Checking In With Sen. Kent Conrad, D-N.D.

As chairman of the Senate Budget Committee, Kent Conrad, D-N.D., will play a pivotal role in this year’s health care debate. A budget hawk, he has questioned the wisdom of pumping more money into the nation’s $2.4 trillion health care system.

The senator, who is also a member of the Finance Committee, tells Kaiser Health News Senior Correspondent Mary Agnes Carey that if the chamber’s health care legislation is not fully financed he will take steps to stop the bill on the Senate floor.

Separately, Conrad, in an apparent effort to find a compromise between friends and foes of a public insurance plan, is advancing an alternative that would create non-profit cooperatives to provide consumers with more choices for their insurance.

Q: You have expressed doubts about spending more money on health care because you think the nation already spends too much. How has that shaped your work on health care overhaul legislation?

A: I’m very concerned about it because we’re spending about 18 percent of our gross domestic product on health care now, which is about double anybody else, so the thought that we have to put a lot of additional money in creates a certain skepticism.

Q: But what about claims that investing more now in prevention or health information technology or comparative effectiveness will change the health care delivery system and ultimately save money down the line?

A: I think we know that, in the short term, investments will be required. But we’ve got to also be convinced that over time we really do reduce costs as a share of our economy. On the trend line we’re on we’re headed for 37 percent of GDP and that won’t work. So we really do have to find ways to change the trajectory.

Q: If a bill came to the Senate floor that you thought was too expensive would you try to stop it?

A: Yes, absolutely.

Q: And what are your options for that?

A: I don’t want to go into those but I have made very clear I won’t support something I’m not convinced does not change the cost curve on health care. We simply have to do it. It would be an absolute disaster for American families, American businesses and the government itself if we didn’t do something that changed the trajectory we’re on.

It’s got to be paid for, and it’s got to be paid for real. But in addition to that, I’ve got to be convinced that it really is going to affect the cost curve, at least the trajectory that we’re on.

Q: Do you think Democrats will use the budget reconciliation process to pass health care legislation?

A: I do not believe it will be used for health care. I do not think it would be wise to use it, as I’ve said repeatedly. I think as people get into the details they find out it doesn’t work quite the way they thought.

Q: What do you mean?

A: Well, how the Byrd rule works. How everything has to be paid for, plus deficit reduction, over six years. Plus every year thereafter there has to be deficit reduction. I think as people get into the details it doesn’t work quite the way they thought.

Q: So it isn’t the slam-dunk it’s portrayed to be?

A: No, that is anything but a slam-dunk.

Q: How successful do you think Finance Committee Chairman (Max) Baucus will be in getting the number of Republicans he wants on his health care bill?

A: I have a lot of faith in the way Sen. Baucus is going about this. I give him very, very high grades for the way he’s conducting this exercise. I think anybody who is involved would have to say that he’s being eminently fair, he’s going through a very disciplined process. It’s really almost a textbook case on how to write major legislation. It’s very well done.