WASHINGTON — Sen. Tom Coburn has beaten melanoma, colon cancer and prostate cancer. He is now in the midst of fighting prostate cancer again.
Last week, Coburn, R-Muskogee, kept up his usual hectic schedule on Capitol Hill and, in an interview in his office, he was as impassioned as ever on topics such as health care and the Senate's operations.
Coburn, 65, a physician, was first elected to the Senate in 2004, and he limited himself to two terms. He won the second term in 2010 and has three more years of service.
He said he is giving a lot of thought to leaving early because of the recurrence of prostate cancer, but then said the decision ultimately would be dictated by whether he and his staff could still make a difference.
Some of the questions and answers have been edited for brevity.
Q: Let me ask you how you feel.
A: I feel good.
Q: What was the treatment?
A: I don't want to go into the details of my treatment. I've got a long way to go but I've got a good plan. February will be my tough month — my tougher month.
Q: This is going to sound like a stupid question, but is there any explanation for why you have had all these cancers?
A: Poor genes.
Q: Can you trace it to your own mother and father?
A: No, but ... everybody gets cancer cells. We have these dimers in our blood that identify cancer cells every day. You get them every day. And you have a good immune system that recognizes them and takes them out. Probably I have a defect. ... I don't have a good system to take out bad cells. And so they get in a focus and they grow. Not many people in my family have lived very long. But most of it's not been related to cancer, and the cancer that's been there has been secondary to smoking. My prostate cancer is a cancer that 1 in 100,000 people get when they get prostate cancer. It's a rare type of prostate cancer.
Q: But it's treatable?
Q: What's the survival rate?
A: Well, I'll tell you in a couple of months when I look at my tumor markers. It looks good. I got good assurances that I'll be around five or 10 years, unless I'm another 1 in 100,000 that doesn't respond to treatment.
Q: How have you been able to fight (cancer) off so many times?
A: 'Cause I have great doctors and great medicine based on the free enterprise system in this country rather than a government-run system. ... If you want to know why I'm alive, it's because of the free enterprise system and the innovation in this country that has nothing to do with the government.
Q: Well, is that entirely true? There's a lot of research funded by the National Institutes of Health.
A: Sure there is, and there's a lot of research funded by drug companies, by universities that aren't taking an NIH grant. It's not that NIH doesn't do a lot of good. It does. But do you think, given the opportunity to treat disease, the private sector wouldn't give a lot of money to fund research? And as the government grows, the private sector diminishes. The government is highly inefficient. Just look at NIH — (It's) the best it's ever run under Francis Collins ... but it still does some of the most stupid stuff you've ever seen because the government is not efficient and doesn't care about costs.
Q: You predicted a couple of years ago — when the House first started its repeal efforts — you said that Obamacare would fall under its own weight. Do you see that happening now?
A: Look, you're going to see a couple of things happen. Next year, when the business mandate is no longer delayed, you're going to see the price for all these businesses' health care go up.
Next April, when everybody pays their taxes, and all our seniors who get meager returns now on their investments, now have to pay 3.5 percent of that return to Uncle Sam for Obamacare, you're going to see another blowup. Because most people don't realize that every interest income, every dividend they get, every short-term or long-term capital gain that they get, Obama takes 3.5 percent of that for this experiment that's going to fail.
(Note: the 3.8 percent surtax applies to singles with adjusted gross income above $200,000 and couples with AGI above $250,000).
And the next shoe to drop — you're really not going to get to see the same doctor. People who are in an ERISA (Employee Retirement Income Security Act) plan probably will, but the other two-thirds of Americans are going to end up having to change doctors.
Remember all the grief (when) I said that people are going to die? They are going to die. Because you're going to get a doctor that doesn't know you, doesn't know your personality, your psyche, the spiritual side of you and isn't gong to know how to read you and isn't going to intervene when they should be intervening on the art of medicine rather than the science of medicine. And that's where real care is given, in the art of medicine, knowing your patient.
Q: Why is it so hard to allow people to get insurance that don't have it now? Why is that so difficult?
A: Because there's no true market out there. What you have to do is create a safety net and you have to create a maximum exposure and let the market take care of everything in between.
Q: The safety net would be for people with pre-existing conditions ...
A: Or people who are very, very poor. And so you create a safety net. That's a function of government that it can do, but it can't be managed from Washington. You know Oklahoma could run Medicaid a whole lot better than they're running it now if we get the (federal) government out of it. I mean, we've got innovative ideas, innovative people. We could actually save a lot of money and treat a whole lot more people if the (federal) government would get out.
The assumption behind Obamacare is we know better than you do on how for you to purchase your own health care. And what I would posit to you is that nobody in Washington knows better how to care for your health care.
It's really about freedom. Do I get the freedom to make a choice for me, versus do I need to have a nanny state that will make my choices for me?
Q: Well, if you give people the freedom to not buy insurance and then something happens ...
A: What you have is auto-enrollment and they can default out if they want. So if you create a tax credit to give people the capability to buy a high-deductible policy so when you're on your Harley and you wreck it and you don't have health insurance, the state bought you a $10,000 or $15,000 deductible so the rest of us aren't paying. So you're really spreading the risk.
You're paying for (the uninsured) now. There's no market forces that are driving that. That's my whole point. We didn't have a real market in health insurance. What you had is prepaid expense that — the insurance industry charges you 20 percent to pay your bills. And then we allow all the hospitals to write off what they don't collect.
There's no market. And what we should have done is go more to a market. Markets aren't perfect, but they're better than anything we can design in Washington in terms of health care. Here's the other thing that you have to do if you want to have a real market: There has to be transparency on price. Why is it when you go to the hospital and you get an explanation of benefits, here's what they charge (and) 30 percent of that is what the insurance will allow. But if you didn't have insurance, they'd charge you that upper price.
Well, it's all bogus — the pricing in health care.
Q: Let me ask you this: Is your frustration with this place at an all-time high, or has it always been at an all-time high?
A: Look at the NDAA (the defense bill, which was on the Senate floor last week). There's been no right to offer amendments by any of the regular guys. It's never happened before in the history of the NDAA. What is that about? Is it about that none of us have any good ideas about how to fix the Defense Department?
The Senate isn't working. And the Senate isn't working because it's being run in a way that's designed not to force consensus. And the only time consensus happens is when several of us — like we did on student loans — go around and create a pressure on something that must pass, and we figure out a deal outside of the committees, outside of everything else and bipartisanly, we do something.
If you set up the Senate and let it run, it will itself force consensus.
Q: But that seems to be belied by these votes on the D.C. circuit court judges. (The Democratic majority) can't even get a straight up-or-down vote to fill a vacancy on a federal court.
A: That's not true. We've put in more judges and more circuit court judges than we did in the Bush administration. That's not true. That's the story that's out there. Go look at the facts.
Q: It's also a fact that the Democratic majority basically has to file cloture (to cut off Republican filibusters) on everything ...
A: No, no. That's not true either. You're buying (Senate majority leader) Harry Reid's line. He files cloture when he starts a bill. And then says we're filibustering it. I mean, when we don't vote cloture on the (defense bill), are we filibustering? Or was he filibustering to not allow any amendments?
It's never been run this way.
Q: And that's only because of him, that's not because Republicans ...
A: It's only because of him because if you let the process work, it will work. He can table any amendment. He's got 55 votes. It's that they don't want to have to be responsible to the American public about voting on things that will drive consensus.
I've got 18 amendments (on the defense bill) and I can't get any of them up (for consideration). And they're all related to the Defense Department. There's nothing extraneous about them. Why won't you vote on those? They don't want to take votes on them. It's all about the 2014 election right now.
Here's the point: If you're a U.S. senator, and you can't defend any vote up here, you have absolutely no business being here. To not vote is cowardly.
Q: Have you given any thought to leaving early?
A: Look, I gave thought to not running again (in 2010). Every day I'm up here, I give thought to leaving early. And I give a lot of thought to it now that I've had another health issue.
Q: Do you have some time frame to decide whether you want to ...
A: No, I'm going to wait until February and see what my tests look like and see what I do.
Q: So in February, there could be a chance where you'll say ...
A: I'm not speculating about that. I don't have any intentions other than doing what I'm doing right now. And then I'll look at it and see. ... It has nothing really to do with my health. It has to do with: Can I make a difference? And if we're still sitting in a situation where I could work like crazy, I've got the best staff on the Hill. ... Can this group continue to make a difference that will change what's coming for this country?
And if I don't think they can, and if I don't think I can, why would I stay here?
Q: You mean why would you stay for another couple of years?
A: Why would I stay tomorrow?