GOP physicians fear health bill

The two physicians who serve in the Senate don’t sound like other Republican lawmakers when they talk about the debate over reforming the nation’s health care system.

Yes, they share colleagues’ concerns about cutting Medicare funding and they want insurance companies to be able to sell across state lines, but Republican Sens. Tom Coburn of Oklahoma and John Barrasso of Wyoming say the Democratic lawmakers’ proposals being presented to Congress would allow the government too much control over physicians’ and patients’ decision-making and destroy the art of medicine.

Mr. Coburn said the best doctors, based on their experience, tailor treatment to an individual — making medicine a combination of art and science. Proposed cuts to Medicare funding and proposals to study the most efficient treatment of diseases, called comparative effectiveness research, would require physicians to prescribe certain treatments or limit how much they can spend, he said.

“If we’re going to go to cookbook medicine, let’s just go and admit that 20 percent of the people in this country” are going to be cheated by it. “About 80 percent are going to do fine,” said Mr. Coburn, a physician who still sees patients once a week. “One of the reasons we have such good medicine is that we’ve allowed the art of medicine to flourish in this country.”

Democrats say the comparative effectiveness research would serve only to provide more research to physicians, not restrict them.

Mr. Barrasso, who was appointed to the Senate in 2007 after a 24-year career as an orthopedic surgeon, said the Democrats’ proposals are centered on the government, not the patient, and don’t do enough to encourage healthy lifestyles.

“There is nothing in these bills that actually [gives] the patient an incentive to stay healthy — to lose weight, to get their cholesterol under control,” he said. “Now, they have billions to build sidewalks, jungle gyms and streetlights, hoping that the community develops a healthy lifestyle, but nothing to give a real incentive to an individual.”

In a debate in which Republicans hope physicians may have more pull with Americans than the average lawmaker, Mr. Coburn and Mr. Barrasso say they plan to be vocal when the bill reaches the Senate floor.

“This is the largest bill I’m probably going to be working on in my career,” Mr. Barrasso said, adding that the bill will impact one-sixth of the American economy and touch every American.

“We’re going to be on the floor when they make statements about what’s going on to absolutely refute it with our own experience, our own knowledge,” Mr. Coburn said. “We have actually seen patients who have been denied care. We’ve actually seen the consequences of someone meddling between the doctor and the patient. We can relate how that truly impacts rather than what somebody theoretically, like [the Congressional Budget Office], thinks it might impact.”

Since June, the two lawmakers have been recording Internet videos discussing health reform, dubbed the “Senate Doctors Show.” They typically answer questions from Twitter submissions or tourists in the Capitol. In August, they went on the road, conducting town-hall sessions in Louisiana, Nebraska, Arkansas and Mississippi.

They’re a bit of an unlikely duo. Mr. Coburn has a brash style and admits his bedside manner is far better than his political manner. Mr. Barrasso is making an impression on his more senior colleagues for his thoughtful rebukes of Democrats’ plans with a polished style befitting his history of hosting Jerry Lewis Labor Day telethons in Wyoming.

Republicans plan to vote against the procedural votes required to get debate started, which could happen as soon as this week as Majority Leader Harry Reid of Nevada sends his bill to the floor. They say Mr. Reid’s bill, which hasn’t been released, is going to be so flawed that they can’t even begin debate on it.

The legislation is expected to include a government-run insurance program, a requirement that all Americans purchase insurance and incentives for employers to provide insurance.

House Democrats passed their health care reform bill earlier this month, with the support of one Republican.