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Kent Conrad: High-Population States Have Disproportionate Level Of Representation

Conrad-Kent-DohKent Conrad’s talking point against the public option tied to Medicare rates is that it would destroy the health care system in his state of North Dakota. He’s said this before, in interviews with Ezra Klein among others. And he always makes this point, one of the silliest I’ve ever heard from a Senator, which he repeated today in the Senate Finance Committee:

The public option as defined by the committee of jurisdiction in the House, the Ways and Means Committee, is tied to Medicare levels of reimbursement. My state has the second-lowest level of Medicare reimbursement in the country. If my state is tied to that reimbursement, every hospital goes broke.

People say, “Just fix it.” I’ve been on the Finance Committee more than 15 years. I’ve been trying to fix the unfair aspects of Medicare reimbursement all the time. We run into the House. Membership is determined by population, and the big population states write levels of reimbursement that unfairly treat hospitals in states like mine. My hospitals get one-half as much as urban hospitals to treat the same illnesses.

The way he termed it today, Conrad said that high-population states have a “disproportionate representation” in the House of Representatives.

OK, so North Dakota has an estimated population of 641,000 as of 2008. They have the same representation in the Senate as California, with its population of 36,756,666.

According to Conrad, this is the way it should be.

To the extent that any state has a disproportionate representation in the US House, it’s… small states like Conrad’s. Their 2000 population was 641,000. In 2000, the Census set the average size of a Congressional district at 646,000. Meaning that the Congressional district made up of the state of North Dakota is smaller than the average Congressional district.

Conrad is welcome to make the argument about Medicare reimbursement rates, but in order to do that he argues that, essentially, the US government should base its representation totals on acreage and not people.

Conrad is considered a very serious person in Washington.

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David Dayen

David Dayen