Disaster Assistance

July 19, 2007: Public Conference on 9-11 Bill

The House and Senate conferees met in the first (and probably last) public conference to iron out some of the differences between the House (H.R. 1, “Implementing the 9/11 Commission Recommendations Act of 2007”) and Senate (S. 4, the "Improving America’s Security Act of 2007") versions of the bill. Only two amendments were brought forward in an attempt to settle unresolved issues:

100% Cargo screening: an amendment was put forward by Congressman Bennie Thompson, Chairman of the Homeland Security Committee. The amendment passed on party line votes in both chambers and will therefore be included in underlying language. Dr. Coburn voted against this amendment.

Transportation security jurisdiction: an amendment was put forward by Congressman Oberstar, Chairman of the House Transportation and Infrastructure Committee to change jurisdictional authority over the transit, rail, and bus grant distribution to have Department of Transportation actually cut the checks to grantees, even though the Department of Homeland Security would award and manage the grants. This language passed on the vote of the House conferees, but failed 5-9 on the Senate side. As a result, the impasse continues and further negotiations will either have to resolve this issue or drop the program from the conference bill. Dr. Coburn voted against this amendment.

July 2007: Dr. Coburn continues to press for needed accountability for Homeland Security preparedness grant programs.

S. 4, the Improving America’s Security Act of 2007, authorizes over $3 billion a year for the next three years (and such sums as determined necessary each year thereafter) in homeland security disaster preparedness and interoperability grants.

S.4 contains comprehensive auditing provisions authored by Sen. Coburn during the Senate committee mark-up process in response to an onslaught of scandals, inspector general and Governmental Accountability Office (GAO) findings and press reports about financial improprieties using preparedness and disaster grant funds, including funding going to yoga classes, puppet shows, credit card fraud, football tickets, divorce lawyers, sex change operations, and more. Dr. Coburn’s audit requirements in S.4 extend to preparedness grant programs, not public assistance administered under the Stafford Act. Dr. Coburn is working to keep the audit language in the bill as it moves through the conference process. Click on the following link to read why "Accountability in DHS Preparedness Grants Needed Now."

February 15, 2007: Dr. Coburn pushes Senate panel for greater transparency, better financial controls and minimum performance standards for homeland security programs. Click here for details on the votes and the Coburn amendments at the 2/15/07 Homeland Security Governmental Affairs Senate Committee Business Meeting considering the "9/11 Commission" bill.

Global Aid Watch

Each year, the U.S. taxpayer gives tens of billions of dollars to foreign operations and global aid. Unfortunately, a number of the programs and organizations that are given this funding receive little or no oversight, and when combined with fraud and corruption, this results in staggering waste of the taxpayer investment and limits the ability to assist vulnerable populations around the world.

Recent Developments in Global AIDS:

• Preserving the Winning Formula on Global AIDS: PEPFAR legislation
• In 2003, President Bush announced the 5-year plan, PEPFAR to combat AIDS around the world. Click here for additional background.
• Reauthorization Legislation Threatens Successful PEPFAR Program 
• Dr. Coburn's Reauthorization Agenda: save PEPFAR!
• Africans agree with the reauthorization of PEPFAR...and Dr. Coburn and his colleagues support them
• Dr. Coburn's Saves Lives First Act of 2008, is a bill that complement any reauthorization bill, while preserving the life-saving elements of the PEPFAR program. Click here for text of the bill. Click here for Dr. Coburn's floor statement.
• Click here for Myths v. Facts sheet about global AIDS legislation
• Treatment cost analysis: can we afford to treat 7 million as Dr. Coburn demands?
• Major HIV/AIDS oversight action page

U.S. multilateral assistance

U.S. multilateral assistance:

United Nations: The U.S. is the largest donor to the United Nations with an annual contribution of over $5 billion, yet the U.N. refuses to account for how it spends this money. The United Nations’ effectiveness and relevancy are undermined by corruption and scandals that include procurement fraud, graft, cash transfers to regimes of terror, and exploitation of refugees.

World Bank: The U.S. is the largest shareholder at the Bank, with a recent pledge of $2.85 billion to replenish the Bank’s International Development Association (the IDA, which must be periodically renewed, is the Bank’s lending and grant making facility for poverty-stricken nations). The Bank’s programs are failing, untransparent at best and corrupt at worst.

Global Fund: The Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria is a multilateral account housed at the World Bank, administered by the UN World Health Organization, and staffed by a Secretariat of hundreds in Geneva. It provides assistance to fight three killer diseases to countries, usually in the form of direct funding of the government. The U.S. is the largest contributor to the Fund, having provided billions since the Fund’s inception in 2002, and now almost providing a billion dollars a year. The Fund is generally more transparent and less corrupt than the UN, but scandals and poor oversight continue to plague this agency.

U.S bilateral operations:

Broadcasting Board of Governors: Americans pay for publicly-funded media to broadcast their values and views to international audiences in countries that include America’s enemies such as Iran, North Korea, and Cuba. The broadcasts are not translated making independent oversight impossible and leaving the content vulnerable to ulterior and sometime un-American values of unaccountable producers and reporters.

USAID: The US Agency for International Development is rife with management problems and lack of transparency. While a program here and there is successful and transparent, most are not.

State Department: The diplomacy arm of the U.S. government is a hit-or-miss operation. Unfortunately, most grant programs at State are untransparent at best and funding the nation’s enemies at worst.

Health

Click here to go to the Major HIV/ AIDS Oversight Page

One of the biggest challenges facing Americans and government at all levels is access and the rising cost of health care. In 2006, U.S. health spending is expected to approach $2.2 trillion and account for more than 16% of our gross domestic product (GDP). And yet over 46 million Americans are uninsured and the average family health insurance premiums rose 7.7% in 2006—compared to a 3.8% rise in wages and inflation at 3.5%.

For over 40 years, the government has been making entitlement promises it can’t keep. For 2006, it is estimated that the unfunded liability (the amount the program will owe compared to incoming revenues) of Medicare is $70.5 trillion—just over five times that of Social Security. The CBO projects that Federal spending for Medicare, Medicaid, and the State Children's Health Insurance Program will total $559 billion and account for about 21% of federal outlays in 2006. Federal tax expenditures for health benefits; health coverage for military personnel, veterans, and federal employees; and spending by Public Health Service agencies are expected to add $247 billion in costs.

Our American health care system is in the Intensive Care Unit, and Dr. Coburn supports the following treatments:

PRINCIPLES FOR CONSUMER-DRIVEN HEALTH CARE

Emphasize prevention - Raising public awareness about the risk factors associated with diseases like diabetes, as well as promoting healthy living and regular screenings for various cancers such as colon cancer can save billions of dollars and countless lives. The federal government must provide leadership in this area.

Expand individual options - Today, American consumers are trusted to make wise choices about every product with the exception of their health care. In the health care economy, third-party payers within health insurance and government bureaucracies have effectively severed the doctor-patient relationship and stripped individuals of much of their decision-making power. Health care needs to be reconnected to the patient so the patient has more control over their own health care decisions. Health Savings Accounts or individual health care tax credits are two tools that can accomplish this goal and should be promoted and expanded. Individuals should be able to own their health insurance policies just like they do their life or auto insurance policies.

Promote innovation in health care - American innovation cuts prices and improves quality in every industry except education and health care. Today, one out of every four health care dollars isn’t going to help anyone get well. Competition is the only force to guarantee patients get the biggest bang for their buck in a $2.2 trillion market. While well-intentioned, government control of 45% of the health care market stymies innovation through onerous regulations, price-controls, and micromanaged benefit structures. Public programs need to change from defined benefits to defined contributions in order to put patients back in charge of their health care.

Limit frivolous lawsuits - Studies show that one out of every three tests ordered today by doctors and hospitals do nothing to help patients get well but are ordered by physicians in order to protect themselves from potential lawsuits. These unnecessary tests add 7 percent to the cost of health in our country. Frivolous lawsuits are enriching personal injury lawyers while driving up health care costs for everyone. The skyrocketing cost of malpractice insurance, which is driving many doctors out of business, particularly in rural areas, is a direct consequence of frivolous lawsuits. Congress must act to limit frivolous lawsuits while protecting patients who have legitimate claims.

Ensure competition in the pharmaceutical industry - The pharmaceutical industry in America today enjoys special protections that enable it to avoid competition in a free and open global market. Americans pay the majority of R&D costs because countries with socialized medicine put artificial price controls on American drugs—and there’s no global competition to change that. Allowing American consumers to purchase affordable and safe prescription drugs from our trading partners will create a global marketplace to reduce the cost of life-saving drugs.

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ACCOUNTABILITY FOR YOUR TAXPAYER DOLLARS: THE WORK OF THE FEDERAL FINANCIAL MANAGEMENT (FFM) SUBCOMMITTEE

Chairman Coburn’s work on the Subcommittee with respect to health policy is to promote solvency, transparency and proper financial management of America’s domestic healthcare programs, and to promote public health globally by ensuring our foreign assistance programs are financially transparent and prioritize proven, life-saving interventions. Continue to scroll down this page to access the latest FFM Subcommittee initiatives in federal health spending oversight.

U.S. domestic health: $806 billion dollars contributed by our federal government (total 2006 estimated U.S. health spending is $2.2 trillion) in just one year is no chump change; consequently, our federal health care programs require aggressive and effective oversight to assure that your taxpayer dollars are not wasted.

Global Health: International healthcare assistance for disease control and health infrastructure building has become a significant portion of U.S. foreign aid. The U.S. taxpayer annually funds over $5.81 billion for programs such as maternal and child healthcare, family planning, and reproductive health, and the eradication of debilitating and deadly diseases such as HIV/AIDS, malaria, and tuberculosis. In addition to this funding, the U.S. is also rebuilding the healthcare and public health infrastructures of Iraq and Afghanistan.

Payment Errors

Every year, the federal government makes billions and billions of wrong payments to individuals, organizations and businesses, among others. The subcommittee is working vigorously to tackle this problem, including forcing agencies to comply with the Improper Payments Act of 2002.

Billions Wasted in Wrong Payments by the Federal Government

Payment errors include inadvertent and irresponsible payments, and are costing the taxpayers at the very least, over $37 billion each year. The Improper Payment Information Act (IPIA) was enacted in November 2002 for the purpose of finding and eliminating payments that should not have been made, or were made for incorrect amounts, by government agencies.

Payment errors consist of overpayments and underpayments. Overpayments are payments made without adequately supported claims, for services not provided, or provided to ineligible beneficiaries in programs like Medicare, Social Security, Food Stamps, Medicaid, and the Earned Income Tax Credit. Underpayments are payments that were never paid out to eligible beneficiaries.

The following four steps are what agencies must do in order to be compliant with the law:

Perform a risk assessment to determine whether or not programs and activities are risk susceptible to making “significant improper payments.”

Develop a statistically valid estimate of improper payments for all programs and activities identified as susceptible to significant improper payments in the risk assessment.

Develop a corrective action plan for all programs where the statistical estimate exceeds $10 million in annual improper payments, agencies are required to develop a remediation plan for eliminating improper payments.

Report the results of Improper Payments Information Act activities on an annual basis in their Performance and Accountability Report (PAR).

One of the most frightening things about the government’s payment errors problem is that the magnitude is not yet known, because some of the largest programs are neither reporting nor performing any of the steps mentioned above.

Voting against legislation to eliminate payment errors means not only condoning non-compliance with a law written and passed by Congress itself; but a vote against a payment errors amendment is supporting wrong payments made by the federal government: fraudulent, wasteful, irresponsible and improper payments.

The subcommittee has had numerous hearings on this topic. The hearing on January 31, 2008, "Eliminating Agency Payment Errors" is one example.

Travel Spending

“Throughout our history, presidents and lawmakers cut back non-defense spending during times of war. Today, Congress must follow that precedent and begin to curb the increase in spending on nonessential activities.” --Chairman Tom Coburn, 9/14/06

In summer 2005 Chairman Coburn launched a government wide inquiry into travel spending and asked federal agencies to report conference sponsorship and participation since 2001 and found that the government had spent over $1.4 billion sending people to meetings and conferences the last five years. The data revealed that such spending had increased 70%. When fiscal year 2006 spending is totaled, these numbers are expected to grow. The investigation uncovered hundreds of millions of dollars wasted on sending employees to conferences of questionable value. In addition to excessive spending on airfare, hotel rooms and per diems, the Subcommittee found excessive attendance levels, where agencies were sending dozens and even hundreds of employees to the same out-of-town meeting, sometimes overseas. The Subcommittee concluded that much travel to conferences is unnecessary given the fact that videoconferencing and the Internet allow the same information to be shared and exchanged.

Chairman Coburn has held two hearings on this subject at which he called 14 government witnesses to defend their agency’s travel spending records. The Subcommittee also heard testimony from a former government official who discussed a “spring break” mentality on the conference circuit and characterized most conferences as “a waste of time and money.”

The investigation also revealed that government employees traveling to lavish locales including Crete, Australia, South Africa and Hawaii will often take annual leave before or after the conference, essentially charging taxpayers the cost of a plane ticket for their personal vacations, begging the question – would the conference have been attended if the employee hadn’t been able to combine with his vacation?

Every conference attended by Federal employees should be able to stand up to the following questions:

Does the conference help further the Department’s mission?

Could the information provided at the conference be disseminated instead through a teleconference, the Internet or scholarly publication subsequent to the conference?

Is the location appropriate and justified?

Is the number of employees attending justified, and could one employee attend instead of many, and provide detailed briefings to other employees afterward?

Is this a wise use of tax dollars when we have an over $9 trillion national debt?

Could the amount spent on the conference have been better spent on a higher priority, or not spent at all?

This is an area the Subcommittee will continue to watch. Check back for updates.

“For the Farmers or for Fun,” an oversight report released by Senator Tom Coburn, ranking member of the Federal Financial Management Subcommittee, examines questionable conference spending by the Department of Agriculture (USDA) — an agency which reported almost tripling its conference spending since 2000, to $19.4 million in fiscal year 2006.

In 2006, USDA sent 20,959 employees to 6,719 conferences and training activities across the nation and around the world (a 191 percent increase since 2000).

Click here to read the full report, "For the Famers or for Fun: USDA Spends Over $90 Million in Conference Costs."

United Nations Watch

The United States is the largest member donor to the United Nations, contributing up to 25 percent of its entire worldwide operating budget (27 percent for U.N. peacekeeping activities) to the tune of billions of dollars each year. In addition, the United States hosts the U.N. headquarters in New York, including the thousands of diplomats and agency employees. Given the level of American investment and the impact of the United Nations on world opinion and events, we must make sure taxpayer money is not subsidizing activities which hurt American security, values and interests.

The evidence is not good. A slew of indictments involving fraud and abuse of U.N. funds (again, a quarter of which comes from the United States) indicates the United Nations is incapable of protecting American taxpayer investment. What’s more, the organization and its member states appear unwilling to adopt any meaningful reforms to better protect against these abuses in the future.

U.N. Watch: U.N. Budget

January 30, 2008

The U.N. does not have a unified budget, and due to the U.N.'s lack of accountability and transparency, it is impossible to know how much money flows through the entire U.N. system. U.N. experts' best guesses usually range from $20-25 billion. The U.S. contribution in 2005 to the U.N. system was over $5.3 billion which means U.S. taxpayers underwrite at least 25% of the entire U.N. operation.

The U.N.'s 2008/2009 core budget marks the largest budget in U.N. history. The core budget is controlled by the U.N. Secretary General and is spent by his office, the Secretariat. The total for the 2008/2009 core budget, after going through numerous amendments and additions, is expected to be at least $5.2 billion or a 25% increase from 2006/2007.

The U.N.'s core budget only represents a small percentage of the total U.N. system that includes the budgets for numerous, independent U.N. funds and programs. According to U.S. Ambassador to the U.N., Mark Wallace, the U.N. funds and programs are following the Secretary General's example by dramatically increasing their budgets as well. For example, U.N. peacekeeping budget will grow from $5 billion to $7 billion in 2008--a 40% growth.

Click here for more information from U.S. Ambassador Wallace regarding the 2008/2009 U.N. budget.

U.N. Watch: the UN Development Program

January 1, 2007

UN Aid for Dictators

The United Nations Development Program (UNDP) is the largest U.N. program that controls up to $5 billion of the estimated $20 billion budget of the entire U.N. system. The UNDP claims to promote democracy, reduce poverty, protect the environment, and combat HIV/AIDS. However, the UNDP refuses even the most basic transparency and accountability measures, so it is impossible to know how the UNDP uses its funding or measure the outcomes of UNDP programs.

The U.S. is the largest contributor to UNDP with annual contributions of over $240 million, but since UNDP coordinates the funding of other U.N. programs, the actual amount of U.S. funds controlled by UNDP is much higher. For example, the U.S. contributes up to $100 million annually to the U.N.'s Global Environment Facility fund which is used by UNDP to implement environmental programs.

Reports of UNDP procurement fraud, whistleblower retaliation, graft, and other corruption indicate the UNDP is plagued by the same problems as the rest of the U.N. system. Even more troubling, the UNDP has an administrative procedure that allows for cash transfers directly to governments, to implement much of its programs. The UNDP makes these cash transfers to terrorist states and regimes with abysmal human rights records such as North Korea, Burma, Iran, Syria, and Cuba.

U.N. Watch: Human Rights and Anti-Semitism

October 18, 2007

In 2006, the UN Human Rights Council replaced the discredited UN Human Rights Commission. The Commission was replaced due to growing criticism over the human rights abusers permitted to sit on the Commission, using the Commission to promote bigotry and anti-Semitism, and doing almost nothing to hold human rights violators accountable. Unfortunately, the new UN Human Rights Council has not changed course from its predecessor as it continues to give abusers seats on the Council while devoting almost its entire agenda to prejudiced attacks on the only democratic country in the Middle East, Israel.

U.N. Watch: Procurement

October 16, 2007

In 2006, the U.N. reports that it spent $1.99 billion in procurement for the U.N. Headquarters, peacekeeping missions, and “other programs seeking procurement services.” This does not include several U.N. entities that have their own procurement budgets. Due to the U.N.’s refusal to enact basic accountability and transparency measures, it is impossible to determine what the real total is for procurement in the entire U.N. system.

Internal U.N. auditors have uncovered over $600 million worth of contracts tainted by corruption, and U.S. investigations have resulted in three U.N. procurement officials found guilty of bribery and related crimes by U.S. federal courts.

U.N. Watch: Terrorism

October 18, 2007

According to the U.N. charter, the purpose of the United Nations is to “maintain international peace and security.” Terrorism is the primary threat to international peace and security, yet the United Nations has failed to establish a legitimate definition of terrorism while it appoints terrorist states to leadership posts, accredits organizations that openly support and glorify terrorism, and props up terrorist regimes with funding and resources.