Dr. Dean’s Health Care Prescription: “The Free Market Just Doesn’t Work in Medicine”

On a book tour in southern California recently, Howard Dean–the ex-governor of Vermont, 2004 presidential candidate, and former DNC chair, who is himself a medical doctor–makes a few points about health care that are worth keeping in mind through the bitter partisan debate (if you can still call it a debate). His book from Chelsea Green is called Howard Dean’s Prescription for Real Healthcare Refom.

Remember that it was Dean who, as governor of Vermont, got through a provision guaranteeing health care covering to all of the state’s children. He was ridiculed on the stump in 2004 as an out of control lefty–which is about as true as the accusations that Obama is a socialist. Dean is a moderate-to-conservative New Englander who has never proposed anything faintly resembling socialized medicine. 

But Dean does believe, as he pointed out at one book tour appearance: “The free market just doesn’t work in medicine. You can’t be an informed consumer. I never saw someone with severe chest pain jump off the table and say, ‘Doctor, I’m going to the cheaper guy down the street.'” And he doesn’t favor compromising on a public option, because “the public option is the compromise.”

The above quote was supplied by Miriam Raftery, editor of the East County Magazine, who  provides a fine precis of Dean’s book and the talk he gave last month at a San Diego bookstore: 

Dean noted that public healthcare in Europe was established not by liberals, but was in fact championed by conservative statesman Winston Churchill. “Disease must be attacked, whether it occurs in the poorest or the richest man or woman simply on the ground that it is the enemy; and it must be attacked just in the same way as the fire brigade will give its full assistance to the humblest cottage as readily as to the most important mansion,” Churchill once stated.” Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.”

Cost savings would occur by moving to a wellness-based medical model that emphasizes prevention, lowering current costs for treating patients who wait and go to the emergency room in a crisis. Eliminating administrative overhead would also save money in a public option. . .

“To fix the economy, we need to begin by fixing our healthcare system,” his book states, noting that General Motors spends more on healthcare insurance for workers than on steel to build automobiles. He cites a Kaiser Family Foundation survey which found that 58% of all small businesses have difficulty keeping up with healthcare costs. “If you want to help small businesses,” he argues, “let them pay lower health insurance premiums.”

Dean has practiced what he preaches. As Governor of Vermont, he led the state’s expansion of Medicaid eligibility to children under 18 in families earning under $65,000. “Basically we made Medicaid a middle class entitlement for children,” he says, adding that the shift saved businesses money and increased profit margins for those that opted to have employees’ children covered by the public plan. Vermont also increased Medicaid reimbursements to assure that doctors would not opt out of the system.

Dean now advocates what is basically a public option, achieved by opening up Medicare to people under 65, while allowing anyone who chooses to keep their private insurance. 

“Americans ought to be able to decide for themselves: Is private health insurance really health insurance? Or is it simply an extension of the things that have been happening on Wall Street over the past five to ten years, in which private corporations find yet new and ingenious ways of taking money from ordinary citizens without giving them the services they’ve paid for?”

Dean dispells myths promoted by the healthcare industry. “There is no country in the world with a public option that doesn’t also have private insurance,” he noted. “A public option allows you to sign up for Medicaid [Medicare] before 65. All the Republicans who’ve been whining and complaining all have a public system,” said Dean, former head of the Democratic National Committee, citing the high-quality government healthcare program that Congress has given its own members. Moreover, satisfaction ratings are high for two other government healthcare programs: Medicaid and Veterans Administration healthcare, Dean noted.

He believes true healthcare reform must include five core principles. Everyone must have the option of coverage. No one should be forced to declare bankruptcy because of medical bills. Health insurance should be portable, meaning you can’t lose your health insurance even if you change jobs, move, retire or have a pre-existing condition. Plus the quality and efficiency of care must be improved. . .

“My bottom line is not single-payer,” he said, noting that most Americans like to have choices. But he added that supporters of single payer should continue to lobby their legislators to prevent healthcare reform in Congress from being watered down to remove a public option. “Public option is the compromise,” he noted.

Dean noted that all countries in Europe now have a public option, except Switzerland and Netherland, where insurance companies are tightly regulated similar to public utilities. Americans spend more on healthcare per capita than any other nation, yet the U.S. ranks dead last in ratings of healthcare quality, access and affordability…

One response to “Dr. Dean’s Health Care Prescription: “The Free Market Just Doesn’t Work in Medicine”

  1. John Lawrence

    The last statement is very telling. The US leads the world in healthcare quality and access. Sure its the most expensive because it is the best and most accessible. I am a double cancer survivor whose life was saved twice by early detection and immediate treatment. Dean used to be a fiscal conservative but after a few terms as governor he got national aspirations and abandoned his conservative ways and morphed into the blabbering idiot he is today.

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