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Coburn Battle Nears Climax

Senate Republicans have crafted a “sense of the Senate” resolution that would, if adopted by the Ethics Committee, give Sen. Tom Coburn (R-Okla.) the ability to continue practicing medicine.

Racing to conclude a nearly 10-month battle to continue his obstetrics practice in Muskogee, Okla., Coburn faces a Friday deadline to wind down his practice, which is not allowed under current Senate rules. The deadline, set by an agreement with the Ethics Committee, stipulates that Coburn must stop receiving payments from his patients after Friday.

While Majority Leader Bill Frist (R-Tenn.) said it was unclear if there is enough time to bring up the resolution this week, Coburn’s staff said the Senator was still pushing for a vote this week.

“Dr. Coburn very much would like this matter to be brought to the floor as soon as possible,” said John Hart, Coburn’s spokesman. “He’d prefer we just get it out of the way.”

Hart said that Coburn would most likely continue practicing medicine next week if the Senate passes the current draft, even though it’s not clear if the resolution would be binding because it is not currently crafted as an official alteration to Senate rules.

Under the chamber’s rules 36 and 37, Senators are specifically forbidden from receiving compensation as doctors, lawyers, engineers and other professions that involve fiduciary relationships.

Any official change of those rules would require 67 votes for passage, but it’s unclear whether Coburn could garner such a super-majority because he is facing deep resistance from leading Democrats. If the Senate takes no action this week on the matter, Coburn has told Roll Call he will dip into his own pocket to continue paying administrative costs so that he can keep advising “prenatal” patients.

Since last spring, he’s been operating his clinic on a no-net profit basis, charging patients enough money to cover his medical malpractice insurance, staff and rent under the deal reached with Ethics. Coburn has already paid his insurance for the remainder of the year, but he cannot afford to pay the estimated $200,000 for all of next year for insurance, nurses and other administrative costs.

Frist and Sen. Trent Lott (R-Miss.), who chairs the Rules and Administration Committee, have crafted a resolution that instructs the Ethics Committee to regard “compensation” as it relates solely with “the practice of medicine” to allow a Senator to collect “actual and necessary expenses” but no actual profits, according to Hart.

It’s possible that the measure, if it’s ever approved, could receive a majority of the Senators — maybe even more than 60 votes — but fall short of the 67-vote hurdle normally required to change rules. At that point, Coburn’s ability to collect payment from patients would be up in the air.

It would also raise the issue of whether the Ethics Committee would try to stop Coburn from practicing, even after he’s received majority support from his colleagues, setting up a potentially awkward political showdown between the committee and the rest of the Senate.

Without stating how much support he has secured, Coburn is happy with what he’s heard from each wing of both party caucuses, Hart said. “He’s been pleased by the support that he’s received by his colleagues, Republican and Democrat.”

But Sen. Tim Johnson (D-S.D.), the vice-chairman of Ethics, which initially rejected Coburn’s waiver request last March, said Tuesday that he has seen the proposal and opposes it because it gives doctors a privilege not given to other professions.

“I think this resolution would be an unfortunate precedent. How do you single out a single profession?” Johnson asked.

Frist is the only other physician in the Senate, and he continues to practice at free clinics around the country and in Third World locales such as Africa, paying his insurance costs himself.

Johnson has previously been backed on this matter by Sen. George Voinovich (R-Ohio), the chairman of Ethics, who co-authored the letters to Coburn spelling out the committee’s initial rejection of the Oklahoman’s request for a waiver.

Johnson said he expected the issue to come up at Tuesday’s Democratic caucus lunch, at which Minority Leader Harry Reid (D-Nev.) was also expected to speak out against the proposed resolution. Reid, who served on the Ethics Committee for years until taking over as floor leader in January, has opposed any change in the chamber’s ethics rules for months.

When Coburn was first notified last December by the Ethics Committee that he wouldn’t be allowed to practice medicine, Reid was still serving as vice-chairman of the panel.

Johnson said the proposal would create “uneven treatment of Senators,” adding that it might open the door for Senators to practice other forms of medicine. Sens. John Ensign (R-Nev.) and Wayne Allard (R-Colo.) were practicing veterinarians before joining the chamber.

“I’m assuming that they mean M.D., medical doctor, but if you’re going to bend the rule for one profession, why not do it for veterinarians and lawyers and other professions,” Johnson asked rhetorically.

And Sen. Mark Pryor (D-Ark.), a member of Ethics who described himself as a friend of Coburn’s, said he was hesitant to support any alteration of the interpretations of the rules. “I’m not sure I’m comfortable doing that,” he said.

Frist said that he supported the resolution that’s been drafted, calling it a “good plan.” However, he noted that the floor calendar is crowded right now and might preclude the provision from being raised this week in time to meet Coburn’s deadline.

“It would be difficult right now,” he said.

And Majority Whip Mitch McConnell (R-Ky.), a former Ethics chairman, said there was no final decision on what to do with the Coburn measure.

“It’s sort of an ongoing conversation,” he said.

During 2003, Coburn earned slightly more than $380,000 from his medical practice, according to the financial disclosure form he filed as a Senate candidate. Coburn pocketed an additional $25,000 from other sources in that same period. Coburn’s net worth was between $1 million and $3 million before running for the Senate.

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