| Just as in Colorado, earlier this year the nation began it's discussions on health care with hopeful signs (such as HR-676) that "Universal/Single Payer" care might finally get some traction. But recently the tone of D.C. has eroded to where people are getting arrested for disrupting committees by trying to get single payer plans to the table.
I asked Howard Dean if he felt that public option was getting a fair hearing from Sen. Baucus. He felt it was, but he was concerned that single-payer was not, because "I don't care what you say about single payer. It is much cheaper."
Was public option a stepping stone to single payer? "Well that depends on what the American people want. You know a lot of people already have a public system. It's called Medicare." He went on to say that people were fairly happy with Medicare, and if after using "cheaper and more reliable" government plans caused a large migration of accounts, he would be fine with that, but it was up to the people to decide.
What if it was not so reliable? What if the worst fears of opponents materialized. Were the fears of long wait times valid? "I don't think so, but that is the genius of the plan. If it doesn't work they can go back into the private system. If they like it they can keep it."
Sen. Ben Nelson has proposed a "trigger", where instead of adopting the reform, Congress would set goals for the insurance industry for seven years. As long as the goals were met, there would be no competing public plan. "That's a terrible idea," Dean said, "They will just change their behavior until the trigger runs out and go back to how they were."
Calling it "fake public option," Dean said that D.F.A. would actively fight against any such plan as being no public plan at all. The same went for any other plan that did not include a public option. "It wouldn't be reform. If we put more into a private system, we are just going to lose money."
He was softer on Sen. Schumer's proposal to create a self-sustaining public option that would be funded entirely from it's own premiums and would follow all the rules private providers follow. He was lukewarm on the idea, but said, "we can do that," and added that he would want the plan to also receive the same subsidies as well as burdens of private insurance.
How would he prefer to fund the system? I asked if he would support taxing as income the benefits of employee based systems; perhaps at upper incomes or for the highest cost plans. He said he was, "not a fan of that," but that he wouldn't oppose it. "I would like to see a gas tax of 10 cents a gallon. Most Americans would say 'absolutely yes' to that for a portable health policy. Of course, you would be hearing from the highway lobby."
Is the White House on board? Paul Begala circulated a nine page memo that may have signaled Obama's willingness to support a public option. Did Dean feel that he had support in the Executive Branch? "I can't really tell," and he then explained that D.F.A. was not looking at that piece. They were calling Senators and Representatives to get Congress on board first.
What about the states? Was there something we could do right here while waiting for Congress to act? Gov. Dean said that they looked at health care in Vermont, but there was really little the states can do, primarily because, "ERISA makes it really really hard to get comprehensive reform." Massachusetts was able to get some reform but, "Massachusetts is probably running out of money," so overall the solution is going to have to be Federal.
We spoke briefly about "Comparative Effectiveness Research", and how it can lower costs throughout the system, but as Gov. Dean felt it was a good idea for both public and private systems, I will share that later in the comment thread.
Gov. Dean will be speaking at the First Unitarian Church at 1400 Lafayette St. in Denver from 5:00 until 7:00
I will be speaking to Mario Solis Marich on AM 760 about this topic at 6:30 pm.
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