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Gov. Howard Dean has a new rallying cry: "You have the choice" when it comes to healthcare reform, or you will, if a healthcare reform plan goes through with a strong public option, and he lays it out in his new book, Howard Dean's Prescription for Real Healthcare Reform.

In fact, Governor Dean says:

The bottom line on healthcare reform is that it is not worth doing if it is not done right....

Subsidizing Americans to buy private health insurance without giving them the choice of a more rational and less expensive system is simply pouring money into a system that increases costs at twice the rate of inflation, serves preferentially those who don't need help, and offers not peace of mind to those at risk in difficult economic times.

In short, the healthcare reform bill is not worth passing unless the American people have the choice of signing up for a public option--a real public option.... If healthcare reform is not the desired outcome, this administration or the Democratic Party or the Congress as a whole should pass guaranteed issue and community rating and be done with it.

Dean points out that guaranteed issue (private insurers won't be able to drop subscribers if they become ill or reach a certain age) and community rating (companies won't be able to have excessive rates for people with significant illnesses or for the elderly) are key insurance reforms, but in and of themselves, aren't actual healthcare reform. That real reform only comes with choice.

Choice, Dean explains, is also why he doesn't think a single payer health system is the answer for the United States:

You can't take choice away from Americans. This country was founded on the idea that individuals can make their own choices and are free to make their own mistakes.

Furthermore, there will be inefficiency and bureaucracy in any plan, public or private. There will be, inevitably, Americans who are dissatisfied with their plan, whether they've chosen the public or private option. They should be free to change plans. If you have only one plan, no change is possible.

Within those parameters, Dean makes an excellent and extremely readable case for why substantive, structural reform isn't just necessary, it's imperative for the nation's economic recovery in the short term, and for establishing an economic base to build a sustainable future. He talks about something that has rarely come up in this debate so focused on the 47 million Americans without insurance--the 25 million who have insurance but don't get regular medical care because they can only afford catastrophic care coverage. He talks about the cost to American businesses--small and large--in trying to keep up with the the cost of insuring themselves and their employees--costs that have risen 119 percent in the past decade.

He, along with co-authors Faiz Shakir from Center for American Progress and Igor Volsky from Think Progress's Wonk Room, provides the reader with all the information she needs to argue for a) the necessity for real reform, and b) the key elements for that reform. That includes a chapter on the myths (aka, the Frank Luntz talking points) the right-wing is using in the debate, and the facts that rebut every one of those myths. Here's the three authors talking about just that.

All of these facts, figures, and talking points are provided in the book for one reason, and it's a familiar one coming from Gov. Dean: to provide you with all the ammunition you need to help get real reform enacted. Anyone who reads this book will be able to talk intelligently and convincingly about a broad range of healthcare related topics, from how various industrialized European countries provide this public good to why his most controversial idea for funding reform, a carbon tax, actually makes sense.

All this is to get you out there talking to your friends, family, and neighbors about healthcare reform; calling your representatives, writing letters to the editor; calling into talk shows and cable shows. As he says in the book, "Successful political campaigns never stop."

The purpose of electing a Democratic president was not simply to elect a Democratic president. The purpose of electing a Democratic president was to have a president in office who cared about ordinary people, and who is willing to fight hard for principles against the well-heeled forces in our nation's capital that resist change at every turn.

This is your fight.

You do have the power, after all. With that, I'll turn it over to Governor (and Dr.) Dean. But first, check out a special announcement I found in my inbox this morning from him, below the fold.

Dear Joan,

As you know, I've been working with Democracy for America—with support from all of you—on a huge grassroots campaign for the choice of a public health insurance option.

We've collected petition signatures, written letters to the editor, held town halls and more in an effort to educate Americans on the necessity of passing real healthcare reform. And it's working—76 percent of Americans now say they support the choice of a public health insurance option.

There's still work to be done.

We must keep the pressure on Congress and those in Washington who oppose real change. We must keep up our efforts to get our message out to all Americans with letters to the editor and neighborhood canvasses. And I will continue to speak out in my nationwide tour of town halls, targeted rallies, and T.V. appearances.

In fact, I hope you can join me at one of my next big events. I'll be hosting a town-hall style keynote session at the Netroots Nation convention in Pittsburgh on Friday, August 14. If you can make it to Pittsburgh, this is a convention you don’t want to miss.

This town hall style keynote won't be a one-way conversation. I'll be answering your questions, as well as answering questions submitted in advance online. We'll chat about obstacles and next steps. Who the leaders fighting for a public option really are and who aren't. And what's next in the Stand with Dr. Dean Campaign.

I’ve spoken at Netroots Nation conventions before, but this is the first time we've been able to make it interactive and conversational. You know I don’t pull any punches. I'm looking forward to speaking honestly with you about how to pass meaningful reform that makes sure everyone in America can get the heatlhcare they need.

The keynote will be held Friday morning at 9 a.m. If you haven't already registered, click here to sign up.

I hope you can join me in Pittsburgh.

Thank you for everything you do,

–Howard

Governor Howard Dean, M.D.
Founder, Democracy for America

Originally posted to Daily Kos on Thu Jul 09, 2009 at 08:56 AM PDT.

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Comment Preferences

  •  Who IS this guy??? (13+ / 0-)

    Who does he think he is, Tom Daschle or something?? Dean gets better with age!!

    They ignored us. Then they laughed at us. Then they fought us. Then - on July 2nd 2009 - we won! [ht: Mohandas K. Gandhi]

    by ezdidit on Thu Jul 09, 2009 at 08:58:25 AM PDT

    •  Really (7+ / 0-)

      And with the sense-making, the fact-giving, the truth-telling...what's his angle?!?

      Hell hath no fury like the vast robot armies of a woman scorned

      by Mike E on Thu Jul 09, 2009 at 09:14:30 AM PDT

      [ Parent ]

      •  I'm very suspicious... (2+ / 0-)
        Recommended by:
        PAbluestater, Jeff Y

        ...also...and hopeful of Democratic success on real health care reform, or there may be some very angry Democratic constituents in '10 - eager to primary a few loser Senators who are playing up to insurance lobbyists.

        Maybe we can TURN a SIXTY vote majority INTO SEVENTY next time around!!! Let's see what Sen. Harry Reid says then.

        They ignored us. Then they laughed at us. Then they fought us. Then - on July 2nd 2009 - we won! [ht: Mohandas K. Gandhi]

        by ezdidit on Thu Jul 09, 2009 at 09:28:26 AM PDT

        [ Parent ]

        •  Don't get cocky, kid (4+ / 0-)
          Recommended by:
          mcmom, ezdidit, Jeff Y, mikejay611

          Dean is the architect of two totally-winning campaigns, party-enhancing recruitment, his only loss was Jefferson the freezer money man.  FIRE HIM!  What's the name of his replacement from MD, Where S. Waldo?

          Democratic success hinges on party reform -- confronting the blue dogs and the Clintonistas/3rd Wayers, making them renounce their corporate alliances.  Leaving Dean out by his lonesome speaks volumes about the current Dem hierarchy, regardless of his fearless persona and singular tenacity.  The Asylum AKA GOP is making a train wreck look like kittens frolicking in a hamper of fresh-dried bathtowels, yet our fave party can't seem to spend enough time trying to include these motherfuckers in fixing their mess.  Sigh.  Where have you gone, Left and Right Testicle?  

          Hell hath no fury like the vast robot armies of a woman scorned

          by Mike E on Thu Jul 09, 2009 at 09:49:21 AM PDT

          [ Parent ]

        •  Hopefully he's just Senator Harry Reid (4+ / 0-)
          Recommended by:
          mcmom, ezdidit, Jeff Y, mikejay611

          instead of Senate Majority Leader Harry Reid.

          Just so sick and tired of his wishy-washy "leadership" and no, even my health care doesn't offer me an option for curing HarryReid as an illness since he's out of network for me.

          And for any Harry Reid staffer reading this, I do appreciate his telling Baucus to stop chasing Republicans for bi-partisanship if it's going to cost Democratic votes, but he should have realized and organized long ago - like about three years ago, that the Republicans are going to solidly band together to block any and all Democratic reforms, and that what watering down that has already been done has been wasting time that could have been put to better use.

  •  Dr. Dean! (10+ / 0-)

    So... what do we do about Joe Lieberman and his recent comments against the public option?

  •  I have been impressed with Gov. Dean (8+ / 0-)

    I think he has done a good job explaining why this has to be done right. I also think he's tried hard to represent people that Sen. Baucus isn't letting into the discussion.

    I wrote a diary on Senator Baucus and how he's listening to Chuck "Twitter" Grassley too much, and how this has to be done right. Not many people read it, so I will post a link here:

    http://www.dailykos.com/...

  •  Would that our representatives were as (1+ / 0-)
    Recommended by:
    PAbluestater

    smart about healthcare reform as Dr. Dean is.

    Repubs - the people in power are not secretly plotting against you. They don't need to. They already beat you in public. (Bill Maher)

    by Sychotic1 on Thu Jul 09, 2009 at 09:01:13 AM PDT

  •  Mr. Dean is right, and Mr. Dean is wrong... (7+ / 0-)

    healthcare reform isn't worth doing if it isn't done right, and single-payer would fit perfectly here in the US. Single-payer does not outlaw private healthcare insurance, which would still be available to anybody who wants and can afford it. We should not be obligated to support an industry that does not serve us.

    •  And, I would add, that citing American tradition (4+ / 0-)

      in an effort to make the insurance industry seem somehow patriotic, is pure and unadulterated bullshit.

      •  You're reading a lot into that (8+ / 0-)

        Nowhere does Gov. Dean imply that there's anything patriotic about insurance companies. He blisters them in the book. What he's saying is that consumer choice is an ingrained American tradition. He's not making a value judgment on that, just saying that's the way it is.

      •  he is also right to say that (5+ / 0-)
        Recommended by:
        ferg, mcjoan, greenapple, pattyp, mcmom

        choice is something that is important to people. Let people decide on thier own to go to the public option rather than require that the single payer optio is the only choice. In the short term it will be more costly than a single payer alone approach, but in the long term I think the argument can be made that it will have more of a lasting impact to people to know that they are making the choice to choose the better plan.

        •  But the public option isn't better (5+ / 0-)
          Recommended by:
          Blutodog, mcmom, Losty, dditt, mikejay611

          www.phnp.org has the correct analysis on this diversion.

          There are 1300 insurance companies.  That is the problem.

          The public option will make it 1301.  More bureaucracy, higher costs, same old shitty coverage.

          Obama used to be for single payer before he came out against it.

          by formernadervoter on Thu Jul 09, 2009 at 09:22:56 AM PDT

          [ Parent ]

          •  this again smells of distortion (6+ / 0-)

            the issue is not how many, but in what way they impact the market. It is 1301, with that 1 creating a significant downward pressure on cost of insurance and upperward shift on quality of services.

            Look, I believe single payers deserve their spot at the tabler. I don't like how they have been treated, but your arguments are less than strong when one thinks about it substantively. It is not merely a question of number of companies- it is about cost reduction and quality of product. If the public option does that- which I believe it has a strong chance of doing if it is the right plan, then it will effectively sell itself.

            I have yet to hear a practice reason why if given a choice between a more expensive private plan and one that is not as quality as the public option, Americans will choose the private plan. Can you provide a reason? because number of companies is not one of them.

          •  I disagree about the "bureaucracy." (2+ / 0-)
            Recommended by:
            dditt, mikejay611

            Old Timer, aka, Joe, and I are both on Medicare. We have had no problem getting excellent care. And, Medicare's overhead is around 3+%. Compare the "bureaucracy" to private insurance companies, and also factor in the nightmare of getting their approval for needed medical treatments.

            I think, therefore I am. I think.

            by mcmom on Thu Jul 09, 2009 at 10:23:15 AM PDT

            [ Parent ]

          •  Not better than single-payer, but it's winnable (1+ / 0-)
            Recommended by:
            Charles Chamberlain

            And public option is an enormous improvement over what we have now.

            I disagree with your reasoning about 1300 + one just makes it 1301.

            Currently, I have for all practical purposes one insurance company: the one used by my employer's plan.  I can choose that or nothing.

            Under the new legislation, I am guaranteed a choice between that plan and the public plan.  So for many many customers, the public option increases their choice from 1 to 2.

            There will be pressure to lower costs and increase coverage.

            •  nope, you have no choice (0+ / 0-)

              Under the new legislation, I am guaranteed a choice between that plan and the public plan.  So for many many customers, the public option increases their choice from 1 to 2.

              i think the house might be proposing this, that anyone be able to buy into the public plan if they want to, but the senate bill limits participation in the health insurance exchanges to those who are without insurance. if your employer offers you insurance, you won't be allowed to buy your own insurance through the exchange[s] and the exchange[s] will be the only place that the public option will be available.

        •  And millions of Americans would like to have a (4+ / 0-)
          Recommended by:
          wsexson, ColoTim, Egalitare, mikejay611

          choice in healthcare that does not include buying insurance or groceries but not both.

        •  There IS a choice with single payer (10+ / 0-)
          And that choice is chosen by ballot and not with $$.

          Dr. Dean, from an admirer, I disagree with your premise. While I agree everyone should be able to choose their healthcare providers, as is done now with Medicare, having a choice of insurance providers on top of that adds complexity and  negates the economic efficiencies of spreading all health risk among one group.  A plan with several insurance providers will inevitably be more costly to all consumers than having single payer and will lead to the same denials and same rationing by obfuscation that they engage in now.

          I'm not worried about the health insurance industry.  THEY are the ones who choose these immoral and indefensible tactics and they must learn the hard way that oppressive and unfair behavior always has a cost that is more dear than the profits realized.

          Health care is equivalent to police or fire protection or libraries, where you don't get to choose among basic providers, but you are able to supplement in the private sector if you do not feel the basic is enough.  I'm sure no one on the left would quibble with having a robust supplementary market.  But basic healthcare has got to be universal, single payer healthcare.

          Just ramp up Medicare for All, the infrastructure is in place, it works, voters like my grandmother on Medicare love it.  We have a program that already works, it just needs to be expanded.  Expanding Medicare can be done much more quickly than coming up with this Rube Goldberg patchwork idea of different health insurance providers for basic care. At least try it for 3 years and see what happens. We don't have anything to lose.  Health insurance companies can fight among themselves to provide a Medicare Supplement and have plenty of opportunity for profit.  

          Please.  I don't have health insurance and I need it. I have health problems that I can't address because putting them in a medical record would ensure I never will get health insurance.

          It HAS to be single payer. Please.

          Republican = A devout believer in the free market theory who denies evolution because it's just a theory.

          by wiseacre on Thu Jul 09, 2009 at 09:34:17 AM PDT

          [ Parent ]

          •  Why is this posted to my comment? (1+ / 0-)
            Recommended by:
            Eddie in ME
          •  Thank you...I have been working for single-payer (3+ / 0-)
            Recommended by:
            PAbluestater, Losty, mikejay611

            for people like you...I already have it, through the VA. Lifetime healthcare, free, miniscule co-pay on prescriptions. The care I have received through VA has been first class, and I believe everybody in the US deserves that. I might add that I received treatment for Hepatitis C through the VA. It would have cost about $40k out of pocket. I have a friend who picked up Hep C on the job (OR nurse) and her insurance dropped her. She's in the advanced stages and can't afford treatment on her own. I buried a friend last year under the same circumstances. This is inhuman. But profitable.

          •  Choice in healthcare providers is the real issue (0+ / 0-)

            I'm not convinced that people care that much about their plan. I strongly suspect that when asked whether they are satisfied with their healthcare plan, they tend to respond in terms of whether they like their doctor, local hospital, etc., unless they've had a beef with their insurer (not a small group).

            What people really want is a choice of healthcare providers, so that they can change providers if they need or want to, access specialists, etc. Insurance plans usually restrict the panel of providers you can see -- whereas single-payer would not.

            Single-payer is the way to go, because it provides that choice, and because it provides universal coverage at the lowest cost because it cuts administrative/marketing/etc. costs (about 20% of healthcare spending currently).

            For a public option to be acceptable it--at least--needs to 1) be run through Medicare, as wiseacre argues, since Medicare is set up to do the administration at the least cost, rather then be run through the states, which are incompetent to do the job and would add bureaucratic costs in any attempt to gear up for it; 2) not use coops, which are a bogus alternative. Coops would have no organizational capabilities in place to provide services, and would end up contracting the job to existing health insurers, in effect becoming simply stalking horses for the health insurance industry rather than a real public option.

          •  Some Single payer questions (0+ / 0-)

            One thing that has not been covered with a Single payer option is the following savings:

            1.  No more high payments by businesses to cover workers comp medical bills.
            1.  Significant reduction in auto insurance rates due to no need for personal injury protection/ medical bill coverage.
            1.  Huge relief (multiple billions of dollars) for states no longer forced to pay Medicaid matching dollars.  This is crippling most states.
            1.  Less payments by local governments for indigent hospital care.
            1.  Lower state and local tax burden due to #4 and #5 above.

            Am I missing something?  Would Single Payer not remove many of these very costly bills we all now have to pay.  Have they been considered in single payer cost estimates?  I have yet to hear anyone mention any of these points.

        •  The big problem with single-payer in America is (0+ / 0-)

          that every once in a while the country loses its mind and elects a government composed of people who don't believe in government. If an administration like Bush's controlled everyone's health care...

          Well, possibly they wouldn't stay in office long. That might actually be a plus, in the long run.

          One nation, indivisible.

          by Doctor Frog on Thu Jul 09, 2009 at 09:55:18 AM PDT

          [ Parent ]

          •  I am not against single payer as one (1+ / 0-)
            Recommended by:
            ferg

            possible idea for reform, but I am against the idea that there are no other choices. That flies in the face of comparisons abroad as much as keeping the crazy profit based system as the solo choice we have now does.

    •  Definitions? (1+ / 0-)
      Recommended by:
      mmacdDE

      It seems to me your comment is encouraging what I usually see referred to as "public option", with private insurance still being an option to those who want it.

      To me, single payer means just that - a single payer for everybody. In such a scenario private insurance would only provide extra "perks" like a private room, or a higher level of coverage, and it would in every practical sense kill the current private insurance industry as we know it.

      "People who have what they want are fond of telling people who haven't what they want that they really don't want it." Ogden Nash (on universal health care?)

      by Catte Nappe on Thu Jul 09, 2009 at 09:08:26 AM PDT

      [ Parent ]

      •  And that is bad? (4+ / 0-)
        Recommended by:
        mmacdDE, wsexson, ColoTim, CMYK
        •  Good or bad is not the question (2+ / 0-)
          Recommended by:
          ferg, Charles Chamberlain

          It is impossible.

          In addition there would be some very "bad" results in shutting down a very large industry at this particular time in our economic situation. None of the other countries we look to for models and ideas ever passed a law and simply pulled the plug on their status quo and said "from now on we will do it this way". They all evolved from unique circumstances and already existing approaches to health care.

          "People who have what they want are fond of telling people who haven't what they want that they really don't want it." Ogden Nash (on universal health care?)

          by Catte Nappe on Thu Jul 09, 2009 at 10:03:42 AM PDT

          [ Parent ]

          •  unemployed in the health insurance industry (1+ / 0-)
            Recommended by:
            The Moonlit Knight

            Medicare contracts out their service work, bill paying, talking to insureds, etc.

            I'm sure the existing health insurers would bid on the new bigger contracts, and there would be work for most of the "ordinary people" who work for them with one contract winner or another.

      •  Kill the beast and put it out of our misery. (1+ / 0-)
        Recommended by:
        The Moonlit Knight

        I don't have a problem with the unnecessary, profiteering, CEO layer of healthcare being phased out of our lives completely.

        The purpose of private insurance is to reap profits by denying benefits, period. It's an artificially created industry that is 100% in the way of health care and health care reform.

        What this country needs are more unemployed politicians. -Angela Davis

        by CMYK on Thu Jul 09, 2009 at 09:41:59 AM PDT

        [ Parent ]

    •  At the very least, he's "Dr. Dean" (1+ / 0-)
      Recommended by:
      mcjoan

      Or Governor Dean.

      I wish there were a Wizard of Oz to give the GOP a heart, Democrats courage, and the media a brain.

      by Malacandra on Thu Jul 09, 2009 at 09:16:16 AM PDT

      [ Parent ]

  •  Dr. Dean ... frank assessment of chances (1+ / 0-)
    Recommended by:
    joanneleon

    for robust public option this year? Assume activitsts are fired up, motivated, and engaged. Damn the torpedoes!

    The invasion of Iraq was a war crime, a crime against humanity, and a crime against civilization. Prosecute the crime.

    by Positronicus on Thu Jul 09, 2009 at 09:03:04 AM PDT

  •  I'm in NY. MY Senators are on board - (8+ / 0-)

    What's the best way to help, if our own representatives are already in favor of the public option?  Which Committees or individuals should we be working on?

  •  Dean 2012 (2+ / 0-)
    Recommended by:
    astronautagogo, Debbie in ME

    Run Howard Run!

    "It's a gay witches for abortion party Flanders, you wouldn't be interested." - Homer Simpson

    by angry liberaltarian on Thu Jul 09, 2009 at 09:03:10 AM PDT

    •  Dean 2016 (0+ / 0-)

      Obama 2008-2016
      Dean 2016-2024
      Chelsea 2024-2032

      We hold these truths to be self-evident that all heterosexuals are created equal and are endowed by their Creator to certain inalienable rights; gays however...

      by ultrageek on Thu Jul 09, 2009 at 09:12:18 AM PDT

      [ Parent ]

      •  no clintons no pumas (4+ / 0-)

        no chelsea

        NO NO NO NO NO NO NYET NON NEVER

        we are not a monarchy.  there are 299999999 other qualified individuals who could serve.

        "It's a gay witches for abortion party Flanders, you wouldn't be interested." - Homer Simpson

        by angry liberaltarian on Thu Jul 09, 2009 at 09:17:04 AM PDT

        [ Parent ]

        •  Maybe... (0+ / 0-)

          ...but I don't know any who will be 40 in 2024.  If you've got a good 16-25 year old Democrat hanging around who has name recognition and fundraising capability, let me know.  In the meantime, Chelsea will be my place holder until we get a little closer.

          We hold these truths to be self-evident that all heterosexuals are created equal and are endowed by their Creator to certain inalienable rights; gays however...

          by ultrageek on Thu Jul 09, 2009 at 09:58:48 AM PDT

          [ Parent ]

        •  I disagree that we should restrict (2+ / 0-)
          Recommended by:
          ultrageek, pattyp

          someone who's relative served automatically.  We'd never have gotten FDR if your restriction was in place.  Course we'd never have had W, but that's still not an equal trade-off imnsho.  Sure, they should have to be judged on their own merits, but one should never be automatically excluded because of their lineage.  I have no idea about Chelsea's interests other than she helped campaign for her mother, but if she wants to enter politics herself, I see no reason to at least listen to what she promises, and perhaps what she delivers.

  •  Howard Dean! (2+ / 0-)
    Recommended by:
    Malacandra, ultrageek

    the man who WOULD have made a difference if president.

    "but I would not be convicted by a jury of my peers. still crazy after all these years".....

    by JadeZ on Thu Jul 09, 2009 at 09:05:05 AM PDT

    •  But our screams mean nothing to those we elect. (1+ / 0-)
      Recommended by:
      The Moonlit Knight

      And by screams I just mean grassroots efforts.

      Obama is turning a deaf ear to actual reform (although he seems to hear the lobbyists just fine) and Congressional reps don't hear us either. They are mostly disconnected from what it means to "need" something like health care because they have good coverage and don't bother putting themselves in other people's shoes.

      Why was Single Payer immediately removed from consideration by Max Baucus, and why is it still considered off the table? Just put it back on the damn table, eh? What's so hard about that?

      It's the lobbyists, right? They're in control and we the voters don't have much of an impact on final results because we can't match their financial contributions. Sorry, but I don't see anyone tackling that issue at all at the national level. We say we want reform but the corruption remains intact -- that's not a prescription for success.

      What this country needs are more unemployed politicians. -Angela Davis

      by CMYK on Thu Jul 09, 2009 at 09:58:06 AM PDT

      [ Parent ]

    •  Off-topic request (3+ / 0-)
      Recommended by:
      N in Seattle, ferg, DClark4129

      My friends in Idaho wish for me to extend an invitation to you to come out and help them fire up the troops for their 44 county strategy. They love you in Idaho, Governor.

  •  If you haven't read it yet (19+ / 0-)

    the interview with Gov. Dean in this month's Esquire is great. My favorite bit:

    ESQ: Speaking of the Obama plan, you're even stronger than he has been lately in support of the public plan. You say that without it, it's not reform.

    HD: It's not. It's a waste of time. Don't pretend you're going to do health-insurance reform unless you're really going to change the system. The discussions in the Senate have not been about changing the system.

    ESQ: They seem to be worried about preserving the status quo.

    HD: Washington is the most conservative town in America. Its culture is the most resistant to change except a few religious cults.

  •  Thank you, Dr. Dean you have it right... (4+ / 0-)

    Health care reform must be done correctly or not at all.  A watered down health care reform plan would only hurt Americans.  
    And a trigger is just out of the question! It does nothing except postpone the debate to a time when the insurance industry will have a better hand at the table!

    Raymond Gellner Charlotte Liberal Examiner at Examiner.com

    by regellner on Thu Jul 09, 2009 at 09:07:08 AM PDT

  •  I have a question... (11+ / 0-)

    There has been a lot of talk about not compromising on the public option, but isn't the public option itself a compromise? whatever happened to the goal of true UNIVERSAL healthcare?

    Image links to my dental horror story.

    ~
    ••• CELEBRATE with America's BAraCK Stickers And T-Shirts •••
    ~

    by KingOneEye on Thu Jul 09, 2009 at 09:07:33 AM PDT

    •  universal health care (28+ / 0-)

      Most health care systems among developed industrial democracies are hybrids of public plans and private insurance plans.  The Dutch and the Swiss for example have universal health insurance entirely through the private sector (although their health insurers are heavily regulated unlike ours) so having a public option can certainly lead to universal health care.  

      You are right however, the public option is  a compromise between a single payer and the system we have now.  the beauty of the public option is that individual Americans make their own choice about the kind of system they want to be in.  Right now, politicians and the insurance industry make that choice for us.

      •  Governor, the fine folks at pnhp.org (2+ / 0-)
        Recommended by:
        Simplify, CMYK

        disagree with your analyis.

        Have you spoken with David Himmelstein or Steffie Woolhander on this?

        Their research shows the public option will not work to address the major insurance issues.

        Obama used to be for single payer before he came out against it.

        by formernadervoter on Thu Jul 09, 2009 at 09:28:20 AM PDT

        [ Parent ]

      •  Thanks for your response. (2+ / 0-)
        Recommended by:
        ColoTim, Involuntary Exile

        While I still prefer a true universal plan, I think it is important to note that our side has already made a significant gesture to achieve agreement. By acceding to the public option proposal, we should consider that as far as we will go and that it is now incumbent on Republicans to demonstrate good faith and accept this compromise offer.

        In other words, the public option is not a new starting point for negotiations.

        ~
        ••• CELEBRATE with America's BAraCK Stickers And T-Shirts •••
        ~

        by KingOneEye on Thu Jul 09, 2009 at 09:33:29 AM PDT

        [ Parent ]

      •  "Choice" is for people with money. (1+ / 0-)
        Recommended by:
        The Moonlit Knight

        the beauty of the public option is that individual Americans make their own choice about the kind of system they want to be in.

        My choice is Single Payer. I'm an American -- where's my choice?

        How can we boot out the unnecessary, padded CEO layer of health care, AKA the insurance industry? Insurance profits are contra-indicated in the actual care of health!

        What this country needs are more unemployed politicians. -Angela Davis

        by CMYK on Thu Jul 09, 2009 at 10:09:03 AM PDT

        [ Parent ]

    •  You are correct (2+ / 0-)
      Recommended by:
      The Moonlit Knight, CMYK

      The public option position is the cave in.

      You don't start negotiating by giving in.  You start with your best option, in this, single payer.

      Then, if you have to, go for medicare for all.

      Then, you might as well cave in totally because the public option leaves all the inefficiencies in place.  Rock solid.

      It gives only the semblance of reform, destroys the momentum for it and after the public option fails, as it must, as it has already done in the states where it's been tried, the public will feel nothing can be done and become complacent.

      Obama used to be for single payer before he came out against it.

      by formernadervoter on Thu Jul 09, 2009 at 09:26:55 AM PDT

      [ Parent ]

  •  I'm so pysched for this! I'll be there at NN09! (10+ / 0-)

    I'm on Twitter so if you'd like to follow my tweets, please do!

    by slinkerwink on Thu Jul 09, 2009 at 09:07:40 AM PDT

  •  A rally in Seattle noon today for public option (6+ / 0-)

    at the federal bldg., 2nd Ave & Marion downtown. We're going to hear speakers and visit Sens. Patty Murray and Maria Cantwell offices to deliver our petitions for the public option.

    Thanks, Gov. Dean for your site,Stand with Dr. Dean that updates who is for and who is undecided. Patty is for; Maria Maria is undecided. We hope to help her support the public option. Thanks again for giving your all, all the time for we the people.

    ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

    by mrobinson on Thu Jul 09, 2009 at 09:08:18 AM PDT

    •  Wish I could be there for that. Please consider (0+ / 0-)

      posting a diary afterward.

      Last I checked with Cantwell's office (the other day), she was for a public option as long as it was a crappy co-op model.

      I hope someone at the rally speaks about the medical lobby and discloses the amount of $$ our Congressional reps receive.

      What this country needs are more unemployed politicians. -Angela Davis

      by CMYK on Thu Jul 09, 2009 at 11:01:52 AM PDT

      [ Parent ]

  •  Public Option in Health Care Reform (5+ / 0-)

    How can we convince the Administration that the most important thing is true reform without a watered down Public Option? We need reform for the benefit of the people rather than the emphasis on bipartisanship.  Don't we have the votes to ignore the Republicans and the stuborn Blue Dogs?

    •  votes (23+ / 0-)

      the Democrats do have the votes to pass a strong public option if they use the budget reconciliation bill.  I respect the President's desire to have a bi-partisan bill.  However, having a good bill that works for the American people is more important than a having a watered down bi-partisan bill.

      •  "You need 60 votes..." (3+ / 0-)
        Recommended by:
        N in Seattle, Losty, CMYK

        ... to pass anything.  I don't remember hearing this much before Obama came into office.  Used to be there was more collegiality on cloture votes, with the understanding that it was OK to put something to a vote and then vote against it.  That's why the reconciliation process didn't come into play so much ever before.  Isn't it?

        Plus perhaps they ought to force some of these filibusters to play out sometimes.  Instead of just folding whenever McConnell winks (so to speak.)  I don't know the numbers, but since 2006, the use of the filibuster has spiked faster than the rate of mortgage foreclosures.

        Blessed are those who can laugh at themselves, for they shall always be amused.

        by Land of Enchantment on Thu Jul 09, 2009 at 09:40:19 AM PDT

        [ Parent ]

        •  not the budget (I think) (1+ / 0-)
          Recommended by:
          CMYK

          IIRC, the budget cannot be filibustered.

          grok the "edku" -- edscan's "revelation", 21 January 2009

          by N in Seattle on Thu Jul 09, 2009 at 10:24:38 AM PDT

          [ Parent ]

          •  Right. (2+ / 0-)
            Recommended by:
            N in Seattle, CMYK

            Not my point, though.  I hate it when I think I've expressed myself clearly, only to find that I've failed.

            There are limits to passing stuff with the budget.  It expires when the budget period expires, for example, and then needs to be fought all over again.  If you're trying to sell off public lands (say), that approach works a lot better than something like health care.

            Let me try again:  My point was that there's many many many many many many many many many many many many many many many many many many many many more filibusters (or rather, threats to filibuster) than there used to be.  The culture of the Senate has changed.

            Used to be it was not that unusual for a Senator to vote for cloture on a bill they were going to vote against themselves.  That changed exactly when today's Republicans got in the minority.

            I never used to hear it said on TV, "It takes 60 votes to pass anything."  As if it had the same meaning to as that it takes 2/3 to override a Presidential veto.  It doesn't require 60 votes to pass a bill, it requires 51.  Or 50 if a Senator is absent.  It takes 60 to get in on the floor for a vote.

            Blessed are those who can laugh at themselves, for they shall always be amused.

            by Land of Enchantment on Thu Jul 09, 2009 at 10:41:20 AM PDT

            [ Parent ]

      •  we the people (2+ / 0-)
        Recommended by:
        PAbluestater, DClark4129

        don't want a watered down bill. or a bi-partisan bill esecially from the likes of Senator Chuck Grassley (R-let them eat cake)

  •  Age factor... (13+ / 0-)

    something not mentioned a lot.

    We get our medical insurance through my husband's employment -- union job, great insurance, well subsidized.

    The Mister is ten years older than me -- he's 60.  So in 5 years the rest of the family loses the insurance when he retires and goes on Medicare.

    I'll be 55; our sons will still be insurable by us as college students.  One son has autism; the other has ADHD and vision issues -- in the current market, we probably won't be able to afford to insure us all.

    Where is Bones McCoy when we need him?

    by Frankenoid on Thu Jul 09, 2009 at 09:11:09 AM PDT

  •  Governor Dean... (7+ / 0-)

    ...we (the collective) need a coherent,  easy to access & understand, highly effective step-by-step form that can be used to debunk right wing propaganda when it comes to health care reform.

     Daily Kos diaries & a scattering of left wing blogs present such forms, but we need to coalesce behind one form so our message will be unified & media-friendly.

    Where is such a form available?

    Uighur, please. -(attributed to John Stewart)

    by wyvern on Thu Jul 09, 2009 at 09:11:36 AM PDT

  •  Dr. Dean: (8+ / 0-)

    As everyone here knows, the conservative punditry is still winning the framing war on "socialized" medicine and continues to repeat the lies that countries who have such programs (France, Britain, etc.) have failed. We'll probably never change the media narrative, so how do you suggest we get around it and convince the American public of the truth?

    Thanks for everything you do!!

    Does this internet make me look fat?

    by pattyp on Thu Jul 09, 2009 at 09:12:07 AM PDT

  •  Do you have a plan (7+ / 0-)

    for the grassroots through DFA at each level of this policy-making process? The committee mark-ups to prevent any weakening of the public option via amendments and to encourage strengthening of the public option via amendments? And the conference reconciliation committee? How do we come into play for that with DFA?

    I'm on Twitter so if you'd like to follow my tweets, please do!

    by slinkerwink on Thu Jul 09, 2009 at 09:12:55 AM PDT

  •  Dr Dean (7+ / 0-)

    I am so happy you are here and working on this.

    i have tried to convey the basics on this blog (Daily kos)to our readers...

    1. reform is difficult
    1. the senate is where health reform traditionally goes to die

    There's reason why single payer may not be politically viable right now, and if it can't pass the Senate, my question to you is what do you think can?

    PS there's a live summit on H1N1 today. Public health needs to be part of the deal  (Can you comment on that?) ;-)

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by Greg Dworkin on Thu Jul 09, 2009 at 09:13:04 AM PDT

  •  do we need a business model for health care? (1+ / 0-)
    Recommended by:
    blueyedace2

    Hi Dr. Dean,  Thank u for having this live blog.

    What are your thoughts about the consequences of using a business model for health care? Are there any positive consequences?  Are there any negative consequences?  In a business model, what is the primary goal of the business?

    Thank you for your time.

    peace,
    jbkim

    •  business (11+ / 0-)

      We're living with the business model of health care right now. Unfortunately for-profit businesses are not well suited to run the healthcare system since their motivation is to take as much money out of the healthcare as possible for their shareholders.  A public option will therefore create competition because of its efficiency and because more of your dollars ends up in providing health care instead of on wall street.

      •  Jesus Christ (1+ / 0-)
        Recommended by:
        dditt

        I am continually amazed that conservative self-proclaimed "Christians" could have opposed things like SCHIP.  I mean really, would Jesus not have wanted to care for sick children - pretty much above anything else?

        The idea that caring for the sick should be a profit-maximizing exercise is sick itself.

        Blessed are those who can laugh at themselves, for they shall always be amused.

        by Land of Enchantment on Thu Jul 09, 2009 at 09:48:39 AM PDT

        [ Parent ]

      •  tnk u for clarifying (0+ / 0-)

        Hi Dr. Dean,

        Your last sentence, "more of your dollars ends up in providing health care instead of on wall street".

        1. should be the clincher for fence-sitters;
        1. would cause supporters of a health insurance industry (because that's all they've known) to stop and re-evaluate their position. And eventually make the wise decision of supporting the a public option.

        In all this discussion, one never reads or hears the salaries and compensations of the CEO's and their executive suite of the health insurance companies, e.g. the Blues, Kaiser, United Health, etc.  Seems to me that is one obvious answer to the question of "Where does all that money go?"

        peace,
        jbkim

  •  But even the public option (2+ / 0-)
    Recommended by:
    Marie, Blutodog

    is being forced to be profit-driven, is my understanding.  That is, it has to be self-funded?  That's just stupid and is making my urge to kill rise.

    •  No it's not. (2+ / 0-)
      Recommended by:
      ferg, pattyp

      What has been pushed is that it must be self sufficient. That means covering costs. Profit driven is where a company wants to make money above costs. They are not the same thing.

      •  Here is Gov. Dean's answer to that in ESQ mag. (9+ / 0-)

        ESQ: You say that the public plan shouldn't be able to dip into general government reserves to subsidize its operations. But the Republicans say it will.

        HD: The Republicans just make things up out of whole cloth. Nothing they say about health care is true. It's all just nonsense and fears and what-ifs. It doesn't happen. First of all, Medicare doesn't dip into government reserves. It has never happened. It might happen in 10 years if they don't cut benefits or raise taxes, but so far, never in the history of America has a program like Medicare used public reserves. The Republican tactic is to raise objections because they never have anything positive to say themselves.

        ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

        by mrobinson on Thu Jul 09, 2009 at 09:18:31 AM PDT

        [ Parent ]

      •  self sufficient / self funded (2+ / 0-)
        Recommended by:
        Blutodog, RequestedUsername

        Is the Defense Department self sufficient or self funded?

        •  I did not say whether I agreed with the idea (0+ / 0-)

          or not. I am simply defining what it means without feeling the need to distort what others are advocating. The reality is that I am not certain where I stand on this. Certainly some subsidization would be preferable at the start, but then I am not sure. Also, I believe the amount of subsidization for indivuals should be above the present plans 400 percent of the poverty line. But that's me looking at the arguments as they rather than distorting them.

        •  well (2+ / 0-)
          Recommended by:
          ferg, joy

          it may be scary if the Defense Department was self funded =)  Iran-Contra anyone?

    •  profit-driven public option (1+ / 0-)
      Recommended by:
      Blutodog

      Agree with you that demanding the public option is to be self-funded is NOT in the best interest of health.  The health of the human being will never be number 1 if there is a choice between making a profit (self-funded)or life.
      peace,
      jbkim

    •  public option (5+ / 0-)

      A strong public option should not be constrained by artificial costs

      •  not constrained by artificial costs (1+ / 0-)
        Recommended by:
        Doctor Frog

        I'm wondering are there cost (real or artificial) constraints are there for military, and intelligence budgets?  It certainly does not appear to be the case.

      •  Whoa, thanks for reading and responding! (0+ / 0-)

        I didn't understand your response, though.  Are you saying it shouldn't be required to be self-funded?

        I'm at least heartened by knowing that Medicare has been self-funded all this time.  Perhaps this isn't the poison pill I've been imagining.  (Although it's still BS to put cost control ahead of saving lives.)

        •  self-funded (0+ / 0-)

          I'm wondering, if self-funded is such a good thing when talking about caring for one's health (which is of PRIME importance cuz otherwise we would be a nation of sick and unhealth people), then is the military and the intelligence agencies self-funded?

          peace,
          jbkim

      •  -- but isn't the whole US health care system (0+ / 0-)

        a byzantine web of artificial costs?  Nobody seems to know the true costs of anything in it or who actually pays for much of it.

        Regarding:

        ...the 25 million who have insurance but don't get regular medical care because they can only afford catastrophic care coverage.

        That number of 25 million is probably too low.  Perhaps by a factor of four.  This is so easy and cheap to correct -- and saves more dollars to the total health care system than it costs -- that it mystifies me why we don't fix this first.  The structures and expertise necessary to do this is already in place.  Ramp up and fully fund public clinics and community health clinics, and then make them free.      

        What FDR giveth; GWB taketh away.

        by Marie on Thu Jul 09, 2009 at 10:50:58 AM PDT

        [ Parent ]

  •  Why? Why? Why? (8+ / 0-)

    Why is any Democratic senator or Representative undecided? Why aren't they listening to We the People - to the 72%?  

    ESQ: Fifty percent of Republicans want a public option?

    HD: Yeah. That's in a Kaiser poll and in a New York Times/CBS poll last week. The Senate is in the process of self-destructing. They are talking about managing health-care reform to make sure that a relatively small sliver of American industry is satisfied at the expense of 72 percent of their constituents. That's unbelievable.

    ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

    by mrobinson on Thu Jul 09, 2009 at 09:15:48 AM PDT

  •  Dr. Dean, How do you see DFA and OFA (2+ / 0-)
    Recommended by:
    blueyedace2, blue armadillo

    (the President's campaign arm): as being complementary, overlapping, or in conflict?

    How can they be made to be complementary?

  •  In a red state that briefly turned blue... (2+ / 0-)
    Recommended by:
    PAbluestater, blueyedace2

    Dr. Dean,
    I am in NC and unfortunately both of our Senators may down the public option, even our Democratic Senator Kay Hagan!
    Are Senators like Hagan being confronted up in Washington in order to change their vote?
    Down here we have writing campaigns going to all our elected officials, but lobbyist money is hard to overcome...

    Thanks,

    Raymond Gellner Charlotte Liberal Examiner at Examiner.com

    by regellner on Thu Jul 09, 2009 at 09:17:33 AM PDT

  •  Long Term Services and Supports (3+ / 0-)
    Recommended by:
    BenGoshi, JayDean, PAbluestater

    Hello Governor -

    Old "Seniors for Dean" organizer here -- is there any mention in your book of how best to include long term services and supports in reform efforts?

    Great that you're coming here to my hometown of Pittsburgh for Netroots Nation.

    Thanks,
    Joe Angelelli

    "The government is us, you and me." - TR

    by Chance the gardener on Thu Jul 09, 2009 at 09:18:24 AM PDT

  •  Starting point: if the rapacious, mendacious... (7+ / 0-)

    .
    . . . Insurance Industry is against it, the it MUST be good for the American consumer/patient.

    Also, I'd call on all Senators and other pols who oppose a Public Option to put their pens where their mouths are and draft legislation to abolish Medicare and VA Benefits -- see how fast they run away from that!  Now you've got 'em:  they HAVE to admit that Public Plans/Insurance ARE good and efficient and work.  Then their other disingenuous, b.s. arguments against the Public Option fall.

    bg
    __________________

    "Unseen, in the background, Fate was quietly slipping the lead into the boxing-glove." -- P.G. Wodehouse (via Bertie Wooster)

    by BenGoshi on Thu Jul 09, 2009 at 09:19:10 AM PDT

    •  I'm surprised that question... (2+ / 0-)
      Recommended by:
      BenGoshi, PAbluestater

      ... is not raised all the time.  Everytime someone says they don't like "government-run" health care.  Though the VA, and the Indian Health Service too for that matter, do have room for improvement.

      But a lot of people out in the wilderness of the private sector - especially in rural areas? - avoid screening or diagnosis because they can't afford to treat anyhow.

      Blessed are those who can laugh at themselves, for they shall always be amused.

      by Land of Enchantment on Thu Jul 09, 2009 at 09:54:10 AM PDT

      [ Parent ]

      •  It's maddening that this isn't part of the Dems' (2+ / 0-)
        Recommended by:
        ferg, Land of Enchantment

        .
         . . . overall strategy.  It's an obvious way to put Republicans and BlueTraitor Dems on the defensive and it's simply not being used.

         I was just talking to a friend of mine in South Alabama yesterday about all of these necks he's around saying they don't want that "Socialized Medicine", but by damn if you told 'em to take their mom and dad (or grandparents) of Medicare and tell 'em to give up their (or their siblings'/cousins') VA Benefits they'd scream bloody freaking murder!

         Anyway, it's just a way to put these Senate Goons on the defensive.  

         bg
        ________________

         

        "Unseen, in the background, Fate was quietly slipping the lead into the boxing-glove." -- P.G. Wodehouse (via Bertie Wooster)

        by BenGoshi on Thu Jul 09, 2009 at 10:01:11 AM PDT

        [ Parent ]

  •  Dean is inaccurate (2+ / 0-)
    ONLY single payer gives you choice.  All other plans require you to stay in network...including the public option, which is going to cost as much as any other plan with the same co pays, denials of coverage and certain drugs.

    Get educated Gov. Dean:

    www.pnhp.org

    Obama used to be for single payer before he came out against it.

    by formernadervoter on Thu Jul 09, 2009 at 09:19:23 AM PDT

    •  We don't know yet how the public plan (4+ / 0-)
      Recommended by:
      mcjoan, Blutodog, pattyp, wsexson

      would be organized or financed. I'm for Medicare Choice. I'm on Medicare just this year and I love it. You still must pay co-pays & monthly fees of about $100, or nothing much if you are poor. Remember, we paid for this all our working lives so it isn't free. I picked my own doctor from a neighborhood clinic. All is well & I want all Americans to have that choice. - Medicare Early - It Is Already yours.

      ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

      by mrobinson on Thu Jul 09, 2009 at 09:24:02 AM PDT

      [ Parent ]

      •  We don't know...? (0+ / 0-)

        major elements of the concept have already been tried, and failed, in some states.

        see pnhp.org for the research on this from Drs. David Himmelstein and Steffie Woolhander.

        Their main point: the bureaucracy that is overwhelming hospitals and doctors remains in place with the public option.

        Further, the private plans will cherry pick the health patients and the public option gets stuck with the sick and poor.  This happens even with regulations to prevent it.

        After all, private companies are in business to make a profit, not provide care.   Unless you eliminate that the problems remain.

        Obama used to be for single payer before he came out against it.

        by formernadervoter on Thu Jul 09, 2009 at 09:33:03 AM PDT

        [ Parent ]

        •  The option in public option (0+ / 0-)

          means that people will have time to choose a single payer system, like Medicare. If they model it after Medicare, or offer Medicare Early, then everyone will eventually move over to it. In other words - single payer wins!

          ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

          by mrobinson on Thu Jul 09, 2009 at 09:36:15 AM PDT

          [ Parent ]

    •  sorry nadervoter, but medicare does NOT force you (0+ / 0-)

      to choose a network - as 95% of practicing physicians and groups participate.

      •  Actually lots of doctors don't accept (1+ / 0-)
        Recommended by:
        Marie

        new Medicare patients it seems, at least in my area.

        •  And if your supplemental is in... (0+ / 0-)

          .. some "group", you're limited as to going to others outside the network.  Like maybe you can choose to - but at a premium cost.

          At any rate, choice is always limited.  I had a dentist I liked fine.  He went to work at the Indian Health Service on a nearby reservation.  No more dentist.  I don't get to choose to go to IHS.

          I'm pretty sure I'd be better off in a public option.  Soon as it's available, I'm likely to switch.

          Blessed are those who can laugh at themselves, for they shall always be amused.

          by Land of Enchantment on Thu Jul 09, 2009 at 09:57:21 AM PDT

          [ Parent ]

  •  Just wanted to point out to some (0+ / 0-)

    who are hanging out in the liveblog that slinkerwink has posted another great action diary here. Please rec it up and hit the phones!

  •  Thank you Dr. Dean and my question (2+ / 0-)

    First of all thank you for your continued work and voice of reason in our political debates.  One of the things I'm most proud of in my life is helping to organize the Philly4Dean group in 2003.  

    My question concerns your thoughts on the difference between the two public plans being discussed - the one currently discussed in the House and the second plan raised by the HELP committee in the Senate.  It seems the HELP plan is a bit weaker than we'd like, but is that an acceptable compromise if it gets us the filibuster-proof majority in the Senate?

    The smartest thing you'll read todayTM.

    by TheC on Thu Jul 09, 2009 at 09:20:30 AM PDT

  •  Howard Dean is the one person I will trust (9+ / 0-)

    on this issue.  

  •  Dr. Dean (3+ / 0-)

    Both my husband and son need health care.  My husband has Diabetes I and wears an insulin pump.  My son has Arnold-Chiari Malformation and Autism.  Both will always need healthcare; therefore, they are considered uninsurable.

    This makes no sense at all.  I am for a single payer system because insurance wants to cherry pick and throw out the folks who need it and will always need it.   It is wrong to make obscene profits off of people with chronic conditions.  

  •  Governor Dean (9+ / 0-)

    Depending on who's statistics you believe, America ranks 44th (or lower) among the nations of the world in infant mortality.

    Most of the nations (if not all) who surpass us in lower rates have public healthcare.

    Wouldn't it seem like this would be both a useful metric in refuting those who claim "we have the best healthcare in the world" and enlisting people support of the public option as a moral imperative?

    I wish there were a Wizard of Oz to give the GOP a heart, Democrats courage, and the media a brain.

    by Malacandra on Thu Jul 09, 2009 at 09:22:22 AM PDT

  •  Dr Dean - I just recieved a copy of a letter (4+ / 0-)

    from a local pediatrician in a small private practice - the heartbreaking decision they just had to make was to stop IMMUNIZING people that HAVE INSURANCE!!  How crazy is that?  The reimbursenment stucture is totally upside down, small practices can't compete when purchasing the vaccines and it is ending up costing these small practices enormous amounts of money to provide this service for their insured patients. Yet, Medicare, Medicaid etc patients can be covered because of the way the system is structured.

    There is A LOT that is wrong with the entire system of starting with vaccine procurement and production (it's WAY more profitable for the drug companies to market lifestyle drugs like Viagra than to research and produce boring old things like pertussis vaccines)

    How can we get vaccines the attention they deserve all along the line, from research, testing, production and delivery? And, how to get credit flowing to these small practices that really need the financial system to be functioning rationally?  Part of the current crisis is that the credit markets are screwed up, credit is tight and expensive and small practices are simply struggling while the corporate exectutives at the health "insurance" industries and banks still continure to rake our money into their pockets?

    Thanks for any comment at all - this is a bit rushed as I am heading out the door for some medical tests I need while I still have insurance (I may be one of the uninsured in the not too distant future!)

    Thanks again - Dr Dean you are truly a good and decent person, one of the few really looking out for the common folks.  

  •  KICK ASS HOWARD!! Backing Down Is Selling Out (0+ / 0-)

    and we've had plenty of that crap for 30 and 40 years.

    rmm.

    Yond Cassius has a lean and hungry look; He thinks too much: such men are dangerous

    by seabos84 on Thu Jul 09, 2009 at 09:22:50 AM PDT

  •  "choice" is a loaded word. (6+ / 0-)

    "option" is better.  That's why I support Opt-In Medicare.

    Also, as presently constituted, Medicare violates the equal protection clause.  There is no logical reason why only the old should have their health and welfare protected.

    How do you tell a predator from a protector? The predator will eat you sooner rather than later.

    by hannah on Thu Jul 09, 2009 at 09:23:40 AM PDT

  •  Or, Medicare-Early (4+ / 0-)
    Recommended by:
    Sandy on Signal, matt2525, JayDean, Losty

    "You've been paying for Medicare all your working life. Now you have a choice to sign up for it early." Nice advert.

    ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

    by mrobinson on Thu Jul 09, 2009 at 09:26:12 AM PDT

  •  Dr. Dean, can you give us an idea of where (3+ / 0-)
    Recommended by:
    pundit, blueyedace2, dalfireplug

    President Obama is really at regarding health care reform? It seems he is more interested in claiming bipartisan support rather then having a strong public option. Yes, no, maybe? Can we influence the White House in any way?

    BTW, thanks for all your good work.

  •  Thank you. (1+ / 0-)
    Recommended by:
    blueyedace2

    For what you've done, for what you're doing, and what you undoubtedly will do in the future.

    The American credo: Yes, we can.

    by Ian Reifowitz on Thu Jul 09, 2009 at 09:28:24 AM PDT

  •  overuse? (2+ / 0-)
    Recommended by:
    PAbluestater, regellner

    Hi Dr. Dean,

    Personally, I fully support health care reform and am a big advocate of universal health care coverage since it just makes more sense to me.

    However, one of my conservative Republican friends always bring up the "moral hazard" argument against universal health care coverage. She argues that if everyone was covered people would stop caring about their health and start overusing the system.  Overuse will then raise costs through the roof.

    Do you have a good response to that argument? I say that we haven't seen that in other countries but that is not persuasive to her.

    Thank you for all of your hard work on this issue - I was sure envious of the people in Vermont when you were there Governor - any chance you want to be gov in CA? we could use someone who knows how to get things done!

  •  The Case for Universal Medicare! (1+ / 0-)
    Recommended by:
    JayDean

    My argument in favor of Universal Medicare is founded upon two main premises: (1) capitalist medicine is not as safe and effective as medicine could be, and should be, and (2) the capitalist medical insurance system cannot compete on an economic basis with a Universal Medicare system.  As a threshold matter, however, I think it is important to address a semantic issue that underlies the major defect in the capitalist medical system.  Medicine is not "health care," it is "disease care" based on the corrupt and flawed allopathic/pathology paradigm - treating disease (pathology) with chemicals (allopathy).  There is no "health care system" in the U.S., and there is no "health care insurance."  Health care (basically proper exercise, proper nutrition and the avoidance of toxic petro-chemicals found in food, water, and air, as well as the avoidance of dangerous, toxic pharmaceutical drugs), is not covered by disease care insurance.  As I see it, the term "health care" is a marketing term, hijacked by the capitalist medical system (primarily the drug and insurance industries), because "disease care" doesn't conjure up the warm fuzzy feelings that the term "health care" does.  But, think about this, if you are healthy, there is no reason to see a medical doctor because there is nothing a medical doctor can do for you.  Few medical doctors are trained in, and competent to provide, health care.  In the capitalist medical system, you go to the doctor when you are sick.

    Why is this important?  It is important because, by the design of the capitalist medical system, medical doctors have been reduced to drug and insurance salesman, and medicine, the marketing department of the drug and insurance industries.  Capitalist pathology/allopathic based "disease care" is designed so that sick and dying medical consumers are literally blackmailed into paying exorbitant prices for medical treatment and medical insurance.  The law of supply and demand is irrelevant to the capitalist disease care system.  When you are sick, you pay.  You don't shop around for a better deal, or wait for next year's model.  I know of some who confuse health care with "preventive medicine" and "disease management."  They have nothing to do with health care.  Preventive medicine primarily focuses on disease and employs the same overpriced, dangerous, allopathic chemicals, more likely to cause disease than prevented it.  Further, in my opinion, disease management is the insidious, diabolical invention of the capitalist medical system in which hapless sick medical consumers are treated by increments for the purpose of perpetuating a state of chronic illness for profit!  Clearly, the capitalist medical system has an irreconcilable conflict of interest.  By curing disease, it loses customers, and therefore it loses money.  As a result, it doesn't seek to cure disease because it has no capitalist incentive to do so.  Conversely, in a collective Universal Medicare system, the incentive is to promote health and a healthy lifestyle, and to cure disease in order to eliminate the financial burden of sickness and disease on a collective, non-profit, system.  

    In addition to the inherent conflict of interest that the capitalist medical system has with the wellbeing of medical consumers, the capitalist pathology/allopathic based medical system is neither as safe nor as effective as it should be.  It is indisputable that the American capitalist medical system is the most expensive in the world, both per capita and as a whole, and that the drug and medical insurance industries are among the most profitable businesses in the world.  And what do we get for this price?  Some studies indicate that, under the capitalist medical system, medical care - as a whole - is among the leading causes of death in the U.S.  More deaths are caused by medical care than heart attacks, or strokes or cancer.  Among the factors that make up "medical care," adverse drug reactions (ADR's) to FDA approved drugs, occurring in hospitals (not in the community), alone, is the fourth leading cause of death, amounting to approximately 120,000 deaths per year.  These pharmaceutically induced deaths do not involve misdosing, misprescribing or any other manner of medical malpractice.  In other words, the foundation of the capitalist medical system - treatment with the indicated FDA approved drug, for the indicated disease, with the indicated dose, is the fourth leading cause of death.  This does not include the 2 million serious non-fatal adverse drug reactions (ADR's) annually.  Further, under the capitalist medical system, hospital acquired (nosocomial) infections, alone, kill almost 120,000 people annually, and medical malpractice, alone, the 6th leading cause of death, kills over 100,000 people annually.  Neither of these statistics includes non-fatal injuries.    

    Now let's look at the economic issues associated with the capitalist medical system.  Under the capitalist medical system, medical bills are not just the leading cause of personal bankruptcy.  According to the most recently reported statistics, medical bills cause 62% of personal bankruptcies, more than all other causes of personal bankruptcy combined.  Further, the current cost of the capitalist medical system is nearly 20% of the GDP (gross domestic product).  This means that nearly one out of every 5 dollars spent in America is spent on the capitalist medical system.  This percentage of GDP is expected to double by 2030.  The current cost of capitalist, for-profit medical insurance is about 45-50% of the total cost of medicine obtained through for-profit insurance.  On the other hand, the total cost that Medicare adds to the cost of medicine obtained through Medicare is 2-3%.  Therefore, if Universal Medicare replaced capitalist for-profit medical insurance, WITH NOTHING MORE, the national savings will be 8-10% of the GDP.  Do you think that might stimulate economic recovery?  

    If anyone tells you that the medical system is broken, I would suggest that they don't know what they're talking about.  The capitalist medical system is working exactly the way the drug and insurance industries have designed it to work.  The capitalist medical system is a parasite on America and the world.  I would also suggest that it is the largest, and most easily removed, roadblock to economic recovery and medical equity in America.  In my opinion, Universal Medicare is the best solution.  

    Having said that, I do think that medical consumers, doctors and other medical providers should have the right to opt out of Universal Medicare if they want to.  As a practical matter, most medical providers wouldn't have a choice because very few medical consumers can afford to pay for medical care out of pocket, and fewer would be willing to pay the 45% additional cost (basically, the profit) associated with for profit medical insurance.  But, that should be the consumers' and providers' choice to make.  I also think that private insurance companies should be free to try to compete with Universal Medicare, if they can.  I doubt that capitalist medical insurance can compete economically with collective, universal medical insurance.  But, in my opinion, it should be allowed to try.  

  •  Here's a question (6+ / 0-)

    Is dental care going to be included as a part of the public option?

    It's a critically important health issue which has always gotten back of the bus treatment in terms of coverage. It's always seperate and usually not very comprehensive.

    "Pay no attention to that man behind the curtain!"

    by jkay on Thu Jul 09, 2009 at 09:32:55 AM PDT

    •  Unlikely (0+ / 0-)

      As the plan becomes increasingly costly, major elements of coverage will have to be dropped.

      This is what occurred in states that tried the public option.  A proposal that is already a proven failure.

      Only single payer solves the health insurance crisis.

      Obama used to be for single payer before he came out against it.

      by formernadervoter on Thu Jul 09, 2009 at 09:35:09 AM PDT

      [ Parent ]

      •  Remember: the cost now is unsustainable (0+ / 0-)

        When cost becomes the argument for doing nothing, that now the insurance companies divert $billions to their own use. That's where the money is now. Remember - the current system is the most expensive in the world and with poor results. Let's remember who get s the money when someone complains about the cost of health care for all.

        ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

        by mrobinson on Thu Jul 09, 2009 at 09:44:22 AM PDT

        [ Parent ]

    •  dental care (14+ / 0-)

      we don't know about dental care.  the dental care system in this country operates much more like small businesses operate than the medical care system does.  you would have to have different financing methods if dental were to be included.

      this brings up the question of mental health as well.  it's my view that mental health parity, which passed the congress several years ago should apply to the new system.

      •  Dental is important though... (2+ / 0-)
        Recommended by:
        Sandy on Signal, Debbie in ME

        as many serious and perhaps fatal infections can start from lack of dental treatment.
        Having dental could save money in the long run, or at least come close to paying for itself.

        Raymond Gellner - Liberal Examiner at Examiner.com

        by regellner on Thu Jul 09, 2009 at 09:51:10 AM PDT

        [ Parent ]

      •  A follow up (0+ / 0-)

        How about situations where you have required dental surgeries (wisdom teeth, mouth cancers, accidents that cause catastrophic tooth destruction) that go beyond routine cleanings, fillings, etc.

        Will occurences like that migrate into the definition of general health coverage.

        "Pay no attention to that man behind the curtain!"

        by jkay on Thu Jul 09, 2009 at 10:16:36 AM PDT

        [ Parent ]

      •  A little late to the game (1+ / 0-)
        Recommended by:
        Caipirinha

        What about vision coverage?  We don't need to buy fancy glasses for everyone, but there are people who can't afford new glasses.  Without my glasses, I can't see the big "E" at the top, so having the right prescription is required for me to drive and do my job.  Not covering vision means only people who can afford it apparently have the right to see clearly.

  •  SELF FUNDED -LEVEL PLAYING FIELD- WTF? (1+ / 0-)
    Recommended by:
    Proleft

    This idea of a self funded or Level Playing Field Public Option is a farce and we shouldn't be supporting it @ all! What damn good is another INSURANCE OPTION PUBLIC OR PRIVATE call it what u will that has to make a Profit? It's just another BAD choice and we already have 1300 of them! This is is a n empty Public Option the one Sen. Chuck Schumer is pushing. We've been had folks , yes had. I'm sorry to say this idea of Choice is BS and Dr. Dean is pushing BS here. ONLY a Single Payer or a Nat'l Health Service ( like the Brits have) will work to lower cost and secure us from medical bankruptcy! Dean, Schumer all of these POLS are pushing BS with this Public Option. Don't all of u get it the Public Option is the bad deal they left as a default after they removed the only REAL reforms that make any sense. Once the watered down shell they'll call a Public Option FAILS and FAILS badly just like their last BAD reform the infamous HMO or Managed Care deal then we'll be looking at the GOPErs laughing in our faces. We don't need this kind of PHONY ass reform folks.

    "It's better to die on your feet then live on your knees" E. Zapata

    by Blutodog on Thu Jul 09, 2009 at 09:35:16 AM PDT

    •  What makes you think the public option... (3+ / 0-)
      Recommended by:
      mcjoan, srkp23, JayDean

      ... has to make a profit?

      Your passion on this subject is clear, but you need to understand that the battle for a public option is a battle for a non-profit option.  In fact, the cost savings of a non-profit option is one of the things that will help to control costs.

      I wish there were a Wizard of Oz to give the GOP a heart, Democrats courage, and the media a brain.

      by Malacandra on Thu Jul 09, 2009 at 09:39:34 AM PDT

      [ Parent ]

      •  The shape of that Option (0+ / 0-)

        Nobody yet knows what the final shape of the so called Public Option idea even is? If it's like the Schumer idea or the Conrad idea it's worthless IMHO. If the option isn't modeled after Medicare what do we need another BAD Ins. choice out here for?

        "It's better to die on your feet then live on your knees" E. Zapata

        by Blutodog on Thu Jul 09, 2009 at 09:49:41 AM PDT

        [ Parent ]

      •  It ain't necessarily so. (1+ / 0-)
        Recommended by:
        Blutodog

        you need to understand that the battle for a public option is a battle for a non-profit option.

        Good luck finding agreement on that. There's no universal definition of "public option" and the Congressional plans being put forward reflect that lack of consensus.

        To some, a public option just means a mandate to purchase junk insurance from private companies (yeah, pretty much what we have now, with the added feature of financial penalties for those who don't buy into it -- a forced public subsidy of the private insurance industry).  

        FWIW, I agree with you that it has to be based on a non-profit system. But most of Congress doesn't, apparently. The medical lobby is calling the shots.

        What this country needs are more unemployed politicians. -Angela Davis

        by CMYK on Thu Jul 09, 2009 at 10:49:20 AM PDT

        [ Parent ]

        •  PO & PO whose is the ? (1+ / 0-)
          Recommended by:
          CMYK

          "To some, a public option just means a mandate to purchase junk insurance from private companies (yeah, pretty much what we have now, with the added feature of financial penalties for those who don't buy into it -- a forced public subsidy of the private insurance industry)."

          Exactly , what I've been saying. Dr. Dean wants a Medicare style PO but I don't hear or see anything near that coming out of any of these committees. Instead we have Bauchus with a totaly farce that is nothing more then a bail-out for the health Mafia and Schumers so called Level Playing Field PO which is another sham idea that changes nothing. I haven't read any of the ones coming out of the House. The best so far is the Kennedy bill and that isn't that great either. I doubt when this is all said and done the bill Obama is going to claim is a great break through is nothing more then another BIG Corp giveaway of more Tax dollars. If it includes a forced mandate to have to buy Ins. and there is either no PO or a PO so weak it's just a empty phrase were all screwed.  

          "It's better to die on your feet then live on your knees" E. Zapata

          by Blutodog on Thu Jul 09, 2009 at 06:44:47 PM PDT

          [ Parent ]

    •  If the US had instituted a single payer (1+ / 0-)
      Recommended by:
      Blutodog

      plan a few decades ago, total national health care costs would be more in line with what Switzerland spends (the highest GDP health care cost EU country).  Care wouldn't be rationed by an ability to pay but provided as needed.  Instituting single-payer now would likely be a disaster in the near term.  The supply far below the demand.

      Better IMHO would be a National Health Service.  Don't want that then buy your health care in the private market.  

      What FDR giveth; GWB taketh away.

      by Marie on Thu Jul 09, 2009 at 11:11:19 AM PDT

      [ Parent ]

  •  Along those lines.... (1+ / 0-)
    Recommended by:
    CMYK

    There is an Excellent article in the current AARP Magazine about 8 Myths they are trying to "lay on us" if we pass Healthcare this year.  There are some great talking points along with Howard Dean's.

  •  Gov. Dean, what is your view of the (0+ / 0-)

    Kennedy-Dodd revised plan. What are its pros and cons? How would you modify it to make it most effective for the goal of maximizing the number of people covered?

  •  Dean is wrong (3+ / 0-)
    Recommended by:
    Blutodog, NeuvoLiberal, CMYK

    when he implies single payer limits choice. When politicians say choice they mean a choice of an insurance plan which most limit choice of doctors and hospitals. Single payer offers true choice because you can pick any doctor or hospital you want. Plus will these private insurance plans close all the loopholes they have?

    •  you make a good point about (2+ / 0-)
      Recommended by:
      Caipirinha, CMYK

      likely expanded choice of doctors and hospitals in a single payer system. At the same time, if someone wants better/expanded care than such a system can provide, they should have a choice of being able to get it, IMO.

      Perhaps single payer along with a supplemental insurance system (for those that want to purchase extra insurance) might be the optimal approach? I'm curious what Dr. Dean thinks about this type of an approach.

    •  "when he implies single payer limits choice" (1+ / 0-)
      Recommended by:
      Losty

      Wrong. Gov. Dean hasn't said that. He has said that Medicare is single-payer. Give the people a chance to choose something like it. This is what he says in Esquire:

      HD: I think that the Senate needs to understand that the American people want a public plan. That's not an advocate talking. That's the facts of the polls. People want the choice. And why shouldn't the American people get to choose instead of the big Washington government making the choice for them? So I think the Senate will come to understand that their first job is to serve the American people and not the health-insurance industry.

      ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

      by mrobinson on Thu Jul 09, 2009 at 09:49:42 AM PDT

      [ Parent ]

  •  If it's been said before it's worth repeating (3+ / 0-)
    Recommended by:
    Malacandra, pattyp, wsexson
    How novel, a real doctor weighing in on health care policy.
  •  Must have Medicare-like Affordable Public Option (5+ / 0-)
    Recommended by:
    slinkerwink, Blutodog, wsexson, Losty, CMYK

    Why is this so difficult to convince many in Congress?

    I am now one of the Uninsured and resigned that I will  be bankrupt when a medical crisis happens. After paying over $18,000 in premiums to Aetna for about 4 yrs - and utilizing only about $3000 of services - I can no longer afford the 50% increase in premiums that Aetna has decided based on a pre-existing condition that has never received any major treatment.

    This is what is so messed up with Senate members. Must see this fantastic in-your-face to Sen. Carper ($$-DE) by MSNBC's David Shuster

    "People ask, is there one word that you have more faith in than any other word, ...I'd say its Participation." - Pete Seeger

    by PAbluestater on Thu Jul 09, 2009 at 09:40:52 AM PDT

    •  health insurance in PA (1+ / 0-)
      Recommended by:
      PAbluestater

      If you live in Pennsylvania, you can get health insurance through the Blues (still theoretically nonprofit) under their voluntary community rating, with preexisting conditions covered after a 1-year waiting period.

      If you've just now left Aetna, you might be able to make the transition without the waiting period.

  •  Totally selfish, but... (2+ / 0-)
    Recommended by:
    Involuntary Exile, CMYK

    today is my birthday, and all I want for a gift is real health care reform. I have "good" insurance through my employer, but I'd drop it in a second for any alternative.

    The lesson of that history is that you must not despair, that if you are right, and you persist, things will change. -Howard Zinn

    by blueyedace2 on Thu Jul 09, 2009 at 09:46:41 AM PDT

  •  Crap -- might just be a meeting of the Deans, and (1+ / 0-)
    Recommended by:
    Marie

    I'm not sure my conservative credentials will survive.

    I've got to look into this --
    sounds like Dean is saying something very similar to what

    I believe: Real health care reform is essential. Health care "reform" without real reform is pointless.

    Sounds like he's more hyped over the public option than I am, but that difference may be smaller than I think.

    My main problem with a public option as litmus test for real reform is that it slaps a new veneer on a rotten system.  Fix up the system, and I don't much care either way.

    Troublesome, though, if first impressions hold.  I'll just have to be very quiet around my conservative friends.

    Free speech? Yeah, I've heard of that. Have you?

    by dinotrac on Thu Jul 09, 2009 at 09:47:31 AM PDT

    •  real reform (14+ / 0-)

      the reason I believe a public health insurance option is the gateway to real reform is that the American people for the first time can get out of the current system which is costing us jobs, economic instability, and ignoring the health needs of more than 50 million people.  I think given the choice the American people will do the right thing and opt for real reform.  the existence of the public option also creates a huge incentive for the private sector to abandon some of their most predatory practices, and reform themselves.  if they fail to do so, then indeed they will be out of business.  but that too will be their choice.  either way, you can't get reform without a public option.

      •  economic stability is critical... (0+ / 0-)

        and we see eye to eye on this.  Health care reform will also help us to remain competitive on the world stage.  
        I wrote a piece on this a few weeks ago...

        Raymond Gellner - Liberal Examiner at Examiner.com

        by regellner on Thu Jul 09, 2009 at 09:58:07 AM PDT

        [ Parent ]

      •  I'm certainly not qualified to argue with you!! (2+ / 0-)
        Recommended by:
        Marie, CMYK

        And it is ridiculous to have what are literally life and death issues beholden to profits.

        My reservations are crystallized in that recent New Yorker article that made the rounds of the President's top staff.

        It compared the vast difference in per-patient Medicare costs from one place to the other. In my mind, the article contains proof that we can provide great care for everybody and save a bundle in the process. It also served as a warning, however, in it's McAllen, TX example, that simply changing the name on the checks is not enough.

        We need to go up and down the line:

        Let doctors be doctors again,

        Bring a little reason to the pharmaceuticals mess, from making it easy to compare old v. new drugs to getting pharmaceuticals out of the CME business to stopping those freakin' TV ads with disclaimers a million miles long.

        And so on.

        A lot of work -- but a huge reward for the effort.

        Free speech? Yeah, I've heard of that. Have you?

        by dinotrac on Thu Jul 09, 2009 at 10:07:59 AM PDT

        [ Parent ]

  •  Jobs... (0+ / 0-)

    One thing never discussed is the fact that the insurance industry employs a LOT of people.  Personally, I think a lot of these people are overpaid (compared to the rest of us) but any 'reform' we do must be looked at from the standpoint of 'how many people will this put out of work', same with the medical profession.  

    As far as I can see, the biggest problem comes from the realm of 'shareholders'.  Basically, the system we embrace is all about the profit motive, the 'investers' are considered in everything but not the 'customers'.  This works with most other realms but when we get into things like medicine and law the profit motive actually works against the system.  I've said for years that anybody who gets into a system designed to help people merely to make money has no business going there.  

    Take the profit motive out of the system and it will correct itself.

  •  dean would get it done... (1+ / 0-)
    Recommended by:
    CMYK

    If Dean were president and had the house and senate I think there is no question he would pass real reform.As it stands now it will be just like the stimulus plan passed.It will cost a trillion dollars we dont have and do very little if anything to solve the problem.  

    •  You're right. The priority wasn't really reform, (0+ / 0-)

      it was the unnecessary bipartisanship and keeping the medical lobby system intact. And the plans being put forward reflect that. It's a slow-motion trainwreck that isn't being stopped no matter how much activism we're putting in its path. Very frustrating. Feels like we were set up by the president for an unsuccessful outcome.

      What this country needs are more unemployed politicians. -Angela Davis

      by CMYK on Thu Jul 09, 2009 at 10:30:05 AM PDT

      [ Parent ]

  •  single payer/medicare for all:what most want(n/t) (2+ / 0-)
    Recommended by:
    Blutodog, CMYK
  •  Question: Why Medicare-like and not just Medicare (4+ / 0-)
    Recommended by:
    Blutodog, wsexson, Losty, CMYK

    for all? Medicare is proven, popular, sustainable, familiar, works smoothly, and has low administration costs. Congress should offer Medicare Early, instead of reinventing the wheel in a public insurance system that will be hard to explain and layered in complexity to satisfy all in congress. What do you think, Gov. Dean?

    ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

    by mrobinson on Thu Jul 09, 2009 at 09:55:12 AM PDT

    •  fee-for-service issues (0+ / 0-)

      and underpayment of primary care physicians is my understanding, like the New Yorker article about the Texas town, which charged Medicare 40% more than other towns.

      Since the specific Medicare payment system does need fixing, "Medicare-like" just means Medicare but with some much-needed reforms.

      (I'd love to see Gov. Dean's answer to your question, though.)

      "At the end of the day, the public plan wins the game." Sen. Ben Nelson

      by ferg on Thu Jul 09, 2009 at 10:08:30 AM PDT

      [ Parent ]

  •  Can't take choice away from Americans? (4+ / 0-)
    Recommended by:
    Blutodog, wsexson, verso2, CMYK

    We would render most public services ridiculously complicated and unworkable if we insisted on a having a choice of varied private highway departments, fire departments, all municipal and state service providers of any category. Dean is better than most but universal single-payer is cheaper, better, and proven. We're about to institute a less suitable structure based on this romanticized notion of the individualist American. I wouldn't be so thrilled to have public option being the only progressive solution being accepted in Washington. Mr Dean does not help the issue by throwing single-payer under the bus claiming it is somehow inherently Un-American.

    •  Disagree "romanicized notion" (0+ / 0-)

      Gateway public option is the essence of practical hard-headed progressive strategy. Get under the tent. Move everyone in.

      ...their struggles for access, the clever things they say, the trappings of their wealth, the techniques by which they have monetized their power. ThomasFrank

      by mrobinson on Thu Jul 09, 2009 at 09:58:39 AM PDT

      [ Parent ]

      •  I'm not insisting on single payer (0+ / 0-)

        continuing to be on the table because of an ideological purity stance but because it's the best, most fiscally responsible and most likely to succeed path available to us.
        My objection, however, is with the need for Howard Dean (or Obama himself in his AMA speech) to denounce and reject single-payer by claiming it goes against our American ideals of individualism and our unique heritage of competition. What a load of hooey. I'm resigned to the fact that the center/right tent won't welcome me but please spare me the American ideals rationalization. We're laughed at by the rest of the world that we buy this crap.

    •  mixtures work (0+ / 0-)

      in Southern California at least, there are a variety of highway departments if you consider toll roads a separate system.  There is the I-5 freeway as a public option, and then there is the 73 toll road that costs some extra if you want. You certainly do not need to take the toll roads, and if you don't have the money you can't, but you can.

      I wonder if that is a good metaphor for the mixed system that is being put into place.  If you'd like to spend your money on toll roads (private insurance) you are free to - but if you either can't afford or prefer public roads you can and just pay for the services through your tax dollars...  

      Everyone has access to some freeway but if you want to spend your money on private roads because you think it's better feel free.

  •  A constituency not heard from in this debate (2+ / 0-)
    Recommended by:
    pattyp, CMYK

    Dr. Dean:

    First I wish to commend you on your unflagging pursuit of quality affordable health care for every American.  However, the millions of Americans with disabilities, particularly those with congenital disabilities and those with developmental delays seem to have been shut out of the debate.  I have repeatedly searched for news stories in the MSM that are inclusive of the disabled in the debate, but have come with a precious few.

    For those with intellectual disabilities and their caregivers, the costs can be staggering when coupled with other chronic maladies and acute emergencies.  States across the nation are choked with millions of Americans placed in decade-long waiting lists for Medicaid waiver services or seeking to move into more inclusive community- based settings.  

    Those Americans with sensory disabilities, the situation is no better, with many doing without the tools or technologies that would allow them the live fuller, more independent lives.  

    Medicaid as it is structured now, is an abject failure. Here in Indiana, the "modernization" of social services undertaken by Mitch Daniels and his privatization crusaders is a system designed to fail by forcing those must vulnerable (folks without technical savvy or access to same) to throw their hands up in frustration and not apply for the services they are in need of the most, especially Medicaid coverage in a state where the economy has wreaked a horrific toll.

    So I ask, sir, what of the concerns of the 54 million disabled Americans whom I feel have been left out of the discussion?

    Thank you for your time.

    Angel

    Progressive Gearhead--supercharge change!

    by Albino 4 Obama 08 on Thu Jul 09, 2009 at 09:57:46 AM PDT

  •  WHY re-invent the wheel? (1+ / 0-)
    Recommended by:
    CMYK

    We already are paying for a Medicare bureaucracy, why create another one for a so called Public Option? Why not just expand the present Medicare system?

    "It's better to die on your feet then live on your knees" E. Zapata

    by Blutodog on Thu Jul 09, 2009 at 09:58:43 AM PDT

  •  Gotta work. Just saying, "HI" and THANKS. NT (0+ / 0-)

    I'll read this entire thing when I can devote full attention!

  •  Jobs (25+ / 0-)

    I have to sign off now - so thank you all for being part of this, we have a lot of hard work ahead of us.  I do want to make one more point.

    Jobs are at stake here.  America is losing jobs not just to China and India for wage reasons but to countries like Canada.  While Canadian companies pay more taxes than American companies, their taxes dont go up at 2 1/2 x the rate of inflation.  But in America businesses have seen their health care costs go up at that rate every year on average for the last 30 years.  

    Furthermore small businesses create 80% of our new jobs.  But their healthcare costs also rise at
    2 1/2x the rate of inflation.  Healthcare is a huge drag on the American economy and our current system is a job killer.  That can't be fixed unless we have real changes to the system we've been using for the last 60 years.  With the public option the changes will come at a pace that the American people choose.  Without a public option there will be no change.

    Keep fighting.

  •  Thank you Gov. Dean (0+ / 0-)

    I think the public option is going towards a positive direction nationwide, so we need to redouble our efforts and not let this fall apart!

    Raymond Gellner - Liberal Examiner at Examiner.com

    by regellner on Thu Jul 09, 2009 at 10:06:10 AM PDT

  •  Two controversial opinions (1+ / 0-)
    Recommended by:
    ferg

    (1)I think the Public Option needs to be IMMEDIATELY available to every single Public employee in the country - from P/T school bus aid to POTUS.

    (2) I think the Public Option needs to be supported by a broadly-based tax. This need not be the exclusive support of the Plan, but everyone should have to "chip in." I have no problem with taxing current Premiums, but that's too narrow a base to grow on (especially if you believe that a Robust Public Option will steadily displace subscription to Private Plans). I propose that we increase the current Medicare portion of Payroll taxes from 2.9% to a full 4% and use the revenue stream to both address the current reimbursement "issues" of Medicare and to underwrite the Public Option.

    Some Medicare Tax increase, combined with some contribuition from future Income Tax hikes on the wealthier among us, and some from a properly created Estate Tax is probably more than enough to fund a truly Robust Public Option.

    Single Payer and WPA 2.0...NOW!!!

    by Egalitare on Thu Jul 09, 2009 at 10:15:46 AM PDT

  •  Is that really you Dr. Dean? (0+ / 0-)

    Dr. Dean, you can't be thanked enough, but thanks anyway for what you do.

    You kick so much ass it's ridiculous!

    "Pay no attention to that man behind the curtain!"

    by jkay on Thu Jul 09, 2009 at 10:19:50 AM PDT

  •  Howard Dean can't be bought (0+ / 0-)

    or manipulated by corporate lobbyists or big pharma. That's why he's not in the Obama cabinet.
    If Obama compromises on a public option i'm gonna work my ass of on principle to primary against him. I would hope many of you would do the same.

  •  Oh man. (1+ / 0-)
    Recommended by:
    Albino 4 Obama 08

    I had no idea that was a "liveblog" with the man himself!

    I just threw a question out there for any old person to answer it and Howard Dean actually answered it!

    How fuckin cool is that?

    "Pay no attention to that man behind the curtain!"

    by jkay on Thu Jul 09, 2009 at 10:24:52 AM PDT

  •  Yes, make sure you read the talking points and... (0+ / 1-)
    Recommended by:
    Hidden by:
    ferg

    spout them out verbatim. Don't think about it, just do it. It worked so well for the stimulus bill.

    Your progrssinve leaders have spoken. You must blindly follow.

    •  talking points? (2+ / 0-)
      Recommended by:
      trashablanca, dditt

      Well, anyone who mentions talking points needs to take a refresher course from good old Frank Luntz!

      •  Did you eve read the article: (0+ / 0-)

        It even tells you that this is all you need to know

        "All of these facts, figures, and talking points are provided in the book for one reason, and it's a familiar one coming from Gov. Dean: to provide you with all the ammunition you need to help get real reform enacted. Anyone who reads this book will be able to talk intelligently and convincingly about a broad range of healthcare related topics, from how various industrialized European countries provide this public good to why his most controversial idea for funding reform, a carbon tax, actually makes sense.

        All this is to get you out there talking to your friends, family, and neighbors about healthcare reform; calling your representatives, writing letters to the editor; calling into talk shows and cable shows. As he says in the book, "Successful political campaigns never stop."

  •  Workers Comp Insurance (0+ / 0-)

    Want a glimpse into what happens when insurance companies target state workers comp premiums?

    ttp://www.sacbee.com/business/story/2011676.html

  •  I'd like to thank Gov. Dean and DFA... (2+ / 0-)
    Recommended by:
    JayDean, dditt

    ...for the Netroots Nation scholarships -- one of which I was awarded. Without their generosity I wouldn't be going to Pittsburgh this summer to meet all of you!

  •  Single payer = no choice? (1+ / 0-)
    Recommended by:
    kovie

    I'm sorry, but when did this nonsense start? Are you saying that under a single payer system we would close any clinic/hospital or medical practice in general that wouldn't treat govt-referred patients 100%?

    Please.
    If you have the money, or need something done quicker, you're still free to choose whatever doctor you want to see, no matter how private or expensive.

    Right? So you still have a choice.

    •  Single payer should be the baseline (0+ / 0-)

      for good, comprehensive, affordable insurance for all. Anyone wants more, they're free to get another plan, or a supplemental plan, or pay out of pocket. I mean, the post office hasn't precluded the existance of UPS, FedEx, etc.

      I HATE being bullshitted by patronizing politicians. They do this by second nature.

      Fox Nauseam Delenda Est

      by kovie on Thu Jul 09, 2009 at 11:30:02 AM PDT

      [ Parent ]

  •  Thanks mcjoan! :-D n/t (2+ / 0-)
    Recommended by:
    mcjoan, dditt

    Does this internet make me look fat?

    by pattyp on Thu Jul 09, 2009 at 10:59:37 AM PDT

  •  as a small businessman. (4+ / 0-)
    Recommended by:
    Caipirinha, ferg, kovie, Losty

    health insurance is killing us.

    One of my guys had  a heart condition, turned out to be genetic.

    Needed Surgery. Cost 250K.

    Next year our premiums tripled....

    Yep. The free market at work.

    George Bush is Living proof of the axiom "Never send a boy to do a man's job" E -2.25 S -4.10

    by nathguy on Thu Jul 09, 2009 at 11:12:48 AM PDT

    •  My sister owns a small business (2+ / 0-)
      Recommended by:
      ferg, nathguy

      and simply can't afford health insurance for her employees. She'd love to be able to offer it, even though she has no problem finding employees, but it would force her to go out of business. In the US, if you're not rich and don't work for a large and/or rich company, you're screwed when it comes to insurance, and thus health care.

      The idea that private insurers can fix this is absurd. Anyone who says that they can is either an idiot or a liar. They can only serve the healthy and rich. Everyone else needs the government to step in and fix things.

      Fox Nauseam Delenda Est

      by kovie on Thu Jul 09, 2009 at 11:34:27 AM PDT

      [ Parent ]

  •  As I read this (2+ / 0-)
    Recommended by:
    Caipirinha, Losty

    I wonder how I'm going to pay for my individual insurance, which just went up 17%, raised by my insurance company that supposedly is more efficient than government at keeping costs down, the same government that just had to raise the price of a stamp by a horrific 4.8% in 2 years. Clearly, we can't let government meddle in insurance!

    Fox Nauseam Delenda Est

    by kovie on Thu Jul 09, 2009 at 11:26:24 AM PDT

  •  DEAN! (1+ / 0-)
    Recommended by:
    JayDean

    DEAN 2012!

  •  people's needs before business profits (2+ / 0-)
    Recommended by:
    ferg, Losty

    I am a small business owner AND healthcare provider who supports a PUBLIC option. We have to spend $16k a year in premiums and annual deductible BEFORE our insurance benefits kick in. At the same time, the CEO of our health insurance company earned $23 million in 2007 in compensation and benefits.  Now that's sickening.  

    Message to Rep. John Boehner and anyone else in Congress who is opposed to a public option:
    Put people's needs before business profits. If they cannot compete for our business, c'est la vie and good riddens to the multi-million dollar profits for insurance companies. I'm tired of paying for their benefits while my retirement account is put on hold to pay for insurance premiums.

    Check out this great report released by Healthcare for America.  Thank you to Dr. Dean for leading this important initiative.

    Terri Spahr Nelson, Reflections from Women

    by tsnelson on Thu Jul 09, 2009 at 12:39:59 PM PDT

  •  So why isn't this guy Security of HHS? (0+ / 0-)

    He seems to be working harder on this than Sebelius, or at least more publicly.

  •  We have a single payer pilot in progress (1+ / 0-)
    Recommended by:
    The Moonlit Knight

    Millions of military people, both retired and active duty are on a single payer health care plan called "Tri-Care". I am one of them. In my region it is managed by Humana (they won the bid). It is excellent coverage, better and much cheaper than the employeer plan I am offered. A single payer option that requires the insurance companies to use a standardized system, is not socialized medicine, it is smart medicine. Just look at any Dr. office, how many people do they have just to work all the different coding and billing systems? More than the health care providers at the same office most likely. This is wasteful, costly and adds to errors in treatment. The health insurance industry, as it stands now, is a relic and a boat anchor on our economy. Not moving to a single payer system is welfare, corporate welfare.

  •  Dr Dean says it all... (0+ / 0-)

    and I really have nothing to add except that we'd be a far richer country if he'd been our President.

    Some say we need a third party. I wish we had a second party. -- Jim Hightower

    by joe m on Thu Jul 09, 2009 at 07:38:26 PM PDT

  •  Reply from Sen Warner (VA) (0+ / 0-)

    Another diary got me writing letters to my reps, and I got a reply from Mark Warner. I supported him in his run for Senate, and I know he's a moderate,  but I'm still a bit irked about his insistence that we still need private insurers. Well, see for yourself. He's going to organize a task force on health technology, but no mention of public meetings on the broader issues of reform. Here's his letter:


    Dear ___,
    Thank you for your recent letter regarding reforming our nation's health care system.  I share your concerns about the need for comprehensive health care reform, especially during this challenging economic time.

    Although I do not support a government-run single-payer health care system, I believe we need comprehensive reform to achieve a competitive, cost-effective, and efficient system.  This effort should be primarily focused on ensuring that all Americans can get adequate health coverage, and the coverage must be cost-effective and based upon data-driven medical standards.  We must ensure that competition remains among health care providers because it is precisely that competition that drives innovation and cost reduction in the industry.  Any final reform should also include measures to promote prevention and wellness, senior navigation through the health system, health information technology ("health IT") and telemedicine.

    The health care reform debate in the Senate will intensify over the coming weeks, with the Finance Committee and Committee on Health, Education, Labor and Pensions reviewing and amending legislation before the bill is debated by the full Senate.  Although I do not sit on those Committees, I am actively engaged in drafting legislation to be included in the final package and in discussions with my fellow Senators on improvements we can make to the current bill.  Much of the current controversy surrounding reform efforts has been focused on whether the bill should include a public health insurance option.  As evidence that there is room to compromise, several alternatives are being discussed ranging from non-profit regional co-operatives to a delayed public option. I will keep your views in mind as we consider these and other proposals.

    Thanks again for contacting me.  As health care reform in the Senate takes shape, I value your opinions.  I recently convened a task force on health IT, the product of a widely-attended conference at VCU, for the purpose of putting Virginia on the cutting edge of health IT.  If you would like information about this initiative or my recently-introduced Senior Navigation and Planning Act, please visit my website at: www.warner.senate.gov.  As we move forward, I will continue to seek out the advice and opinions of all Virginians in order to help shape an improved health care system that will be in all of our best interests.

    Sincerely,
    MARK R. WARNER
    United States Senator

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