Howard Dean on Health Care

Former VT Governor; Former Democratic Candidate for President

Medicare was put in place without a single Republican vote

Just think about who put Medicare in here without a single Republican vote. Everybody over 65 now has got health insurance in this country because of the Democrats. Who did Medicaid? Children all over America have health insurance. Who did the earned income tax credit? It was Nixon with Democratic support. It makes a big difference whether you have a Democratic or Republican administration. All I'm asking is that we not let the perfect become the enemy of the good, because in this election it matters
Source: NPR, "Justice Talking" Dean-Nader Debate Jul 9, 2004

Improved economy is best fix for Medicare

Q: Medicare cost up to $1.2 trillion in the next 10 years. What do you think?

A: Clinton showed that when you improve the economy and get people jobs, then you increase payroll taxes and you make these funds more solvent. That's how we're going to fix Medicare, is to get somebody who has executive experience in governing, particularly in health care, particularly somebody who is a doctor who understands these things, who is willing to get stuff done.

Source: Democratic 2004 primary Debate in Greenville SC Jan 29, 2004

Rx plan: govt. buying; reimportation; price competition

Q: How, if at all, would you change the new prescription drug benefit for the elderly?

A: As president, a high and early legislative priority of my new administration would be to improve the prescription drug benefit to create one that is affordable, federally administered and for all of America's seniors; uses the government's buying power on behalf of 41 million seniors to negotiate and drive down drug prices; contains meaningful cost containment including reimportation of safe, effective medicines and the use of Preferred Drug Lists to ensure affordable premiums and co-payments; assures stability of coverage; and promotes price competition and real pharmaceutical innovation by supporting drug therapeutic equivalency and cost-effectiveness studies, not by setting drug prices through the federal government.

Source: Associated Press policy Q&A, "Medicare" Jan 25, 2004

Fact Check: Dean agreed with Clinton on cuts, not Gingrich

FACTCHECK on Medicare: Gephardt again dragged up a misleading figure from 1995 claiming Dean was in league with Republicans trying to cut Medicare by $270 billion.

GEPHARDT: The Republicans tried to cut Medicare by $270 billion. And Bill Clinton and the Democrats fought them off. At that time, you were head of the governors' association, and you agreed with their proposal.

Source: Jan 4, 2004

No single payer system, since it won't pass Congress

Q: How is your proposal for health insurance superior to the Canadian National Health System?

A: I don't propose a single payer system because I do not believe it would pass the Congress. What I want is the system based on what I did in Vermont, where 99 percent of our children under 18 have health insurance and 1/3rd of our seniors have prescription benefits.

Source: Concord Monitor / WashingtonPost.com on-line Q&A Nov 6, 2003

If you want total healthcare reform, I'm not your guy

Dean's liberal [healthcare] positions, he makes clear, are more moderate than radical. "I do not believe in free health care or free anything," he says. "If you want to totally reform the health care system, I'm not your guy. Just expand the system we already have to include everybody. I'm not interested in having an argument about what the best health care system is."
Source: Citizen's Guide to the Man Who Would be President, p. 26 Oct 1, 2003

Build senior Rx program on Vermont program

KUCINICH: Dr. Dean's plan would leave 10 million Americans out. It's important that all Americans be covered, [including] alternative medicine, a prescription drug benefit, vision care and dental care and mental health care, and long-term nursing care- all covered under one Medicare For All, single-payer program. I'm the one who has that plan. I'm the one who's offering it. I'm the only one on this stage who can say that.

DEAN: In all due respect to all the candidates here, these folks have been in Washington a long time and talked about health insurance for a long time, and we have very little to show for it. In my state, 99% of the kids that are eligible for health insurance who are under 18, 96% have it. Everybody under 150% of poverty, all our working poor people, have health insurance. And a lot of seniors have prescription benefits. This does need to be a system that's built on what we have. We've done that in Vermont. I'd like the opportunity to do that for the whole country.

Source: Debate at Pace University in Lower Manhattan Sep 25, 2003

Bush's Rx program is a political trap: looks good, bad plan

Q [to Sharpton]: Gov. Dean has called this prescription drug plan that is now pending in Congress, "a political trap for Democrats." He says that it could make the Democrats look bad if they vote against a bill that they really view is a bad plan. Would no bill getting out of Congress be better for senior citizens than the prescription drug bill that is now pending?

SHARPTON: We've got to quit the compromising on the principles that the party should stand for. So in this particular case, I agree with Gov. Dean. I have supported single-payer plan. I think the only way you're going to solve these problems is you've got to have a national single-payer plan for everyone. I think that we've got to stop going with half a loaf. I would rather have no bill and fight for something real than to continue to give people something that I think is a diluted version of what we need to have. So in this case, I think he's right. We must define policy, and this is one of those areas we must define it.

Source: Debate at Pace University in Lower Manhattan Sep 25, 2003

Wrong to compare any Dem to Gingrich: I support Medicare

DEAN: Many of the things that I suggested in 1995, which Dick Gephardt has attacked me for, were actually incorporated into the Clinton plan to save Medicare and Social Security, and has resulted in the savings of over $200 billion.

GEPHARDT: Howard said in 1993 that Medicare was the worst federal program ever. He said that it was the worst thing that ever happened. Howard, you were agreeing with the very plan that Newt Gingrich wanted to pass, which was a $270 billion cut in Medicare. We don't need someone who agreed with the Gingrich Republicans.

DEAN: That is flat-out false. Nobody up here deserves to be compared to Newt Gingrich. To insinuate that I would get rid of Medicare is wrong. I did say that Medicare was a dreadful program because it's administered dreadfully. I've done more for health insurance, Dick Gephardt, than you ever have, because I've delivered it to a lot of seniors and a lot of young people. And I'll stake my record on health insurance against anybody up here.

Source: Debate at Pace University in Lower Manhattan Sep 25, 2003

Join every other industrialized country on health care

Q: How would you get more of the 41 million uninsured covered?

DEAN: [I implemented a workable plan in Vermont]: Every child under 18, 99% eligible, 96% have it. Everybody under 150% of poverty has health insurance in my state. Every senior under 225% of poverty gets prescription help.

Now, if we can do that in a small rural state and balance the budget, surely the US can join every other industrial country in the world [which all have] health insurance for all its people

Source: Democratic Primary Debate, Albuquerque New Mexico Sep 4, 2003

Cover 42 million uninsured then reform healthcare system

I'm tired of the ideological debate in the Democratic party over whether we ought to have a single payer or something else. Because when the Democrats fight among each other, the Republicans and their special interests kill the bill, and the 42 million people with no health insurance go for another 10 years without health insurance. That's not what we want! We're going to end up with a comprehensive plan that will pass, insure everybody, and then we're going to have a big fight about how to reform the health care system, but we're not going to keep those 42 million people out in the cold anymore.

What we ought to be demanding as Democrats, is what Harry Truman put in the 1948 Democratic Party platform: health insurance that covers everybody, just like they have in Germany, France, Costa Rica, Japan, Ireland, and Italy! Every single industrialized country on the face of the earth has health insurance for all of its people. Why can't we have what all those countries have?

Source: Speech at the Take Back America Conference, Washington, DC Jun 5, 2003

Bush prescription: take 2 tax cuts and see me in the morning

We have a president who recommends cutting taxes, which make it impossible to have a decent health-care program in this country. The president's prescription for everything is take two tax cuts and see me in the morning.

My prescription is a little different. I want a different kind of America. In our state everybody under 18 has health insurance, and I want an America where we all have health insurance that can't be taken away.

Source: AFSCME union debate in Iowa May 17, 2003

As doctor, knows health system; and knows how to pass plan

Q: Some who critique your plan say it's piecemeal, that it doesn't go far enough.

DEAN: I'm a doctor. Not only do I know how the system needs to work, I also know what we need to do to make it pass. My plan covers every single American. It's cost is less than half of the Bush tax cut so you all can guess how I plan to pay for it. It uses public programs and private programs, and it does not give big corporations subsidies. It costs about a third of Gephardt's plan.

Source: AFSCME union debate in Iowa May 17, 2003

Subsidize health care for small businesses, not corporations

I have two advantages [on health care]. First of all, I'm a governor and we've actually done a lot of this in Vermont, and second of all, I'm a doctor. [My plan] costs a little less than half of the Bush tax cut. First, everybody under 25 gets Medicaid if they want it. It worked well for us in our state. It's not expensive. Second, prescription benefits for every senior. That makes Medicare into a pretty decent policy. Third, between 25 and 65, subsidize small businesses, don't give the tax credits to the big corporations, subsidize individuals who need help buying health insurance, and then help individuals who work for companies that don't do it. The cost is half of the Bush tax cut. It'll pass because most of the interest groups that oppose the Clinton plan will support it, and it's affordable. And it will pass now, and it covers everybody.
Source: Democratic Debate in Columbia SC May 3, 2003

96.4% of Vermonters are covered; deliver that to America

KERRY: Every American ought to have access to affordable health care through the same plan that the President & Congress give themselves. I will lay out how you can do that, how you can buy into Medicare [at age] 55, and also how we can cover children. But when Dean became governor, 90.5% of the citizens of Vermont were already covered. When he left as governor, 90.4% were covered. So you've got this problem of bringing people into the system and getting to the percentage that America ought to get to, which is covering more citizens.

DEAN: When I came into office, Vermont had a program that insured everybody up to the age of 6 to 225% of the poverty [level]. I expanded that up to the age of 18 for 300% of the poverty [level]. That means if you live in a family that makes $54,000 a year or less in our state, everybody under the age of 18 gets coverage. In fact, Senator, about 96.4% of all our people are covered today, something which I intend to deliver to America when you all make me president.

Source: [X-ref from Kerry] Democratic Debate in Columbia SC May 3, 2003

Guarantee health ins. like other industrialized countries

We ought not to be the last industrialized country in the world to guarantee Health Insurance to all our citizens.

As a doctor, I understand the fear facing families without health insurance. As a Governor, I am proud that virtually every child under 18 and more than 90% of adults in Vermont are eligible for health coverage. But as a country, the US can do better on this front.

To help finance this effort, we must repeal the President's tax cuts-which have thrown America back into the huge deficits of the 1980s-and balance the federal budget. We cannot build crucial social programs without a solid financial foundation. Guaranteeing coverage to all Americans will involve a mix of state and federal programs, as well as the existing private sector.

Source: Campaign web site, DeanForAmerica.com, "On the Issues" Nov 30, 2002

Three-tiered coverage: state, federal, and private

    Guaranteeing coverage to all Americans will involve a mix of state, federal, and private programs:
  1. States should be required to guarantee coverage for all children under age 23. In return, the federal government should assume responsibility for drug and acute medical care for Americans over age 65.
  2. Older Americans deserve a pharmacy benefit under Medicare (an unaffordable impossibility under Bush's current fiscal policies). This would cost $450 billion over 10 years, a little more than 1/4 of the value of Bush's tax cut. With a pharmaceutical package, Medicare becomes a decent insurance program.
  3. Finally, to cover those between the ages of 23 and 65, we should use the present employer-based system with refundable tax credits and federal subsidies to cover low- and moderate-income Americans who lack insurance.
This plan is affordable and simple, relying on three existing systems-one for children, one for seniors, and one for those in between-which all Americans understand
Source: Campaign web site, DeanForAmerica.com, "On the Issues" Nov 30, 2002

Patient Bill of Rights is hot air: get people insured

Dean dismisses as a farce the extended wrangling over a national patient's bill of rights. "The difference between the Republicans and the Democrats is that one side says you can sue your HMO, and the other says you can't," Dean snorts. "Meanwhile, not one additional person is going to have health care. What a lot of hot air. I'm interested in getting people insured.
Source: Charles P. Pierce, Boston Globe Nov 24, 2002

Full access first, then tackle reform afterwards

Dean, who became a physician after working as a stockbroker for two years, is prepared to take another crack at fixing the way the country delivers health care to its citizens, the problem that nearly sank the Clinton administration at the start. "The mistake they made was that they tried to reform health care and improve access at the same time," argues Dean, who has overseen a program that now guarantees Medicaid coverage for every Vermont child in families with an income below 300 percent of the poverty line - which is to say, $50,000 per year for a family of four. "The first thing you do is create access," he explains. "Once you get everybody in the system, once it's an entitlement, then you can fight about reforming it."
Source: Charles P. Pierce, Boston Globe Nov 24, 2002

Universal access for all Vermonters; insure the last 6%

I propose that our achievement-the achievement of this biennium-is to design and implement a better system of health care in Vermont. We have one of the lowest numbers of uninsured citizens in the country. But the fact that you are one of only 6% does not pay the doctorís bill.

This biennium our goals for health care are finding ways to control costs, helping small businesses afford private coverage for their workers, and making government-guaranteed insurance for children, seniors and working Vermonters sustainable.

This also means assuring access to health care for every Vermont citizen. We will never control costs without universal access. Vermont deserves a health care system where small businesses are not bankrupted by trying to treat their employees responsibly, and Vermont deserves a system where all Vermonters have access to health insurance and to quality care.

Source: State of the State Address to Vermont General Assembly Jan 4, 2001

Keep ďcommunity ratingĒ: insure older people at same rates

Let me talk for a moment about what will not work. Vermont has a system of community rating where all age groups are charged the same for their coverage, despite the fact that older people use more health care than younger people. Some insurance companies left the state because they wanted to avoid insuring older people so they could make plenty of money by only covering low-risk Vermonters. Eliminating community rating will not make health insurance more affordable or accessible. It will simply add on another cost shift, causing those employees over 50 and their employers to pay even more money so that costs can be reduced for those under 35. I donít believe Vermonters want this solution.

Our challenge is to find solutions that will work. I am appointing a special Governorís Commission on Health Care Availability and Affordability, to find ways we can achieve the dual goals of controlling costs and guaranteeing universal access.

Source: State of the State Address to Vermont General Assembly Jan 4, 2001

No federal pre-emption of employee health plan regulation.

Dean adopted the National Governors Association position paper:

The Issue

In 1999, 42.6 million Americans did not have health insurance. All states have been fervently working to reduce the number of uninsured Americans, to make health insurance more affordable and secure, and to provide quality health care at a reasonable cost to the uninsured. However, the federal government has also expressed an interest in this issue. Any action taken at the federal level could have serious implications for traditional state authority to regulate the health insurance industry and protect consumers.

NGAís Position

Although the Governors are extremely sensitive to the concerns of large multi-state employers, the fact remains that the complete federal preemption of state laws relating to employee health plans in the Employment Retirement Income Security Act (ERISA) is the greatest single barrier to many state reform and patient protection initiatives.

The Governors support efforts designed to enable small employers to join together to participate more effectively in the health insurance market. In fact, Governors have taken the lead in facilitating the development of such partnerships and alliances. However, these partnerships must be carefully structured and regulated by state agencies in order to protect consumers and small businesses from fraud and abuse and underinsurance. NGA opposes attempts to expand federal authority under ERISA. The Governors have identified the prevention of such federal legislation in the 107th Congress as a top legislative priority.

States have the primary responsibility for health insurance regulation. Across the nation, Governors are working to protect consumers and patients and to properly regulate the complicated health insurance industry.

Source: National Governors Association "Issues / Positions" 01-NGA13 on Oct 5, 2001

Protect state tobacco settlement funds from federal seizure.

Dean adopted a letter to Congressional leaders from 53 Governors:

As you know, preserving and protecting the state tobacco settlement funds is the nationís Governorsí highest priority. We strongly urge you to reach final agreement and pass the conference report on the emergency supplemental appropriations bill soon, and to retain the Senate provision that protects our settlement funds from federal seizure.

Many of our state legislatures are currently in session, and some have already completed work on their budgets. Therefore, it is critical that conferees reach agreement quickly on this issue. Governors are unified in their commitment to ensuring that the funds remain in the states and that there be no restrictions on statesí ability to tailor spending to meet the needs of their citizens.

We offer our strongest support for conferees to recede to the Senate version of the bill containing the Hutchison/Graham bipartisan tobacco recoupment protection legislation.

Source: National Governor's Association letter to Congress 99-NGA31 on Apr 14, 1999

Other candidates on Health Care: Howard Dean on other issues:
George W. Bush
Dick Cheney
John Edwards
John Kerry

Third Party Candidates:
Michael Baradnik
Peter Camejo
David Cobb
Ralph Nader
Michael Peroutka

Democratic Primaries:
Carol Moseley Braun
Wesley Clark
Howard Dean
Dick Gephardt
Bob Graham
Dennis Kucinich
Joe Lieberman
Al Sharpton
Civil Rights
Foreign Policy
Free Trade
Govt. Reform
Gun Control
Health Care
Homeland Security
Social Security
Tax Reform
Adv: Avi Green for State Rep Middlesex 26, Somerville & Cambridge Massachusetts