The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform Makes It Clear: Howard Dean is No Ted Kennedy

Posted by Alan on December 16, 2009

Dr. Howard Dean was governor of Vermont for 12 years. He was a front runner briefly during the 2004 presidential campaign. He became chair of the Democratic National Committee. And now he is demonstrating why he failed for Governor and why Democrat are better off having him as the “former” chair of their party.

As Democrats in the Senate struggle to cobble together a super-majority in support of health care reform, Governor Dean is busy throwing bricks into the room. Upset that the legislation likely to emerge from the Senate will contain neither a government-run health plan nor the ability for 55-to-64 year olds to buy-in to Medicare, Governor Dean is urging defeat of the bill. The reason, according to a report by the Associated Press, the Senate health care reform bill is “an insurance company’s dream.” Which is malarkey. I don’t know any insurance carriers happy with the direction of health care reform in Washington. As the AP reports White House spokesman Robert Gibbs putting it, “If this is an insurance company’s dream, I don’t think the insurance companies have gotten the memo.”

Governor Dean asserts that “You will be forced to buy insurance. If you don’t you’ll pay a fine.” True enough, although in the Senate bill the fine is $750, far less than the cost of coverage. Then he goes on to assert that insurance companies would not be prohibited from denying coverage for preexisting conditions. And that older Americans would pay more than their younger neighbors for coverage.

Let’s look at the substance of the Governor’s complaints. Does he seriously believe that whatever health care reform bill emerges from Congress will allow health insurance companies to deny applicants for coverage? If so, he’s the only pundit in the country who does. Even Republicans support guarantee issue of health insurance coverage.

As for older people paying more for coverage than younger people, he’s right. Both legislation passed by the House and being considered in the Senate allow carriers some flexibility in setting rates by age. But both bills substantially reduce the differential that exists today. In California, for example, a 64 year old can expect to pay six times more than a 19 year old for the same coverage. (Anthem Blue Cross offers a $3500 deductible PPO that costs a single 19 year old in Los Angeles $110 per month and his 64 year old neighbor $664 a month). Under the legislation being considered in the Senate, the ratio would could be no more than 3-to-1. The House bill limits the differential to 2-to-1. Governor Dean never complained about this premium spread before. Now that the public option is likely to be cut from the Senate bill, a 3-to-1 limit on premiums becomes a decisive factor for him?

Governor Dean’s attack on the Senate bill is a loud reminder of how much Senator Edward Kennedy is missed in Washington. Senator Kennedy was as liberal, if not more liberal, than Governor Dean. The difference is that Senator Kennedy accomplished a great many things on the national stage. Governor Dean has accomplished nothing nationally. Senator Kennedy was successful in large part because he recognized the need to seize progress when and where he could. He knew there would be future opportunities. Even more importantly, he understood that, in broad terms, America becomes more progressive over time. Consider: it wasn’t that long ago that the fight was over whether the government should provide a medical safety net for older citizens. Republicans called Medicare socialism. Now they defend the program.

There’s a lot in the current health care reform bill I don’t like. There’s a lot about the status quo I don’t like either. What is infuriating about Governor Dean’s attack on the bill is that it is as nonsensical as those of the right. His “insurance company dream” is to the left what former-Governor Sarah Palin’s “death panels” are to the right – ideology masquerading as dire warnings.

Liberals in Congress will probably come around to supporting what they consider a watered down, insufficient health care reform bill. Liberals outside of Congress, like the former Governor from Vermont, will call on them to defeat the bill and start over. Underlying their logic is apparantly the belief that it’s possible to pass an even more liberal Congress.

What liberals like Governor Dean need to realize is that moderate Senators like Ben Nelson and Blanche Lincoln are just a part of the party as liberals like Senators Jay Rockefeller and Charles Schumer. I suppose Governor Dean could recruit liberals to run for the Senate in Nebraska, Arkansas, Indiana, Louisiana and other states from which moderate Democrats hail. There’s only one problem. Liberals don’t get elected to the Senate from those states. Not in 2010.

Members of Congress understand the need for compromise. They may not like it, but they accept that their less-than-liberal colleagues represent their constituencies. Those on the sidelines have the freedom to ignore such realities and to throw bricks with abandon. These ideologues won’t solve many problems, but I guess the brick throwing makes them feel better.

Senator Kennedy understood the need to work with those less liberal than himself, to keep issues alive by passing significant reforms that may not be all he wanted to achieve, but laid the groundwork for future efforts. Governor Dean is blind to this approach. But then, Howard Dean is no Ted Kennedy. Never was. Never will be.


14 Responses to “Health Care Reform Makes It Clear: Howard Dean is No Ted Kennedy”

  1. There is one thing that Dean is not wrong on and that is that this bill needs to be killed.

  2. Health care reform or health insurance reform….which is it?
    If we are concerned with access to care and the cost we have to pay for this access….then should we not focus on the following?
    Who is denied access and why? If it is people who have pre-existing conditions, then let’s define them…..apply a fix and move on…..
    If we want to eliminate all denials because of pre-existing conditions, then how do we make sure everyone joins? (remember….insurance is pooling risks of things that might happen to anyone of us that individually we can not afford. Knowing that not everyone’s house will burn down makes it easy to understand how fire insurance works…everyone chips in a few bucks they can afford to replace their house if it burns down….something they can not afford by themselves). Most people can quickly realize the absurdity of imposing a mandatory plan for coverage by the insurance industry without a mandatory requirement to join….it would be like being able to buy fire insurance only after you call the fire department to report a fire.
    If COST is the issue, then should we be focussing on insurance companies who only PAY the bills or Doctors and Hospitals who CREATE the bills?…..We should be studying what costs does a doctor or hospital incur that they must charge the patients…..THESE are what are going through the roof! Anyone who studies the issue will find that insurance companies make a profit of 2, 3 or 4% on health insurance….so, let’s say those who believe the insurance companies are ALL no good and that ALL are thieves, so they should ALL be eliminated…then what? So eliminating insurance companies will save 2, 3 or 4%….at most, is this kind of saving going to solve the financial crisis that health care is causing?
    Perhaps looking into the bills created by doctors and hospitals would be more fertile ground from which to reap the savings we need to maintain our economic well-being would be more productive.
    The Government needs to legislate and regulate a socially acceptable plans that conforms to our principles of capitalism in a democracy.
    The Insurance companies must be allowed to compete on a national, regional and local level with a well defined product and services that offer a minimum level of protection for all….
    Doctors and Hospitals must be allowed to receive compensation for keeping people well, not just treatments….
    People must be incentivised for making healthy choices about diet, exercise and lifestyles and punished when they make poor choices…..
    Employers must be taken out of the system….They bring nothing to the party.
    Tax laws must be changed to allow individuals and families to take care of their basic necessities of life with tax free dollars.
    A tall order, but one that is do-able….remember, no one can eat an elephant in one bit, but we can all eat an elephant…one bite at a time!

  3. Mark said

    If we can get past all the ranting and deal with issues that may actually become part of a signed bill I’d like to see a substantive change in the “fine” for those who choose not to purchase coverage. The amount of the fine in not an incentive to purchase coverage. The fine should be equal to an available program so facilities aren’t hung out to dry like they currently are and the rest of us have to pick-up the tab.

    In other words if you don’t choose a plan one will be chosen for you and you will pay for it.

    • I agree – we have to keep people from gaming the system because you know that many will. If the fine is too smaller than the cost of insuranc, then why not pay that until you need the insurance itself. I think folks will probably try this method as they have in Massachusetts.

    • Dale said

      Why do we have to be fined if we don’t feel the need to purchase health insurance? Has everyone forgotten that we can still pay in cash if we choose? Believe it or not, for some people that’s the cheapest option. Allowing the government to force us to purchase insurance seems unnecessary. I would love for someone to explain to me why a fine is even a consideration. What is the purpose of the fine? Who does the fine benefit? If it’s a pool of money you’re looking for, then you should be talking to the people who choose to participate. Not forcing others to join. If your insurance company isn’t getting enough business, it should fail. That’s capitalism. Some businesses thrive and others fail. There is a reason for that. It’s so businesses that can provide what the people want can take the place of the businesses that are no longer providing. And for real?! Not purchasing insurance and paying cash is gaming the system?! Is that what you’re saying? I pay more than you, and I’m not even complaining about it! So who is picking up what tab? You’re not picking up my tab. I’m not burdening you with my bill. I don’t cost you anything. It seems to me that if you force me to get health insurance I’ll be picking up your tab. Don’t get too greedy now. I don’t purchase health insurance because I pay in more than I need to take out. How am I hurting you? Other than not giving the company more money to distribute to other people? If it doesn’t benefit me, what’s the incentive? Health care costs money. It always has and always will. Why is that so surprising? I pay cash. It’s the cheapest option for me. Please, explain. Maybe somehow I just don’t understand how this all works. I just don’t see how paying for health care without insurance is hurting you or anyone else for that matter. If I’m doing anything wrong it’s hurting me, not you. And if you want to talk about picking up the tab, look into what medicare and medicaid pay the doctors compared to private insurance and the uninsured. As far as I can tell, that’s the tab that’s being picked up. It’s not the uninsured, it’s the government insurance plans that make private insurance as well as not having insurance cost more. You aren’t paying my medical bills. Why should I be forced to pay yours? I thought I was living in America.

      • Dale….This is why each of us must have insurance…
        We live in a Republic….a form of government where individuals elect representatives to speak for them. Do not confuse our political system with our economic system which is a regulated form of Capitalism…
        The Representatives (Senators and Congressmen) have mandated that Hospitals, for example, MUST NOT TURN ANYONE AWAY, regardless of ability to pay…..They MUST provide services to anyone in need.
        Someone has to pay for this…..and since Congress has decided the Government will not, these bills have to be paid by those who use the services.
        The legislature has ruled, therefore, that a Hospital is allowed to SHIFT the bills created by people who can not pay to those that can pay…

        You say that you should not be forced to pay for health insurance because you do not need it. You pay cash.
        In your basic argument, what you are doing is confusing HEALTH CARE with HEALTH INSURANCE….
        You are very correct….it should not be forced upon you to buy insurance for your normal and routine HEALTH CARE…..Each citizen has a social responsibility to take care of themselves so they are not a burden on society…..and what most of us do not realize is that the lifestyle choices we make have an immense impact on the quality of our life and the costs we incur….Health lifestyles…that is, a balanced diet coupled with regular exercise and regular sleep will allow an individual to spend 1/2 as much on their health care than a person who does not make healthy lifestyle choices…
        The reason YOU MUST buy insurance is for the CATASTROPHIC LOSS…the serious injury or illness that you can not afford to pay for by yourself…..Every year, the majority of bankruptcies in the US are directly or indirectly caused by medical bills that can not be paid, so individuals file for bankruptcy, then “society” will pay their bill in the form of higher costs for the goods and services they purchase.
        What you should be advocating is a system where individuals pay for their routine health care on their own, but “pool” their risk for catastrophic losses.
        There is such a program… It is called an HSA…A health savings agreement…
        It has special tax qualifications that allow the “insured” to decide how much they can afford to pay….they are allowed to spend “tax free” dollars for this amount and, once this amount has been paid, the “insurance” steps in and will pay the remainder of the bill.
        If you do not want to be forced to buy any insurance, then you should elect new Representatives. So long as we mandate hospitals and doctors must be forced to provide “everyone” service, then “everyone” must be forced to pay….

  4. Anti-Objectivist said

    Dean is being attacked really because he is “impractical” because “politics is the art of the possible”, that the insurance mafia and the drug companies own Congress and that this is a natural way of things and that they should be expected to be showered with goodies at everyone else’s expense as a price for any reform. This is ultra-corruption of the worst kind. It’s also clear that Obama and Emanuel and the rest of that triangulationist mob has decided long in advance that this corruption shall continue and nothing will be done to fight it in any way. In truth, Dean and many others admit to the fact that they’d have to make deals with the insurance and drug rackets, understanding the reality of America’s ultra-corruption, but the deal cut is so lopsided that it’s no longer a case of “the perfect being the enemy of the good” if they stop supporting it… the result is rubbish. The Obama administration has made no efforts to produce a better result. They are total sell-outs of the worst kind and Emanuel is a traitor to his own party. He after all helped get the Contract on America mob into power with his NAFTA work in 1993.

    • Allen H. said

      Bitter much? I guess when you voted for Obama, you were naiive enough to actually believed in his slogan “Change you can believe in.” Its a tough pill to swallow that he is a politician, just like all the rest.
      Lastly, you state that he is a “traitor to his own party.” Hate to break the news to you, but the Dem party is not solely made up of ultra left/progressives like yourself.

      Alan, as usual, great post.

    • Rick said

      I monitor to this site for health care information not some Hugo Chavez rant.

      • James S. Thornton said

        I don’t think you can fairly characterize this as a Hugo Chavez rant.

        Allen continues to be the voice of reason here, and I must say it is such a relief to hear something sane in the roar of all that is going on.

        To me, there is no question that money talks in this country, and that the more of it an institution has, the more it will get its way.

        The idea of some reasonable shared sacrifice seems to have long ago been thrown out the window. There are millions of truly miserable, unemployed folks in our country today, suffering severe anxiety and depression reactions, “their whole happy go lucky selves gone” as one woman put in the New York Times early this week.

        On the other hand, you have a smaller handful of exorbitantly reimbursed people, from the CEOs of healthcare chains and insure companies, to the Goldman Sachs manipulators of financial “instruments” that are often not what they seem, to a mercenary army fighting “our” wars for us so that the defense industry can profiteer on weapons systems that many in the Pentagon themselves do not even want.

        Money, money, lobbying for tax advantages and write offs and changes in the fine print to some subtle contract language, and on and on and on it goes, these back room strategies by the wise guys with their genius for sweeping more and more luchre out of the pockets of the not-so-smart and the not-so-lucky and the not-so-well-connected.

        Predatory loan practices that make usury laws of the Bible seem like ridiculous. Recision of policies when a paid informant can track down a high school classmate who remembers, “Oh, yes, I did see George smoke a cigarette in seventh grade!”

        We need to treat each other better. The ideology on all sides is so blindingly out of whack that it seems hopeless. Not a time for abortion–that could be the battle line drawn that keeps 56.6 million uninsured Americans out of the system? Killing fetuses is so horrible that it better by far that children and adults of all ages should die instead?

        Why won’t anybody on the right even consider negotiating?

        So cruel. so petty. tribes that hate each other, it’s descended to that.

        Winners will live in their gated communities, earning the admiration of wannabes and dullards who cannot understand they will never reach this status.

        The rest of us will be played by different rules that are patently one sided and unfair. The system is sick to its heart, and the reason is that greed has a cherry that every one of these bastards wants for himself.

        • Rick said

          The proof of a Hugo Chavez rant is in the name Anti-Objectivist.

          Then these choice words: “The insurance mafia” “Insurance & drug rackets” “Understanding the reality of America’s ultra-corruption”

  5. Anti-Objectivist said

    Howard Dean was a Vermont governor whose record was such that he made a White House run, and he also ran the DNC and was the architect of the 2006 victory in Congress. That is more than nothing. I know that the so-called liberal media chose to credit that bungling Rahm Emanuel and his stable of pro-war prospective Blue Dogs whom he parachuted into districts in opposition to the grassroot-supported candidates, and almost all of his hand-picked candidates lost – that his gambit was a miserable failure didn’t stop him from being lionised as the architect of victory.

    As for Obama, who benefited by the way most handsomely from the 50-state strategy of Dean’s (remember Hillary complaining that she won more blue states and thus deserved to be nominated, whilst Obama won in red states) he chose Emanuel and his bungling at the beginning and so predictably the ship Obama is headed to the bottom of the ocean.

    Some people seem to think that every time change is needed and a law must be created, that the most powerful in society have the right to a pound of flesh extra for each change made. This is the logic employed here. This is typical for an ultra-corrupt society that the United States is, the most corrupt in the world, where bribery is lionised as free speech in order that the maxim “those who own the country ought to run it” is adhered to.

    • Allen H. said

      AntiObj- I enjoy your political rants!
      For whatever reason, you thought Obama was an ultra liberal, when in fact he is a left-leaning moderate.
      You thought with Dems running the show, a progressive agenda would be a cinch. Problem is, most Americans are not progressive, and Dems are not as adept at getting things done in Washington as Reps are.
      Sure, lobbyist and special interest groups (both left and right) run the show in Washington. (no cadillac tax, no tort reform, Pharma deals, etc). This makes policy making far, far from ideal. Corrupt, sure, a little. But I assure you, most other governments around the world are far worse.
      Lastly, if Obama get HCR passed, although far from perfect, it will be a tremendous legistative achievement.

  6. Alan said

    A brief explanation for younger readers concerning the “Howard Dean is no Ted Kennedy” line. My hope was to echo a famous exchange from the 1988 Vice Presidential debate between Republican Senator Dan Quayle and Democratic Senator Lloyd Bentsen. Senator Quayle was 41 at the time and, to be kind, had a somewhat thin resume. During the debate, in an attempt to bolster his qualifications to be one heartbeat away from the presidency, he invoked the name and Congressional tenure of Senator John Kennedy circa 1960 who, at 43, was to become the youngest person elected to the presidency. I forget how many times Senator Quayle brought up Presidetn Kennedy, but it eventually was one time too many for Senator Bentsen (age 67) had enough. Turning to his opponent he said, “Senator, I served with Jack Kennedy, I knew Jack Kennedy, Jack Kennedy was a friend of mine. Senator, you’re no Jack Kennedy.” For those watching at the time it was one of the most dramati political moments of all time.

    Listening to Governor Dean attack heatlh care reform for failing to meet his litmus test for reform forcefully reminded me of the differnce between politicians and statesmen. You may disagree with Senator Kennedy’s political views, but he is widely considered to be an extremely effective lawmaker even by his opponents. Governor Dean is not. Hence this post.

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