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Saturday, Nov 22, 2008
As far right as Coburn is on fiscal issues, he is even farther right on social issues. "I favor the death penalty for abortionists and other people who take life," he told the Associated Press in July. Last week, he told the Hugo [Okla.] Daily News: "We need someone who will speak morally on the issues and not run from the criticism of the national press ... We need to have moral clarity about our leaders. I have a 100 percent pro-life record. I don't apologize for saying we need to protect the unborn. Do you realize that if all those children had not been aborted, we wouldn't have any trouble with Medicare and Social Security today? That's another 41 million people."
At a House subcommittee meeting on the Safe Drinking Water Act in 1996, which heard testimony on the danger of the parasite cryptosporidium, which had killed 104 and sickened 400,000 in Milwaukee in 1993 and killed 19 in Las Vegas in 1994, Coburn displayed his expertise as a doctor. The lethal spores, he held forth, "can sometimes ... be very helpful -- for doctors -- because it helps us identify those people who in fact are immuno-compromised."
A year later, Coburn gained a moment of national attention when he condemned NBC for televising the Academy Award-winning movie on the Holocaust "Schindler's List." According to Coburn, the film encouraged "irresponsible sexual behavior," and he called for outrage against the network from "parents and decent-minded individuals everywhere." He added, "I cringe when I realize that there were children all across this nation watching this program." Even conservative avatar William Bennett felt compelled to rebuke him: "These are very unfortunate and foolish comments."
In 1999, after the massacre at Columbine High School in Colorado, Coburn opposed President Clinton's proposal for making adults liable if they allow their children to buy guns and harm others. "If I wanted to buy a bazooka to use in a very restricted way, to do something, I ought to be able to do that," said Coburn.
Medical fraud has been one of Coburn's signature issues. In his freshman term, he introduced the Health Care Anti-Fraud Act of 1995, which focused mainly on Medicare fraud but also touched on Medicaid. Speaking on the House floor on behalf of a Republican Medicare bill that year, Coburn said, "Our goal is to eliminate fraud and abuse. The way we do that is to make sure we change the expectation of those who are defrauding and abusing; that we, in fact, will catch them. If we change that expectation, then we will limit greatly the amount of people, and number of people, who attempt to defraud."
Unsurprisingly, in proposing this legislation Coburn was careful not to raise his own case involving Medicaid fraud.
In the early hours of Nov. 7, 1990, Dr. Coburn was summoned to Muskogee Regional Medical Center to attend to a pregnant patient who had been admitted with severe pains. The patient was a 20-year-old woman in her third pregnancy. After each of her first two pregnancies, she had asked Coburn to perform a tubal ligation to ensure that she would not have any more children, but he had refused, according to his testimony, telling her that Medicaid did not cover elective sterilization for women under 21. "I told her that she was too young, that it was irreversible, that she needed to wait," Coburn recounted telling the patient in December 1989. "I also told her that [Medicaid] wouldn't cover it."
Coburn found that she had an ectopic pregnancy, in which a fertilized egg is implanted somewhere other than the womb. In this case it was in her left fallopian tube. Coburn operated, removing both the left tube and the unaffected right one. The woman subsequently filed a malpractice suit, charging that he had tied her healthy tube without her permission.
In his Feb. 27, 1992, deposition in the case, Coburn insisted that the woman had repeatedly asked him to remove the second tube. In fact, she had signed a written consent form for the operation to deal with the ectopic pregnancy, but had not signed a consent form for the second procedure. Coburn testified that he had asked a nurse to obtain that form and that he did not know why it had not happened.
The suit was initially dismissed in October 1992 because it had been filed beyond the applicable statute of limitations, but was reinstated upon appeal. It was finally dismissed in December 1995 because, according to court records, the woman, for unexplained reasons, failed to show up for the trial.
In his deposition, Coburn also explained how he had gotten around Medicaid's restriction against coverage of the costs of elective sterilization for a woman under 21: He did not report the ligation of the right tube on his discharge summary. "The reason that it was not dictated as both [procedures] is because she was under 21 and was being paid for by Title 19, and to have a tubal ligation under 21, Title 19 would not have covered that," he said. He noted that under the law, sterilization even as an incidental operation accompanying a covered procedure -- i.e., removing the left fallopian tube to deal with an ectopic pregnancy -- would have nullified eligibility for federal reimbursement.
"I did not dictate [the second procedure] because of her Title 19 status," he testified. "If I had dictated both, it would have been a sterilization procedure and she wouldn't have had it covered."
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