Howard Dean: ‘We [Should'nt] Impose A Single-Payer On Everybody’

[Political Tiger]

In an interview with ThinkProgress yesterday, Gov. Howard Dean laid out the principles that he thinks should guide the health care reform debate. Dean argued against a single-payer system, against an individual mandate, and for extending free health care to all Americans under the age of 25.

The former DNC Chairman advocated building upon the existing employer-based health care system by giving Americans the choice of keeping their existing insurance plan or enrolling in a new public option. “People hate the health care system, but they love their own doctor and they pretty much like the care they get,” he explained. “So what you cannot do is create some system that is going to scare people.”

Dean — who had expressed interest to the Obama White House in becoming HHS Secretary — argued that free choice and competition should be the cornerstones of health reform. “The brilliance of Barack Obama’s plan on the campaign trail was a) no one has to change if they like what they’ve got and b) if you want to, you could essentially buy into Medicare,” Dean said. If Obama enacts health reform that contains a public plan option, Dean predicted that Americans will choose it:

The American people will preferentially choose Medicare, but not all of them will choose Medicare. So we will have a hybrid system. Many more people will be in a public sector because it will probably be better for them. But they will only be in the public sector if they want to be, and they can get out of the public sector if they choose to try something different later on. That seems fair to me. I don’t think we should impose a single payer on everybody, but I do think we should give Americans the choice of having one if they like it. If it works for them, that’s what they’ll choose; if it doesn’t work for them, they’ll choose the private sector. But I don’t buy that the private sector has a right to compete and be more inefficient. I don’t think anybody has a right to serve people worse than somebody else just because they’re private sector.

http://thinkprogress.org/2009/03/04/dean-on-health-care/

[Pavulon]

1. Seems reasonable to me

my plan works, I pay a fair price for it. Any change is just going to screw it up.

[leftstreet]

2. He says 'choose' as if most working Americans will have a choice

Employers will dump insurance benefits like hot potatoes.

Meh.

[DJ13]

5. Yep

And because not everyone is in one program the cost savings the government might hope for wont be as great.

[RB TexLa]

15. Depends on what the government requires for section 125 compliance

if that is loosened there will be plenty of health plans available. The insurance companies will get very creative with benefits to provide something better than the government plan. Those who can afford it will. The more problematic side will be companies that come up with plans to undercut the government plan on price and the quality of those plans.

I think this is ultimately the way we go. There are too many people like me who want universal access to health care but do not want to force everyone into it and want the government funding for it to come from normal taxing mechanisms. By that we pay for it based on income and not health. There are too many ways to save money at various stages of life through insurance choices. A plan where there are tiered costs for the government plan all the way down to provided as a safety net.

I don't have a specific plan, but those broad ideas are in line with what I'd like to see and think we'll get.

There will defiantly be a market for employer based plans, perhaps not targeted at all employees but it will be there.

[leftstreet]

19. Okay, but don't say 'force.' That's a RW talking point

I see what you're saying, I just don't feel optimistic that this isn't the beginning of the end of Medicare - and Medicare could (should) have been the beginning of universal single payer.

Like I said in another thread, it's the Geico-ing of American healthcare.

[nadinbrzezinski]

3. I get public sector care, Dr. Dean would do well to look at Tricare Prime

[tsuki]

27. Mom get Tricare for Life. Excellent. nt

[Massacure]

4. Letting people buy into medicare would be a start

But doesn't medicare still need some work done to it yet?

[madfloridian]

6. Can be solved by having traditional Medicare funded....

getting rid of or regulating those Medicare Advantage plans that are meant to destroy the traditional program.

I think Obama intends to do some work on that.

Money that should go to Medicare is often going to private companies now like Humana. When you give money to private companies, it tends to destroy the traditional program.

[aquart]

7. I'd so much rather destroy Humana.

Just a mean, nasty streak I have.

[defendandprotect]

8. Since when is a national health care system "imposed" on citizens . . .???

I don't get it --

Plus, what properly run Single Payer couldn't compete with the "private sector" --- ???

Only a very lousey program wouldn't be able to overwhelm the private/for profit system!

[madfloridian]

9. Mandatory insurance. Must buy.

I think Dean is actually fighting just to keep the single payer option there at all.

[defendandprotect]

11. So the anti's big argument is that Single Payer would be "imposed" -- an imposition . .. !!??

[madfloridian]

14. Not sure what you are saying.

But I don't think that is Dean's point at all. He is fighting just to keep a public option available.

[Lugnut]

10. I'm pretty happy with my health care plan.

I have Medicare.

[exboyfil]

25. Opening Medicare to everyone would mean either the elimination of

private health plans because Medicare is currently subsidized by payroll taxes (not enough payroll taxes for the long term though even with the 65+ barrier to entry) or facing the same premium problem that currently exists (Medicare Part A market price of $5,500/yr is not competitive). If you have a subsidized plan that costs less than any sort of private plan, it would be irrational for any company to continue to offer a private plan - they would all move towards Medicare (you could not afford to compete otherwise).

If I was a large manufacturing company that offered a Health plan and Medicare was opened up, I would immediately increase the pay of my workers by the premium amount and instruct them how to sign up for the Medicare plan. Currently my employer and I (but mostly my employer) pays $12,000/yr for my family coverage. Medicare is a whole lot less unless you have to buy Part A which is up to $5500/yr for a single person (you have to buy Part A if you did not contribute with payroll withholdings during your working career). The $5,500/yr can be thought of as representing the level of susidiziation from payroll taxes for Part A.

To put it in perspective the Germans pay 16% of their income for health care (through their national insurance with non-profits). We currently spend 24% through a patchwork of public and private etc. Our Medicare withholdings are only about 3% (combined employee/employer) and projections show that Medicare is becoming grossly underfunded very quickly (even taking out all profit aspects of Medicare - we would quickly be reaching an underfunded state).

I really think any sort of incrementalism is doomed to failure. Reading through all of these medical plans can only give an individual a headache. I think we need Single Payer UHC that rolls all systems into one plan (both public and private) with a much more simplified funding source (ie payroll and other income tax???) with possible needs testing at retirement. Anything less will continue to result in risk pool shopping, nightmarish administration, and continued profiteering by the insurance companies. Our national goal should be to get to at least the German level of 16% of income spent on medical care.

[xchrom]

12. 'impose'? -- interesting choice of word.

why can't people buy extra insurance -- obviously not at the same cost as we have now if we have medi-care for all -- and simply opt 'up'?

[Maru Kitteh]

13. Howard should let the administration handle it now.

[madfloridian]

16. I disagree. I think we should all speak up loudly.

[Maru Kitteh]

22. You find it constructive for Democrats to trash the President on healthcare along with the repigs?

I don't.

Howard FAILED. He failed many times in many things - and I do NOT want Howie's failures (or his need to remain important) to taint the window of opportunity we must embrace now to change the course of healthcare. A full-stop and 180 course would be heaven, but it isn't practical. A sharp turn of course will lead us in relatively short time to a better destination.

[tsuki]

28. So, freedom of speech is gone? He has a much right to speak out

as anyone.

[RB TexLa]

17. I've never been a Dean fan but he's got as much right to speak up about it as anyone

Even more so being a doctor and public figure.

[madfloridian]

18. You don't think we should have a say?

If Zeke gets his way and phases out Medicare....well...what can I say.

I hope all the young folks here are financially prepared to take care of their parents' needs in that event.

Because...if private companies get all the benefits there won't be much left for Medicare.

[FrenchieCat]

20. You have blown Zeke totally out of proportion in your haste

to make Howard Dean a martyr.

Howard Dean wants what the Obama administration wants...
and that is exactly what he is saying in the Op posted.

But go ahead and have your day in the sun,
as soon enough this will be all settled.

[madfloridian]

21. He is saying what Obama said he wanted during the campaign.

But now he is seeing Obama change to accepting mandatory insurance.

Maybe not wanting it but pressures getting him to change.

Dean is no martyr. He is supportive of Obama, but says the insurance industry will try to stop him from getting what he wants.

You are totally intolerant of anything said anymore. It would be nice if we could peacefully co-exist. But this is my country, too. Obama is not just your president, he is mine as well. I have a right to critique and I do it thoughtfully.

And Zeke Emanuel's plan worries me a lot..it should worry any of us. The Emanuels are way too much in power right now, and I will speak up.

I don't agree with everything Dean says on the topic, but IF Obama is considering changing his mind and accepting mandatory insurance....that would be a sell-out.

[FrenchieCat]

23. Obama would quite agree that the Insurance Industry will try to stop him....

It's not like he was born yesterday,
and I believe that you are erroneously underestimating him,
as to what he knows and what he doesn't.

You giving Zeke Emanuel the kind of prominence you do
is simply because you dislike Rahm because of the story
about Dean and Rahm. It is quite obvious too.

The problem with your entire thesis is the fact that it depends
only on IF Obama does something different from what he said
he would do during his entire time on the campaign trail.
and then IF....THEN, your last word is "sell out" which has effect,
but is still a matter of speculation.
I find it to be cynical at best, on your part....which is fine of course,
but that does confirms the fact that your OPs as of late,
are based on nothing more than speculation.

As far as my tolerance, just like our co-existence,
I think it is all just fine.

[madfloridian]

29. No, I used Zeke's own words.

Yes, I do dislike Rahm. He has been glorified for being an "a**hole", and for telling other Democrats to eff off.

And when his brother says phase out Medicare....it sends alarm bells. They are powerful and very close to Obama.

[Sunnyshine]

26. Madflo- I like your input and it should worry us. Please continue speaking out.

It is troubling and tiresome seeing history repeat itself again on this issue- that should be acknowledged.
Mandatory insurance would be a sell-out, especially if UHC/SP is not even considered.

Majority of America wants SP, and once again DC is already giving in to the bloated czars and negotiators of health care inc.

It's not right. I work in HC, and I see how wrong it is first hand. Dean agrees we should have a Single Payer option.

[Sunnyshine]

24. Dean also said: I do think "we should give Americans the choice of having one if they like it"

We want a single payer option. Once we have it, we will support and use it. The majority wants it.

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
–Martin Luther King, Jr.