As previously detailed here, the state of Oklahoma has become the poster child for the often comic and always tragic contradictions of the Republican war on health care reform. A 2007 study by the Commonwealth Fund ranked Oklahoma dead last in state health care performance. Yet in 2008, the Sooner State remained among the most Republican in the nation, giving John McCain a whopping 31% win over Barack Obama. Meanwhile in Washington, its congressional delegation of John Sullivan, James Inhofe and Tom Coburn is waging an all-out war to prevent the health care reforms their constituents of all Americans need most.

On Saturday, Michael Schwartz, chief of staff for Senator Tom Coburn, headlined a discussion on "The New Masculinity" at the Values Voters Summit. Decrying pornography as a "blight" and a "disease," Schwartz concluded the smut (which, ironically, one recent study suggests is disproportionately consumed by red state denizens) encourages homosexuality:
Now in the span of just a few days, the students and political leadership alike of the state have again made clear something is rotten in the state of Oklahoma.

And one of the things that he [a friend] said to me, that I think is an astonishingly insightful remark. He said, "all pornography is homosexual pornography because all pornography turns your sexual drive inwards. Now think about that. And if you, if you tell an 11-year-old boy about that, do you think he's going to want to go out and get a copy of Playboy? I'm pretty sure he'll lose interest. That's the last thing he wants." You know, that's a, that's a good comment. It's a good point and it's a good thing to teach young people.

But as it turns out, another study found that what Oklahomans are teaching their young people is problematic, indeed.
The conservative Oklahoma Council of Public Affairs announced last week only about 3% of Sooner State students could pass a basic civics exam. Only 23% could identify George Washington as the nation's first president. As KWTV Channel 9 in Oklahoma City lamented:

About 92 percent of the people who take the citizenship test pass on their first try, according to immigration service data. However, Oklahoma students did not fare as well. Only about 3 percent of the students surveyed would have passed the citizenship test.

One sure path to improvement for the children of Oklahoma would be to avoid emulating their elected representatives at all costs.
As the data show, the Obama birther movement is strongest precisely in those states where Republicans poll best and health care is worst. And at a gathering of the Tulsa Republican Club last month, First District Congressman John Sullivan embodied that paradox incarnate:

"This is a scary time in Washington. It's a very frightening time. I see Barack Obama is creating an enemies list of people who oppose this miserable health care plan. I think that's frightening. That's from a guy that can't even show a long-form birth certificate. I think we all ought to be prepared to fight that."

But if "miserable health care" described any place in the United States, it would be Oklahoma.
The 2007 Commonwealth Fund report, "Aiming Higher: Results from a State Scorecard on Health System Performance," examined states' performance across 32 indicators of health care access, quality, outcomes and hospital use. Topping the list were Hawaii, Iowa, New Hampshire, Vermont and Maine. Bringing up the rear were the Bush bastions of Kentucky, Louisiana, Nevada, Arkansas, Texas, with Mississippi and Oklahoma. The 10 worst performing states were all solidly Republican in 2004. (8 voted for McCain in 2008.)
And Oklahoma was the worst of the worst. Ranked 50th overall, the state scored 49th on access to health care, 43rd on quality, 50th on avoidable hospital use and costs, 47th on healthy lives and 50th again for equity across its population. Fully a quarter of its residents between the ages of 18 and 64 were uninsured in 2007, a staggering figure truly higher than an elephant's eye.
Despite his vitriolic comments, Sullivan amazingly called for the better angels of our nature to win out:

"Everyone demonizes the other side. We need to all sit down and focus on these vital issues. That's the only way we can address these very, very tough issues."

Sadly, his Oklahoma colleagues in the Senate similarly failed to practice what he preached.
Senator James Inhofe, who six years ago famously called global warming "the greatest hoax ever perpetrated on the American people," came to the defense of the Obama birth certificate crowd:

"They have a point. I don't discourage it...But I'm going to pursue defeating [Obama] on things that I think are very destructive to America."

Of course, one of those "things" is better health care for Oklahomans. As Inhofe made clear, he's fare more concerned about the health of the GOP:

"I just hope the President keeps talking about it, keeps trying to rush it through. We can stall it. And that's going to be a huge gain for those of us who want to turn this thing over in the 2010 election."

Meanwhile, Tom Coburn, Schwartz's boss and Inhofe's fellow Oklahoman in the Senate, has also been fighting health care reform at all costs. Among Coburn's claims to fame is his support for the death penalty for abortion providers and, more recently, his role as C-Street marriage counselor. (As a Senate candidate in 2004, Dr. Coburn famously warned that "lesbianism is so rampant in some of the schools in southeast Oklahoma that they'll only let one girl go to the bathroom.") Ironically, despite their profound disagreements, Senator Coburn is a friend of President Obama.
Though you'd never know it from Coburn's broadsides on health care.
In March, Coburn wrongly declared, "Remember, under the Obama plan . . . all the health care in this country is eventually going to be run by the government." In an April piece titled, "Health Care Reform that Will Kill the U.S. Economy," Coburn argued hyperbolically:

Unfortunately, the President's plan will not only endanger the U.S. economy, but millions of patients as well.

He wasn't joking. In July, Coburn insisted government health care will "absolutely" kill more people than it saves.
While its elected representatives continue their demagoguery, Oklahoma remains the sick man not just of America's heartland, but of the whole nation. For Sooners who desperately need better health care, the likes of Inhofe, Coburn and Sullivan are doing their best to ensure reform will come later - or never at all.
For the tragic tale of how social issues came to trump economic self-interest in America's heartland, see Thomas Frank's excellent book, "What's the Matter with Kansas?"