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Why Do Democrats Hate Medicare? An Interview With Rep. Chris Van Hollen.

PH2009073002532.jpgRep. Chris Van Hollen (D-Md.) is chairman of the Democratic Congressional Campaign Committee. I spoke to him Tuesday about Medicare cuts, the result of August, and what passing health care through the reconciliation process would mean for the House of Representatives.

Michael Steele tells me the Democrats want to dismantle Medicare. So my first question is simple: Why do Democrats hate Medicare?

The hypocrisy is shameless. I won't go through the history of Medicare, but for Republicans to say that you should trust us on Medicare is like Colonel Sanders guarding the chicken coop. I think most seniors know that, and these scare tactics will boomerang. I don't think people will buy it, since the guys peddling this stuff are the very people who have been trying to undermine and weaken Medicare for years and years. There was a budget alternative put forward by Paul Ryan this year that would have ended Medicare as we know it and given all seniors a voucher to get their health care on the private market. And they voted for it. So we know what they wanted to do with Medicare.

But to ask the question slightly more seriously, there will be cuts to overpayments in the Medicare Advantage program. There will be money coming out of so-called waste, fraud and abuse. Won't there be some service cuts out of this?

It's wrong to equate quality health care with overpayment to insurance companies. Seniors are as interested as anyone else in ensuring that dollars are well-spent on quality care. They will have other and equally good medical benefits. And Medicare Advantage has been overpaid, as found by CBO and other nonpartisan organizations.

Some of the other changes reflect the fact that we'll have more people covered. Take reimbursements to hospitals for uncompensated care. If we cover 30 or 40 million more Americans, we can reduce payments to hospitals for uncompensated care. AARP has said this bill doesn't cut benefits, period. For Republicans to try and scare people otherwise will be seen for what it is.

What about the argument, which I hear fairly often from people, that the sudden influx of newly insured people will strain the medical system and there won't be enough doctors?

As part of the update to the physician reimbursement formula, we're significantly increasing the rate for primary care physicians precisely because of the recognition that there's a shortage of primary care providers, and as you bring new people into the system, there'll be a need for more of them. We're doing other things as well. We are cognizant of that issue and are taking steps to address it.

What has been the end result of August? What are you hearing from your members?

Their takeaway was that the noisiest voices at the town halls might have attracted the most media attention but do not represent their constituents as a whole. The majority of their constituents want them to come back and get something done. There is a unified theme on the Democratic side which is that we need to move forward this year on health-care reform. Now, there'll be specific issues that they raise. One of the first orders of business will be an opportunity to provide the feedback from their districts and propose any additions to the legislation.

There's been some talk that the Senate might pursue health-care reform through the reconciliation process, which will change the process for the House substantially. What's your take on that?

We'll be in very close contact with them, and they're still trying to determine whether that's a fruitful approach. But that approach is only necessary in the Senate, so we in the House will look to them for their determination. That requires that they talk to their members and determine whether there's a strategy. We don't need reconciliation to get something through the House.

Is there a timetable for passage in the House?

No, there's no timetable yet.

Right now, you have Senate moderates saying they can't pass a bill with a public plan and House liberals saying they won't pass a bill without one. Is health-care reform between a rock and a hard place?

We need to let it play out more. In the House there's a consensus in support of the public option, and people coming back from their districts continue to support a public option. Then we'll have to see what the Senate does and where we go from there. As we come back, the White House will have to play a bigger role in this debate.

Photo credit: By Chip Somodevilla — Getty Images

By Ezra Klein  |  September 1, 2009; 3:57 PM ET
Categories:  Health Reform , Interviews  
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Next: The Great Centralizer?


Please take a look at this:

Posted by: RichardHSerlin | September 1, 2009 5:02 PM | Report abuse

Good link for the Paul Ryan bit in the first paragraph? Would be good to send to some people.

Posted by: AZProgressive | September 1, 2009 6:18 PM | Report abuse

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