doctors to not go into primary care. less than one in 50 doctors who graduated last year from medical school went into primary care. why was that? it's because we pay them less than we pay an accountant. and yet they have five to seven years more education than an accountant has. and yet we pay them less. and the government has directed that through the medicare payment model and the medicaid payment model on how much you'll reimburse primary care. so we have this big shift away

from primary care. we need to incentivize prevention. pay doctors for prevengsz, pay primary care so we get more doctor going back into primary care. host: connecticut for senator tom coburn on our independent line. guest: good morning. caller: yes, good morning. thanks for taking my call. i just wanted to make a comment. i've been unemployed now, been over a year, and went through, you know, all of my employer's $700-plus cobra plan for medical which has been exhausted now. i have been collecting unemployment with please i can't. i do not -- want to seem ungrateful but i have been informed that i am receiving too much money collecting in order to receive medical from the

state, medicaid plan. because i do have medical conditions that, you know, that i'm desperately in need of medical attention. i don't even know where to turn. you know, it's either collect and pay most of my bills, you know, just general housing, utilities, and put food on the table or maybe cut that in half and get the medicaid plan until i find a job. then i wouldn't be able to pay all the other utilities. necessities, yeah. so, you know. it's unbelievable to think that that's making too much money, but that's where the cutoff is. host: we'll leave it there. thanks.

guest: under our bill if it were to become law, she would have $5,700 that would be in the supplement, in addition to what she has today that could be apply for a plan whether she contracted with a doctor for a year for all of her care, for x amount, or she bought a $3,000 deductible plan for $2,700 and have that other to her expenses for health care in between there. that's what would be available to her. even though she wasn't available for the medicaid program in connecticut. so the point is we don't leave anybody out. it doesn't mean you get everything for free and it's zero -- you know, first dollar coverage. it means that there is a way to help people to make sure that they're not going to go broke that they are still going to have access. there is a means to do that that's fair to every american, that we treat every american family the same.

host: there will be a hearing july 13. what does that mean? guest: it means a lot of hard work. i wish they would have delayed it. we have a commitment to get that nomination through before justice souter retires. there's 4,000 cases. and for me to do a good job and to make an appropriate -- i've got stay. i'm spending an hour a day on it right now. i'm sorry that we've got the conflict over time. actually, i heard the debate on the floor last night. it sound like a bunch of children argue between the republicans and democrats on it. fact is, it's not about time, it's about making a really good, informed decision. as long as we commit to get the vote done and time have justice take place of the retiring justice, that should be good enough. i may be ready by july 13, but

it's going to be a difficult time because i have to set aside everything else, including health care to be able to prepare. that's the other thing. if we're going to do it july 13-rbgs we're going to be right in the middle of the health care debate which is going make it very, very difficult for several of us. there are four members of the judiciary committee on our side that are on finance. and there are two that are on the health committee. so it makes it. so that's six out of seven are going to be involved in a health care debate on the floor at the same time we're supposed to be attending a supreme court hearing. first of all, i think it's unfortunate that we're seeing this. the american people are sick of seeing this. the important thing for us is to make a good, informed choice and to do good home work so that we can ask the appropriate questions of judge sotomayor. host: one of the other agreements is that with john roberts it took 73 day?

guest: to me it doesn't matter. i don't care how long we took on anybody. i was at those hearings. the fact is let's do it the right way and let's get it done by the time it's needed. but it's childish. what i hear going on back and forth is childish. let's just do what we have to do and get it done. quit fighting like a bunch of little kids. host: the former first lady weighed in on this discussion a couple of day ago on "good morning america." here's what she had to say. >> a lot of people were pleased with president obama in that all of his nominees that he was considering for the supreme court were women, all of his top candidates were women. and with sonya sotomayor, people are very excited. of course, the hispanic community. what were your thoughts? >> i think she sounds like a very interesting and good nominee. as a woman, i'm proud that there might be another woman on the courts. so we'll see what happens.

but i wish her well. host: first thought? guest: i agree with her i think we need more women on the courts. we need the balance. women are different than men in terms of how they look at things. i think that's a great perspective that we need to have. i think it's great that we have a hispanic nominated as well. i think that adds to the credibility of our court. you know, one of the things i've been worried about recently in our country, and the thing that really holds us together -- we can say all of these things. the thing that holds us together is that people have a confidence that would truly do have a fair and equitable justice system, and that you can trust having an appropriate hearing before the courts. in other words, the rule of law means something. and one of the things that concerns me is as we've done a lot of things even towards the end of the bush administration is that we're undermining that.

if we undermine the confidence and the rule of law in this country, we have lost our country. and so i think the fact that she's hispanic, she's a woman, i think that lends tremendous credibility to the supreme court. and the question comes does she meet the test to have a lifetime appointment for that position? host: from your reading an hour a day or so of her cases does that raise any questions? guest: i don't want to get there because i might communicate to her what i might ask. we want -- nobody can come and look at a case without having some of themselves come and look at it. the question on a good judge, i think is, can you separate your emotion and your feelings from what you are required to do a judge? which is, you're required to look at the facts of the case,

law, and previous decisions and to make an unbiased and unemotional decision based on that. that's how we build and continue confidence in the rule of law. and so that's the real question. are there case where's we've seen? you know, 4,000 cases is a lot of cases to read. that's the question that has to be answered. that's what i'll try to get to as i read and study and learn more about her. host: brooksville, florida. walter on our democrats line. thanks for waiting. go ahead. caller: good morning, representative. guest: good morning. caller: my opinion real quick is, as long as we have the lobbyists up there that can help so much of power with you representatives, you're not going to straighten this health care out. what you need to do is all your lobbyist people be discontinued in washington and you representatives get together and

come up with the health care plan that represents the united states. guest: that's a good input. i have a different viewpoint. if a lobbyist can influence me to a decision that's other than what i've taken for an oath, what's in the best long-term interest of this country, i shouldn't be here. i don't defend lobbyists. and don't do earmarks. and i don't do things for lobbyists. but the cheap is not lobbyists. the problem is members of congress. because, in fact, if you can be influenced, if you can be pushed, if can you have an implied tit for tat, what happens is, the best things don't happen. so it's really about integrity and the character of the members of congress rather than the lobbyists. the way the federal government interacts, and so many areas in

our country, people, whether it be teachers, unions, or whatever, everybody has to have an input through a representative to that. so i think the bigger cheap is the character and integrity of the members of congress than it is the lobbyists. host: florida, good morning. our republican line. caller: thank you. it's a real pleasure to talk to you, senator coburn. i called c-span, trying to get in three, four times a year, talking about the tax code and how it asktsz our country. and will rogers in the 1930's made a speech that said our tax code in the states will turn our nation into a nation of liar and cheats. and a nation of liars and cheats ultimately we can't stand. a couple of months ago i called in and got senator conrad. mentioned this to him. he was talking. i didn't get the chance to finish about w him, but he said, well, i'm supporting the fair tax which you're familiar with. and i said to him, you know --

and now he's talking about a vat tax and all of this stuff. actually, everything, health care, all of this stuff, will never, ever get taken care of until we change the tax code. now the reason i mention that is this. they talk about lobbyists. and a lot of americans don't understand that a lobbyist gets paid hundreds of thousands of dollars on k street. the corporation that pay them, then write that off against their tax liability which ends up with us having these little things put in the tax code that really affects us. we don't even know it. guest: i agree. i am a big advocate of the flat tax. in terms of what it will do for news exports in terms of how it will normalize our taxes. the more you consume, the more you will pay. i think, look, we have a tax code that nobody knows, even the i.r.s. doesn't know. they don't even give the same answer fuzz ask the same

question -- if you ask the same question to two different field offices. think that does have some impact on lobbying. if, in fact, you couldn't deduct the cost of a lobbyist, there probably would be fewer lobbyists, especially at lower prices. so i think you make some good points. host: beverly hills, california. you're next. kim on our independent line. guest: good morning. caller: hi. good morning. guest: you're up awfully early. caller: yes, i am. but i love c-span. and there's a statement i wanted to make then i have a couple of questions for senator coburn. thank you, sir. the statement i wanted to make was, you know, yesterday you had senator sanders on. and he spoke eloquently and passionately about this same subject. it would be really good for the american people if could you have someone such as senator coburn on who's taking a slight index position, well drastically, than senator sanders. it would be good if you could have them on together so you could hear the contrast and the answers. but one of the things i wanted

to say so senator coburn as well is that i do disagree with you passionately about the influence of lobbyists. i have no cheap with lobbyists. but the insurance industry is lobbying very strongly, and they are powerful in washington. and we all know that. and, yes, you're right, representatives of government should not be influenced. but let's look at it. it's the real world. my two questions are this. this health care cheap has to be handled. a friend of mine, she's a registered nurse, she worked for an insurance company, and she was aadjudicating some of these cases as a private insurance company. she had to leave that company because she thought she was going to there make good decisions about health care and what to provide for people, what procedures to approve. and when she left there, so stressed, she realized her mission was just how to -- guest: deny care.

yeah. caller: how much money have you received from insurance companies for your re-election? guest: that's a good question. i just announced that i was running for re-election. i haven't raised any money to speak of. and insurance companies typically didn't support me last time and probably won't this time. caller: the other thing i wanted to say though is that you talk about the government. people don't want their health care in the hands of people in government making those decisions. that's a place where you work, sir. and i think that whenever this conversation comes up, the government all of a sudden is this big, bad elephant in the room. however, why would i want to keep my health care and those decisions in the hands of bureaucrats in private industry who have shareholders? host: we'll leave it there. thank you. guest: that's a good point. that's a fair point. the fact is what my hope would be, is that eventually we would all make our own determineion

rather than where we worked. and that we would all have the ability, one, of the resources to the access to where we can decide what we want and how we want it. a great example when medical savings accounts first came out and then they got converted to health savings accounts, my employees gotten rolled in that. i was in congress and still practicing medicine. they've done really well on that in terms of what they've been able to say and what they've been covered. the fact is they're covered at a level today that they never would have been covered before, plus they had a lot of money in the bank. so the point is, you ought to be able to -- she makes a great point. can i trust my employer more than i can trust the government? here's the thing. you have an option with your employer. can you not take it under our bill. can you do what you want. when the government-run, you're not going have real options.

that's the difference. a bureaucrat will decide. and a bureaucrat, you're never going to able to talk to. they don't have a personal person are personnel where can you go in and say what's gong my health care. you're going have to work through the bur beaurocracy whis atrocious. the other point is, i work hard to try to make the government smaller not bigger. in terms of getting rid of waste and duplication. and i'm not real happy that we find ourselves where we are today. host: "usa today" took a poll asking who speaks for the g.o.p. the results are on the front page this morning. 13% of those responded said rush limbaugh, 10% dick cheney, 6% equally divided between john mccain and newt gingrich. 1% for michael steele what dot results say about your party? guest: it says that they lack one effective coherent leader. that's what it says.

number two is it shows you the power of the press in terms of labeling people. you know, newt gingrich is a great idea man. had a lot of problems with him in the house as far as leadership but one of the smartest people there are in the country. rush limbaugh does not speak for the republican party. he speaks for a conservative thought. i don't listen to rush limbaugh. but he has a viewpoint that a lot of americans follow. dick cheney is probably up there now because of what he's been saying about the war on terror and defending past administration's actions. so i think you can manipulate that all you want. to get kind of the outcome based on what's been in the news cycle. the fact is there's a lot of people who really love this country, who believe the government can be a lot better, a lot more efficient that we really ought to pay attention to

the constitution and what the powers said which gives the very list of what the federal government is supposed to be doing. and also believe in the 10th amendment that says whatever isn't in this list is supposed to be for the states or the people. that's a legitimate position. the question is, has it been managed well? and has it been articulated? the fact is, we have a government that's way too big. we can't afford it. we're going to run a $2 trillion deficit this year. we had the president come out this week and say we have to speed it up. it's not going to do what it wants. very little of it, less than a third of it, is true stimulus. there is a legitimacy to the position that says the citizens ought to be holding the government accountable rather than the government holding the citizenry accountable. and we find our selves in a fix today -- ourselves in a fix

today where we're off the mark in washington about what people are concerned about we have $11.6 trillion worth of debt. a child born today comes into the world owing $400,000 for things they're never going to get a benefit from but their parents got in terms of their medicare, social security and health care. and the enly way to really solve the pron and think long-term to help our children and our grandchildren is to fix health care where we disoabt charge more money to our -- don't charge more money to our kids. we need to be reversion out the $38 trillion of medicare that we're stealing from our kids for our health care today. i ask grandparents all the time, do you really want your health care stealing the education of your grandchildren? we're going to get down to those choices. people don't want to vocalize those right now but real choice is as we take future benefits away from our kids, they're real benefits. whether they have a high school education, whether or not they can afford to own a home because we have this massive debt. we're spending money faster --

we've sment $3,796,000,000,000,000 already this year and -- spent $3.6 trillion already this year. you're seeing in the financial news today where russians will move out reserve china. they don't have the confidence we're going to make the tough decisions, choices on priority, get rid of the things that aren't working and make sure we have the money for things that are. host: palm beach, florida. democrats line. caller: yes. thank you for taking this call. my question deals with the federal health care benefit program which is probably one of the best-run federal health care programs in america, as far as i'm ceshed. one of the reasons is hospitals are adecreehospitals -- hospitae accredited. insurance companies to federal employees must be under an accredited plan. also, i'd like to know what you think of the state insurance departments which control the rates in every state. and should there be a limit on

administrative costs and health care delivery systems say of 8%? can you answer that? guest: that 8% comes from a claim that medicare and med why ok'd -- medicaid have such low administrative costs. but in fact, when you look at the fraud rate about 20% therk don't have a low rate. the fraud rate in the private health insurance market is about 1. 5 -- 1.5%. i personally believe that if you truly have competition -- we don't. and i would agree, we don't have competition in health care today. but i truly believe if you allow individuals the power of purchasing and you have a transparent market what you're going to have is you're going to see that 19% go down to 8% or 7% because they're going have to compete. what we have in our bill is we allow what's called risk readjustment which means every insurance company selling into a state or a region, states can combine if they want to increase their purchasing power -- if

you're cherry picking patients where you're only taking healthy ones and somebody else is taking care of the sick ones, we actually readjust rates so that you transfer some of your revenue to the insurance company that was doing it. so all of a sudden now it's not a insurance industry about picking health -- picking healthy people. i think you'll see all of that come down. i would not be ultimately -- if that did not work, it would not ultimately be opposed to put something statutory maximum on it. i think once we start mandating the market, then we're going to move. we're going to lose some innovation. we're going to lose some efficiency. host: senator tom coburn, republican of oklahoma. thanks for spending time with us today. guest: glad to do it. host: we will hear from governor howard dean in a few minutes. but first, an update from c-span radio. >> it's 8:59 a.m. eastern time. the obama administration is dropping its plan to cap