The last time Gov. Howard Dean joined us back in July, we talked about his book, Howard Dean's Prescription for Real Healthcare Reform. In the book, Gov. Dean writes:
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.
We're at a critical juncture now in the reform process, as the various commitee bills in both chambers are being merged. Guaranteed of a good bill with a strong public option coming out of the House, the Senate is key. A sign of how high the stakes are in this is the new assault on reform by AHIP, the insurance lobbying group.
So it's a good time to check in with Gov. Dean. To start off the discussion, I asked him about AHIP's actions.
JM: You bust a number of reform myths in your book, and we see a bunch of them reemerging out of the report AHIP issued on Sunday. Which are the most pernicious?
HD:The whole report is pernicious. This is a classic knock down special interest fight in Washington with the Congress caught in the middle between donors and voters. In a fight like that, which is simply about money, the truth is the first casualty. The insurance industry takes the Fox News approach which is that you can get people to believe anything if it has a minimum of fact and is repeated often. In my book, Howard Dean's Prescription for Real Healthcare Reform, I devote a whole chapter to debunking the pernicious lies the Insurance industry repeats over and over again.
JM: AHIP has also started an ad campaign intending to scare seniors about what reform might do to their Medicare. What's the best way to debunk this one?
HD: The best way, and only real way to debunk the Medicare myths is to use Medicare as at least part of the public option. If the Democrats want to escape 2010 reasonably unscathed they have to enroll some reasonable proportion of Americans in an insurance plan about five or six months before Election Day. Facts on the ground are the most effective way to attack misinformation.
The only way to allow people to enroll before election day is to use Medicare as the vehicle. Trying to start a new bureaucracy that fast would be a disaster from both a policy and a political point of view. I would allow people over 55 or 50, depending on the CBO score, to enroll in Medicare with an income appropriate premium. This could be part of the public option using an established system with high favorablity and familiarity that already pays over a billion claims a year. You would not have to use Medicare rates from a bureaucratic point of view (the Schumer public option). That kind of duality could be easily handled by the system. A difference in benefit package could not, so you would need to keep the Medicare benefit package.
Finally I have tried this out on a few of the leaders in the debate, and a few staff people. There is a group of folks in New York who care about this a lot who have come up with financial estimates which I have shared. I think this is a real possibility, because every one understands the politics of it, not just the policy end of it.
Gov. Dean will be here for the next hour or so to answer your questions about healthcare reform and what we can do now to make this reform real. Join us in the comments.