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Former House Energy and Commerce Committee Chairman has some advice for Republicans who want Medicare beneficiaries to聽pick up part of the tab聽for聽home health services:聽 It won鈥檛 work.

鈥淸Home health] is not an elective thing. You get assigned to it by your doctor. You have to have it or otherwise you鈥檙e in the hospital or a nursing home,鈥� says Tauzin, former head of who is now a senior adviser to the Partnership for Quality Home Healthcare, a coalition of home health care providers.

While Medicare imposed a co-pay for home health in 1965, Congress repealed it in 1972 because 鈥渋t was counter-productive,鈥� he said.聽 Seniors who couldn鈥檛 afford the co-pay didn鈥檛 get home health care, became sicker and cost Medicare more, he said.

A list of potential discussed as part of the ongoing debt ceiling talks included instituting cost sharing for home health services in Medicare. 聽The also has聽recommended a home health co-pay and the said that taking that step would raise $47 billion over a decade.

Tauzin says that 60 percent of those payments would fall on the nation鈥檚 poorest and sickest seniors. 鈥淵ou鈥檙e going to put a sick tax on them that鈥檚 going to encourage them not to use the cheapest, most efficient health care available to them,鈥� Tauzin said in an interview. 鈥淭hey end up in emergency rooms. 鈥� Rehospitalizations go up, you end up with a lot more nursing home care.鈥�

Tauzin doesn鈥檛 buy the argument that beneficiaries must share in the cost of Medicare services to keep the program solvent for future generations. 鈥淵ou go ask a senior veteran whether he鈥檚 already put skin in the game. You go ask grandmas and grandpas who build this country 鈥� whether they have skin in this game already. They鈥檝e been paying into this system all of their lives. You鈥檝e got a debt so you want to tax the oldest and the sickest in our country?鈥� 聽A better approach, the home health alliance says, would be to pursue waste, fraud and abuse in the program.

Tauzin also has some advice for his former colleagues as they debate ways to raise the federal debt ceiling.

鈥淲e all went to college right? When did you do your term paper? We all started a week out but we really didn鈥檛 do it until the night before. And you probably had to be real careful about staying sober that night. That鈥檚 where they are right now,鈥� he said. 鈥淭hey鈥檙e bouncing around and they鈥檙e posturing and聽the bottom line is they鈥檙e going to get something done.鈥�