Howard Dean and the Goal Posts - His healthcare plan in 2004 was worse than the current bill.

[jefferson_dem]

From August 14 column by Ezra Klein -

Howard Dean and the Goal Posts

It was about five years ago now that Howard Dean was peaking in his campaign for the presidency. Dean's campaign is best known for the prescient foreign-policy progressivism -- or maybe it was common sense? -- and the refreshingly proud tone adopted by the candidate. But that was all an accident. Originally, Dean's campaign was about health care. Dean's claim to national relevance was having achieved near-universal coverage in Vermont, and, as a doctor and successful governor, he figured he had the credibility to advance the cause on a larger stage.

Re-reading Dean's plan is useful to anyone looking for a bit of perspective on the national debate. The Vermonter was, of course, one of the more liberal candidates in the race, and the most oriented toward health care. But there was no public plan in his proposal. There wasn't even a co-op. Dean's plan would have insured millions fewer people than the bills being considered in the House or the bill that we think we'll see out of the Senate. As I read the policy -- and it's possible there's a more detailed summary than the one I've dug up -- it didn't even include insurance market reforms like banning discrimination based on preexisting conditions or outlawing rescission.

For all that, it was a good and well-meaning plan. But it was a lot worse than what we're considering now. It was a lot worse even than the compromises we're considering now.

There are reasons for that. It was a less progressive moment. Democrats had fewer votes and a more constrained sense of the possible. There wasn't a candidate like the 2008 version of John Edwards, or an institution like Andy Stern's SEIU, that was forcing the Democratic field to the left. (Gephardt was the closest, but his plan was far worse than what Edwards offered.)

But it was considered, at the time, a good plan, and it was. It addressed the core issue in health-care reform: that so many people lack health-care insurance and so have to live in fear. It also had some virtues of its own, particularly in the way it reimagined and expanded the Children's Health Insurance Program. The heart of this is now, and has always been, providing coverage to the people who wait in line for hours because they can't afford relief for a rotten tooth, or because they haven't had a mammogram in years. Dean's plan did that, and the plans on the table today do even more of it.

<SNIP>

http://voices.washingtonpost.com/ezra-klein/2009/08/howard_dean_and_the_goalposts.html

[HiFructosePronSyrup]

1. So like Lieberman who was for Medicare expansion before he was against it.

What's Dean gunning for? Some cable news position?

[TwilightGardener]

2. That's interesting, if true. Funny how standards change.

[jefferson_dem]

3. His plan - no public option, no co-opts, no market controls such as protection from denial...

based on pre-existing conditions. Now he wants to lecture the Administration, Congress, and all of us, on what "reform" should look like.

Funny. Indeed.

[Laelth]

40. No individual mandate?

That makes a big difference, you know. I suspect Dean's plan didn't enrich the evil health insurance cabal.

:dem:

-Laelth

[Tom Rinaldo]

8. Standards can change when circumstances do

"Don't Ask Don't Tell", while clearly always a modest compromise, was seen as a small step forward for gay rights by most in 1992, now it is seen a a major barrier to them.

In 2004 neither Dean nor any other Democrat had reason to believe that a Democrat could defeat a war time President while Democrats simultaneously rolled up commanding majorities in both houses for him or her to govern with. That was then, this is now.

[jefferson_dem]

11. But doesn't this lend credibility to the "don't let the perfect be the enemy of the good" argument?

Since the current "reforms" are bolder than what Dean was proposing. We should take what we can get and continue to work hard to improve.

[Tom Rinaldo]

16. There is also the "don't let the so-so be the enemy of the good argument"

Using reconcilliation for the government role aspects, and the standard route for private industry regularion, the type of "good" compromise that Lieberman is trying to kill is attainable now, even if "the perfect" (single payer) still isn't.

[jefferson_dem]

19. I hear you.

We both wouuld be jumping for joy if they used reconciliation. Sadly, I don't see that happening so we have to deal with reality.

[Name removed]

4. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[Armstead]

5. People are allowed to evolve and change their mionds based on changing circumstances

Much was different five years ago.

His desires now are hardly radical either. He was with the Democfratic plan even as it was being watered down.

So his coming out against it now says more about the current proposal than it does about dean.

[uponit7771]

12. What has practically changed in regards to HC from five years ago? TIA

[blm]

Practically speaking? The number of Dem votes in Senate and Congress.

Back in 2003, ANY proposal submitted by a Dem candidate for president who truly PLANNED on being in the Oval Office would have factored in the likelihood of having a majority of votes to pass in 2005.

There is a huge difference in what a Dem WH could do in 2009 and what could be passed in 2005.

[Armstead]

29. Much higher rates, more angry policyholders, Democratic majority, etc.

[Clio the Leo]

20. lol, is the President? NT

[atreides1]

6. But was there a mandate

That forces people to purchase private insurance in Dean's plan?

[Larkspur]

9. Need mandate to make it universal and so people don't game the system

but the mandate to buy insurance was to be matched with increased choices for people so that premiums will stay affordable. That competition part will effectively die with the removal of the public option and Medicare buy-in.

[quiller4]

36. Yes. There was a mandate just as there is a mandate in the Vermont state plan.

[dsc]

38. false on both counts

there wasn't then, nor is there now, a mandate to buy insurance in Vermont (only MA and HI have such mandates). There also wasn't a mandate in Dean's plan in 2004.

[Larkspur]

7. Dean also told Countdown that Congress can pass the few good parts of the bill

via seperate legislation and could possibily pass the Medicare buy-in via reconciliation since it deals with the budget.

[Armstead]

10. Shhhhhhh....No thinking allowed.

[Cha]

14. Yes, thinking is quite allowed..I welcome it.

Instead of the kneejerk shit that's going on around here.

[jefferson_dem]

13. So the good parts of this bill are still better than the best parts of Dean's.

I think Dean has realized he's jumped the shark with this one, and predict he will be walking back his "kill the bill" nonsense very soon.

[Clio the Leo]

22. And how long will that take?

And why does he suddenly no longer care about the 2010 mid term elections?

[Cha]

30. So what's with all the "Kill The Bill"? That's not

killing it.

[harun]

15. It aint 2004.

[Kdillard]

17. Pretty remarkable. Thanks K and R.

[Sebastian Doyle]

18. 6 reccomendations on a Dean bashing post?

Guess that settles the question about who the cheerleaders work for, once and for all. The traitorous little bastard with the pathological hatred of the ONLY Leader this party has had in decades.

Message Discipline LLC has made a joke of GD:P

[jefferson_dem]

21. Wow.

Dr. Dean? Is that you? :shrug:

[BeyondGeography]

23. T'weren't for Dean, there's be no party

(Get over yourself.)

[Clio the Leo]

24. lol, some leaders are worthy of hero worship and some aren't?

The notion that any opposition to the President was based sound logic and rational thinking (as opposed to those supporting him being mere idolatrous fans) never held any water.

[Cha]

25. I see it as facts being brought to light and you think it's bashing?

Nobody's perfect..not Dean not president Obama..nobody.

[CBR]

35. Who do people work for? The DEMOCRATIC president -- Barack

Obama? I like them both. Good grief. I love double standards -- bash Obama -- fine "dissent is patriotic" rah rah rah, bash Dean -- horrible traitor!!!!!

[Zodiak]

26. Nice try, Ezra

Boy, spending a lot of time trying to slam critics lately eh?

Here is Howard Dean's plan ca. 2004 in his own words, from the citation in Ezra's article

"First, and most important, in order to extend health coverage to every uninsured child and young adult up to age 25, we'll redefine and expand two essential federal and state programs -- Medicaid and the State Children's Health Insurance Program. Right now, they only offer coverage to children from lower-income families. Under my plan, we cover all kids and young adults up to age 25 -- middle income as well as lower income. This aspect of my plan will give 11.5 million more kids and young adults access to the healthcare they need.

Second, we'll give a leg up to working families struggling to afford health insurance. Adults earning up to 185% of the poverty level -- $16,613 -- will be eligible for coverage through the already existing Children Health Insurance Program. By doing this, an additional 11.8 million people will have access to the care they need.

Many working families have incomes that put them beyond the help offered by government programs. But this doesn't mean they have viable options for healthcare. We'll establish an affordable health insurance plan people can buy into, providing coverage nearly identical to what members of Congress and federal employees receive.

To cushion the costs, we'll also offer a significant tax credit to those with high premium costs. By offering this help, another 5.5 million adults will have access to care.

Third, we need to recognize that one key to a healthy America is making healthcare affordable to small businesses.We shouldn't turn our back on the employer-based system we have now, but neither should we simply throw money at it. We need to modernize the system so employers will have an option beyond passing rising costs on to workers or bailing out of the system entirely. Fortunately, we have a model of efficient, affordable and user-friendly healthcare coverage: the federal employee health system.

With the plan I've put forth to the American people, we'll organize a system nearly identical to the one federal workers and members of Congress enjoy. And we'll enable all employers with less than 50 workers to join it at rates lower than are currently available to these companies -- provided they insure their work force. I'll also offer employers a deal: The federal government will pick up 70% of COBRA premiums for employees transitioning out of their jobs, but we'll expect employers to pay the cost of extending coverage for an additional two months. These two months are often the difference between workers finding the health coverage they need, or joining the ranks of the uninsured.

Finally, to ensure that the maximum number of American men, women and children have access to healthcare, we must address corporate responsibility. There are many corporations that could provide healthcare to their employees but choose not to. The final element of this plan is a clear, strong message to corporate America that providing health coverage is fundamental to being a good corporate citizen. I look at business tax deductions as part of a compact between American taxpayers and corporate America. We give businesses certain benefits, and expect them to live up to certain responsibilities."

So...to sum up

FREE healthcare for children
FREE healthcare for those under 25
FREE healthcare to 185% of poverty
Public insurance exchange for the rest of us
Tax credits to help with premium costs
70% of COBRA paid
Using tax incentives to regulate the health insurance industry


So yeah, Dean's plan was different, but to say it totally sucked is wrong. I see no MANDATE to private corporations in there at all, and no fines or jail time. This was a radical plan in 2004, and the cost was only 66 billion.....not the 900 billion giveaway to the health industry it is now.

Ezra Klein is really pulling out the stops here, but in neglecting to tell you exactly what Dean was proposing, he is free to spin what he likes. This plan Dean proposed is better than the current plan in some ways, worse in others.

So a couple of days ago, Klein does a hit-piece on Taibbi, and now one on Dean. Ezra Klein sure is shilling lately, is he not?

[PassingFair]

28. +1

:applause:

[ima_sinnic]

37. +++1 that needs an OP all of its own

and good point about Ezra Klein. He can go fuck himself.

[sandnsea]

45. I hope so. Show people what a fool Dean really is

And people who can't interpret what the man said. If you interpret Dean's proposal accurately, not the way that poster did, then you quickly discover it IS NOT as good as what is being proposed now.

[dana_b]

41. great post

they will do all they can to shut up someone who spoke up - spoke the truth.

[Blasphemer]

43. Thanks for this. Klein is clearly working someone's agenda... nt

[sandnsea]

44. You have a whacko interpretation of what the man said

First of all, the current bill extends coverage up to age 26 on the parent's plan, so if the parents have CHIP, tuhduh, so will the kids. Same as Dean's #1.

Second, the current bill extends Medicaid to everybody up to 150% of poverty, not just young adults.

Third, the affordable health insurance plan, like federal employees have, is the EXCHANGE. NOT a free public health plan. It's Health Insurance - with a fucking subsidy.

There's NO free insurance for kids, many SCHIP programs have a premium. NO Free health care for adults under 25 and no public insurance AT ALL.

[PassingFair]

27. How much have insurance premiums increased since 2004?

How many more unemployed people are there now, compared to 2004?

How much have hospitalization costs gone up since 2004?

How many people are losing employer-sponsored health care now?






The crisis has intensified beyond recognition since 2004.

[dflprincess]

33. You know how Obama used to support single payer - but now we're told his position has "evolved"?

(I'd say devolved in this case)

Perhaps Dr. Dean's position has actually evolved because, as you point out, things are getting worse fast.

[Cha]

31. Not sure how we could get another

bill on the table if the Dems are going to lose like predicted all over the place?

[jefferson_dem]

32. Kick.

:kick:

:)

[SpartanDem]

34. It's not only better than Dean's plan, it is better than Clintons too

[Laelth]

39. Did it contain an individual mandate? I doubt it.

That fact alone makes Dean's plan far superior to the one we're considering now.

:dem:

-Laelth

[BklnDem75]

42. Did Obama's before it hit Congress?

Welcome to reality.

[Laelth]

46. Admittedly, Obama "changed his mind."

He ran this ad against Hillary last year:



But the fact that Obama "changed his mind" and betrayed his supporters does not prove that Howard Dean would have done the same.

:dem:

-Laelth

[BklnDem75]

48. You call it changing his mind

I call it working with the hand he's dealt. Betrayal? Perhaps you should wait until Obama actually signs something before you unleash that can of crazy, don't you think?

[Laelth]

49. If I am lucky, he will veto the bill that hits his desk.

Here is what he said:

Obama said, "That’s why any plan I sign must include an insurance exchange — a one-stop shopping marketplace where you can compare the benefits, costs and track records of a variety of plans, including a public option to increase competition and keep insurance companies honest, and choose what’s best for your family."

At this point, it seems likely that the bill that Congress produces will not have a public option. If it doesn't, will he veto it?

Or is he a triangulating, closet Republican like Clinton? Is he more interested in just passing any bill so that he can claim victory, or is he actually interested in passing legislation that actually benefits the American people more than it hurts them?

We'll find out soon enough.

:dem:

-Laelth

[BklnDem75]

50. Until then, let's all panic!

Some base, huh?

[Laelth]

51. Once the bill is signed, there will be nothing we can do.

We have to make noise now to shape the debate and prevent disaster. Complaining after the fact is truly useless. Speaking out now is the height of patriotism.

:dem:

-Laelth

[BklnDem75]

52. How's that working out so far?

There's nothing more patriotic than yelling out towards his base how he's betraying us before he actually betrays us. It's the height of patriotism... on another planet. There's a huge difference between energizing and demoralizing.

[Laelth]

55. I hope he'll listen and alter course. We'll see.

But I am compelled to speak out. I don't really have much choice. It's an ethical thing.

:dem:

-Laelth

[brentspeak]

53. Yes, let's wait until he signs the mandate into law.

Until then, let's shut up and allow him to put pen to paper. Then we should let him know how we feel about it...

[BklnDem75]

54. Or better yet

Wait to see the bill that appears on his desk! No no! That's too... how do you say... sensible?

[grantcart]

47. This is like watching one of those terrible MTP episodes when comments taken out of

context are put up on a pedastal and the moderator yells "Gotcha".



I would be interested to know what exactly the composition of the US Congress was on the date that Dr. Dean put forth his proposal.


I think that reasonable people would agree that you would put one type of plan up when you controlled both houses and another when you controlled nothing but were running for office in a primary.