The Truth about Dean's Health Care Program

[Maddy McCall]

Howard Dean often cites free health care in Vermont as his grandest achievement. However, during his administration, Vermont had the the third highest percentage of Medicaid recipients in the United States. Is Dean taking credit for something the federal government was providing anyway? Was his "achievement" funded by taxpayers across the United States?

http://www.boston.com/news/politics/president/dean/articles/2004/01/14/gov_dean_aimed_to_avoid_conflict/


On the campaign trail, Dean boasts that 99 percent of Vermont's children are eligible for health insurance and that 96 percent of children have it, and that 90 percent of adults are insured. It is an impressive record by any measure; no state has a smaller percentage of uninsured children. (Rhode Island is tied with an uninsured rate for children of 4 percent.) By comparison, Texas, where Bush was governor until 2000, has 22 percent of its children uninsured, the nation's highest rate, according to a study by the Henry J. Kaiser Family Foundation, a nonpartisan health care analysis group.

Vermont's strong record in children's health care was achieved through overwhelming reliance on Medicaid, the federal-state program to provide health care to the poor. "Damn right," Dean said in an interview with the Globe last week. "That was pretty smart, not to have to put a big hole in the budget to insure everybody. That was the Medicaid program, and we figured out how to use it."

Critics say Dean expanded the Medicaid program without sufficient foresight. Governor James Douglas, a Republican who served as state treasurer from 1995 to his election in 2002, said in an interview last week, "We maintained a balanced budget, but now I am seeing the consequence of that balance. . . . We have a Medicaid program -- just heard from someone on our senior staff today -- that will be in a hole five fiscal years from now to the tune of about $200 million because it is on a projectory of costs that is just not sustainable."

Dean says the answer lies in not cutting people from the rolls but in reducing the number of benefits the method he employed during his tenure. In 1993, for example, Dean proposed cutting $1.2 million in Medicaid, which affected dental coverage as well eye care benefits for some elderly residents. Following protests and a lawsuit by Vermont Legal Aid, Dean dropped most of the cutbacks.

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I would like to know more about this issue and would appreciate DUers providing me links to more sources of information (no campaign propaganda, please :-) ) that offer OBJECTIVE critiques of the health care plan in Vermont.

[blm]

1. Didn't Kerry say in a debate that Vermont benefitted from FEDERAL programs

some of which he crafted with Kennedy? Like CHIPS bill?

[Maddy McCall]

3. I believe that's correct.

The CHIPS program has covered almost all children here in Mississippi, and would cover more if parents would just go apply for it.

That is a program that emanated from Washington, not from Vermont.

[Maddy McCall]

2. Waiting...anybody know enough about this to respond?

Guess the article is correct, then, and Dean funded Vermont's health care system with federal dollars and future endebtedness.

Doesn't sound too "model" to me. :shrug:

[Cuban_Liberal]

4. I can respond, to a degree.

The 'analysis' is incomplete. What it fails to mention is the deliberate under-funding of certain Medicaid programs by the Bush administration through their 'block grants' ruse. They increase the overall AMOUNT of the block grant every year, but the increase doesn't cover the actual anticipated growth of the cost of coverage provided.

This article, in essence, only tells half of the story. Dr. Dean should not be held accountable for deliberate underfunding of programs by Congress and the Bush administration, IMO.

Edit: typos

[Maddy McCall]

5. How long during the Dean administration was Bush in office?

My question is whether or not it is true that Vermont's health care program is funded federally, not merely by state-only funds.

My understanding is that TANF is dispersed in the form of block grants, but Medicaid is federally funded and people qualify according to federal criteria. Governors do have discretion in co-pays and deleting certain services from coverage, though.

[Cuban_Liberal]

6. I was just pointing out the 'why' part of the '$200 million hole'

I'm not sure about how to answer your other questions, frankly, but was merely pointing out how the future budget 'hole' the new governor mentions is going to occur, which isn't as a result of any action by Dr. Dean. :)

[Democrats unite]

9. She was asking about the past.

Sorry can't blame bush for this one.

[Cuban_Liberal]

11. If she was, I misunderstood the question.

In any event, the relevat statement still stands; it is Bush, and not Dr. dean, who will be responsible for the budgetary shortfall the new governor referenced.

[Democrats unite]

15. It is relevant it happened under Dean...

you can't spin that. not even with a maytag!

[Cuban_Liberal]

16. What are you even talking about?

You've completely lost me. :wtf:

This is what I wrote:

"The 'analysis' is incomplete. What it fails to mention is the deliberate under-funding of certain Medicaid programs by the Bush administration through their 'block grants' ruse. They increase the overall AMOUNT of the block grant every year, but the increase doesn't cover the actual anticipated growth of the cost of coverage provided.

This article, in essence, only tells half of the story. Dr. Dean should not be held accountable for deliberate underfunding of programs by Congress and the Bush administration, IMO."

[TreasonousBastard]

7. Look at this another way.

Granted Vermont couldn't possibly have afforded to fund any sort of health care on its own, it's not so much where they got the money from, but how effectively they got it and used it.

What was Dean's input on this whole thing? Did he spearhead healthcare, or did someone else find the money and he went along for the ride?

How good was the care provided? Was the money spent efficiently? Did the Doctor put health first and politics and budget later, to whatever limited extent possible?

These are not rhetorical or bashing questions, and I would hope the answers are positive. It gives an idea how he would consider healthcare as President.

[msanger]

8. why haven't other states done this?

It seems like 99% of children having health insurance is a good thing. If there was a federal program that provided it -- well I thought that was part of why we have a federal government.

It seems the question is why New Hampshire, or Colorado, or New York or Alabama or most other states didn't do the same thing?

I assume if a lot of other states were doing this, the "anti-dean" folks would have brought that up a long time ago.

[Maddy McCall]

12. Because you would have to cut services to people who are

already on Medicaid, those far beyond the poverty line. Services such as eye care and dental care.

Cutting some benefits to the poorest people to provide some benefits to all isn't really an improvement in a state's health care. It's just spreading the peanut butter really thin so that you can make more sandwiches.

The other alternative is to use funds from other programs to fund health care, or spending money that isn't there and ending up with a huge deficit.

[Frederic Bastiat]

10. As a Clark supporter I see nothing wrong with this

Dean says the answer lies in not cutting people from the rolls but in reducing the number of benefits the method he employed during his tenure. In 1993, for example, Dean proposed cutting $1.2 million in Medicaid, which affected dental coverage as well eye care benefits for some elderly residents. Following protests and a lawsuit by Vermont Legal Aid, Dean dropped most of the cutbacks.


I live in Canada and I have an idea of how healthcare costs are spiraling out of control. If you want healthcare coverage for everybody you have to cut some of the benefits for some. The Canadian system for example does not cover prescription drugs, dental, eyecare etc and is already consuming the biggest chunk of the governments revenues at both the federal and provincial level.

As populations get older the bigger the burden is on our respective healthcare systems. At some point it becomes a question of how much one is willing to spend on healthcare at the expense of other social programs.

[Maddy McCall]

13. I do have a problem with cutting services to people who can't

afford health care to provide services to people who can.

For a person who is living below the federal poverty line, a dentist visit costs more than a months worth of groceries or more than that person might make in a month.

For people who can afford health care, they don't see it as a big deal. A $200 dental visit is something they can afford.

On Medicaid in most states, women receive birth control pills for free. Would that be something that should be cut?

[Frederic Bastiat]

17. I have a problem with that too

Question is, do we discuss healthcare from a moral POV or from a fiscal one?

In Canada it's a moral issue, so we are mentally prepared to foot the bill and as you probably know the ever mounting bill for healthcare has been exacting a toll on other sectors such as the military (on a federal level) and public infrastructure, education and social programs (provincial level).

If I had to balance the budget as Dean probably had to do then I would have to address the issue from a fiscal POV.

[Maddy McCall]

19. Absolutely from a fiscal point of view...

as has been proved in other states, if poor people don't have access to services that are needed--let's say dental, then problems can mushroom and become very expensive health issues.

That's fiscal, not moral.

[flaminbats]

14. If propaganda is what you give, then that is all you deserve!

:puffpiece:

[Maddy McCall]

18. Thank you for your brilliant contribution to this discussion.

Do you have anything substantive to add? Do you know anything at all about this issue?

[Gin]

20. I favor health care for all....but we cannot afford to pay for everything.

Basic care should be provided...those who can afford better..great..go for it...those with no coverage at least would get basic coverage..The question is...what defines basic?

These are tough decisions that Governors have to make.