Of all of the candodates.
His fiscal conservatism is merely political code for corporate whore.
Thats the deal behind Deans Health care plan, and why he doe not want to make significant changes to the Health Care industry.
Deans economic ideas are the kind that favor a small number of individuals, at the expense of the greater good.
The most striking example of this was his supposed health care initiaitive in Vermont which was designed to use what non-ideologue economists call political mathematics. Dean never designed, or called for a design of a structured health care system in Vermont in order to cover as many people as possible. Essentially, he used federal medicaid exemptions to take what was supposed to be unspent funds from federal money provided for areas outside of health care, such as building roads and such. Dean underfunded these projects, and then used the exemptions to move the fund into the medicaid program. But Deand had the medicaid program set up to get small copayments from a lot of people for a a lot of differnt medical services, at the same time, Dena kept on reducing the rate at which doctors and hospirals were reinmbursed. Doctors and hospirals were bearely paid enough to provide the services, and patients had various small copayments for various services....
Here is where the political calculus comes in, as with programs like medicare and medicaid, a third party comes in. Since the Government is not set up for handling things like medical insurance claims, this service is contracted out to the private sector, invariably, one of the large Health Care providers, like Blue Cross. Here is the political calculus. A large number of relatively poor people are charged a few dollars for a doctors visit, the hospital is paid a very small sum for the diagnostic services it performs. all medical sewvice providers are paid a very small sum, compared to what they woiuld recieve from private insurance given by an employer.
The company hired to do the administrative wirk decides what services and charges are acceptable, and pay those who provided the medical services a small amount for allowable charges, and disallow others and so on. The company administereing the claims makes payments to doctors, and hospitals and so on, and telles the patient what they can expect to be billed for their share, and then this corporation doing the administrative work, gets the lions share of the state fubnds allocated to health care for their administrative services.
By 2002, A bipartisan commission mandated by Dean, comprised of people appointed by him found that the health care system was in complete chaos, and more money was going into the health system than all other government services put together, yet there had not been a significant increase in the number of people who had health insurance.
Large sums of money were being spent on those administrative services utilized to manage the insurance claims:
Governor's Bipartisan Commission
On Health Care Availability & Affordability
Final Report
I. Authority, Scope
A. On January 24, 2001, Governor Howard Dean issued an executive order establishing a Special Governor's Bipartisan Commission on Health Care Availability and Affordability...
B. Based on what we have learned, we do agree on this: Health care in Vermont is near a state of crisis -- some of us would say it is already in crisis -- and all health care sectors are on edge. We also note that many of these problems are national or even global in scope and that our abilities to solve them at the state level are limited.
C. Health care costs in Vermont, now exceeding $2 billion a year, are of a sufficient magnitude, however, and are increasing at a sufficient rate to place state government itself in jeopardy, including every program for which it appropriates money. By comparison, Vermonters budgeted $1.8 billion for all state government services in FY 2001 (not including federal funds).
We are rapidly approaching the point at which these costs will directly conflict with our ability to do such things as to maintain roads and bridges, for example, or to provide cost-effective services to our infants and children, to promote agriculture and tourism, or to provide any other services our citizens have come to expect.
D. We do not have a health care system in Vermont.4 That means:
1. No one is in control.
2. No one is responsible for ensuring that high-quality medical care is adequate for the needs of the public.
3. No one ensures that medical charges are appropriate or that they are paid in full.5
4. There is a "disconnect" between the consumer receiving health care and the entity paying the bill. Consumers are shielded from the cost of the service.
5. There is no global budgeting or targeted growth planning for health care in Vermont.
6. There is little in the way of public accountability for the performance of health care institutions, or for their long-term planning.
7. Although administrative costs, including those associated with government paperwork burdens, have reached an unacceptable level, no one has been able to do anything about it.
http://216.239.37.100/search?q=cache:aC9QzqwOEmkJ:www.state.vt.us/health/commission/docs/report/mainreport.doc+%22Howard+Dean%22+%22Incentive+Plan+for+Medicaid%22&hl=en&ie=UTF-8It is one of the most amaizing cases I have ever seen of special interests being given great preference over the common good.
Disguising it as a program designed to assist the poor was rather audacious. The claims of services provided almost outrageous.
It was sort of like taking ten dollars from 25 million people in order to start a program that gave 1000 dollars to 100 thousand people. No matter what, you still end up 150 million dollars in the red. It is simple math.
The beauty of schemes like this is that there is no big public outrage about taking such small sums from individuals even though the sums involved are enormous, and no one but the doctors complain about the pittance they received for their services but the doctors, and as the latest arguments that doctors are making about how blood sucking trial attorneys are sending thm to the poor house fall on deaf ears. No one will listen to doctors poormouthing themselves.
So the real winners are the insurance companies that administer claims, deny treatment, charge individuals an extra dollar here or there, cut doctors and hospitals reimbursements by ten dollars here and there, and the health insurance companies keep what remains as a stipulated by the contract with the states.
This is why Dean is so vehemently opposed to single payer plans, why his universal health plan relies almost totally on the private sector, and why he wants each state to handle universal health, exactly the same way, by contracting with a large health insurer to manage the claims, and decide which charges are allowed, disallowed, and how how much is reimbursed to doctors, and howe much patients pick up afterwards.
Interesting, and completely in line with the practice of the politics of supporting speacial interest groups. Relatively small sums of money are diverted from a very large group of people, in order to turn the total of these small sums to a very small group as very large sums...