Dean: Give Americans A Choice, ‘I Don’t Think We Should Impose Single-Payer On Everybody’
Dean: Give Americans A Choice, ‘I Don’t Think We Should Impose Single-Payer On Everybody’
Some political pundits have portrayed former Gov. Howard Dean (D-VT) as a wacky liberal caricature, whose online supporters spam blog comment sections in favor of single-payer health care. But during an exclusive interview with ThinkProgress, Dean described parts of his own health care philosophy as conservative.
Rather than advocating for a broad overhaul of the health care system, for instance, Dean argued that we can build on what works in our current system and reform health care by giving Americans the choice of keeping their existing insurance plan or enrolling in a new public option.
Dean predicted that more Americans would chose a public plan, but he ultimately argued against a single-payer proposal:
The American people will preferentially choose Medicare, but not all of them will choose Medicare. So we will have a hybrid system. Many more people will be in a public sector because it will probably be better for them. But they will only be in the public sector if they want to be, and they can get out of the public sector if they choose to try something different later on. That seems fair to me. I don’t think we should impose a single payer on everybody, but I do think we should give Americans the choice of having one if they like it. If it works for them, that’s what they’ll choose; if it doesn’t work for them, they’ll choose the private sector. But I don’t buy that the private sector has a right to compete and be more inefficient. I don’t think anybody has a right to serve people worse than somebody else just because they’re private sector.
Watch it:
Dean proposes an interesting framework for opposing critics who argue that progressive plans would result in a “government-take over” of health care. At their core, progressive proposals compliment true conservative values of personal freedom/choice and business competition, and push back against those who want a monopoly of private sector options.
Obama, for instance, establishes a government framework within which private insurers can compete with a new public plan on a level playing field. The key here is ‘regulated competition.’ Health care system can’t function in a real free market. Free markets require informed consumers and plenty of comparison options. But when we get really sick, we don’t really challenge professional medical opinion or haggle over the price of a given procedure. We put our trust in our doctors and hope for a speedy recovery.
Ultimately, health care is like no other consumer good: it’s about life and death not likes and dislikes. Obama is trying to re-orient the system so that it competes on the quality of care, not the quantity. He’s applying free-market principles, but he’s staying away from the extremes. It’s something Dean’s critics may also want to consider.
5 Responses to “Dean: Give Americans A Choice, ‘I Don’t Think We Should Impose Single-Payer On Everybody’”
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The key is community rating all around. Without it, Medicare stands to be at a disadvantage. The elderly utilize more health care services. Should Medicare be the only choice for those with pre-existing medical conditions, that will impact the cost of Medicare for the average citizen.
If there is no community rating, I want to buy into the federal government employee insurance program, not Medicare.
March 4th, 2009 at 5:56 pmA NEW STUDY SHOWS THAT SINGLE-PAYER REFORM WOULD BE MAJOR STIMULUS FOR THE US ECONOMY and would provide:
** 2.6 Million New Jobs,
** $317 Billion in Business Revenue,
** $100 Billion in Wages, and
** $44 Billion New Tax Revenues
You can find out more about this study here: http://www.CalNurses.org/
The press release is here: http://www.calnurses.org/media-center/press-releases/2009/january/nurses-to-congress-expanding-medicare-could-reverse-job-losses-and-repair-our-broken-healthcare-system-and-safety-net.html
March 4th, 2009 at 8:45 pmThis sounds like the impression I got when I read about Stark’s plan: very nicely transitional. I hope Stark has a substitute into Conyers’ language for those aspects. It seems like a reasonable enough amendment and I am looking forward to that debate, too.
Disallowing the decision as to whether to accept a new patient based on a pre-existing condition is reasonable at both the regulation and legislation levels, and a stated goal of Congressional leaders (which means Congress, as this is going through in the budget bill) and the Administration. I thought “community rating” was something else. Under single payer, there is technically no community rating.
Under a transition to single payer, insurance companies can convert their subscriber base to single payer if that is the most economically viable option for them. Then then can find jobs making windmills or plug-in hybrids instead of charging huge sums keeping people from medical care.
March 4th, 2009 at 8:50 pmP.S. When I wrote, “Under single payer, there is technically no community rating,” I should have also said, “because people generally pay different amount of taxes per our long-standing progressive income tax at the federal level.”
March 4th, 2009 at 8:51 pmOk- I’m a Deaniac from way back- the man is a clear crisp thinker and obviously knows more than I do. On the other hand, the insurance companies are slicker than gooseshit- and quite capable of gaming the system in ways that any reputable thinker could not begin to dream up. see:http://www.time.com/time/nation/article/0,8599,1883149,00.html
March 6th, 2009 at 1:19 pmSo my concern is how do you prevent the insurance companies from sucking up the profitable healthy customers while dumping the ‘adverse risks’ on the public plan- there’s a zillion ways to do this with price and marketing and slimy tricks.
they’ve done it already- witness the dumping of the sickest onto medicaid and medicare while private insurers concentrate of healthier current workers. they are on record hating cobra too.