Out with a new book on the need for comprehensive health care reform, former Gov. Howard Dean offered his support on Thursday for a hybrid public-private plan proposed by Sen. Chuck Schumer (D-N.Y.).
In an interview with the Huffington Post, the former DNC chairman and author of "Prescription For Real Healthcare Reform" described his current modus operandi as making the "case for passing a health care bill the way it was described by the president on the campaign trail."
As a sticking point, he's insistent that any reform effort include a public plan. The public entity would provide insurance that, by avoiding the demands of the private market, could help control cost and expand coverage. Cognizant that such a proposal will engender stiff -- if not universal -- opposition from Republicans in the Senate, Dean said he had no objection to Schumer's modified version.
"If we can get Schumer's proposal out of the Senate, I think that would be a very good thing," he told the Huffington Post. "It can't be any weaker than that though. We don't want what would be a fake public option."
As one of the leading progressive voices on health care reform, Dean's endorsement of the Schumer proposal is no small thing. The New York Democrat has envisioned a plan for insurance coverage that, while run on public funds, is self-sustaining and subject to private market rules. Money would come from the payments and premiums of consumers. The same officials who ran the plan would be forbidden from regulating it. And a reserve fund would be set up to handle a potential influx of claims.
The stipulations, Dean said, would assuage critics without actually diminishing the public option itself.
"[Schumer's proposal] is still run by the public," he added. "But it is subjected to insurance rules that are there in order to protect the public from for-profit institutions, which is obviously not necessary if you are running your plan on the public side. Because the consumer needs the protection because of the profit-motive, but they don't need protections from a non-profit or the government. So Chuck has those things in there to level the playing field. I understand that. And I don't think we need to be doctrinaire about this. But I think, the bottom line is a public option is run by the public and financed by the public, it is not administered by the private sector."
Months removed from running the DNC, Dean currently finds himself on a whirlwind tour of speaking engagements, writing and political consulting. His main area of focus and passion, however, remains health care reform. The former governor said he has held discussions with elected officials on a prospective health care bill, though he declined to name names. His book is designed to gin up pressure from outside the government to help achieve that reform.
"America has had 'socialized' medicine since 1964," he writes, "It's called Medicare; it covers every American over 65, and they are very happy with the program. The rest of America deserves a similar option."
From Dean's vantage point, opposition to a public plan is driven by insurance companies protecting their bottom lines. As such, he wasn't surprised when many of the private players in the health care reform debate backtracked on commitments they made to cut $2 billion in largely administrative costs. They wanted the credit for sacrifice, he reasoned, without the reality of wholesale reform.
"The insurance folks believe that a public option will destroy their business," he said. "I don't believe that is true. But they think it is true, and they are acting like it is going to destroy their business. But they are too smart to come out and oppose it because they know what their numbers are. And so they are sort of talking the talk without having any intention of walking the walk."
As for the specifics of a reform effort, Dean cautioned Democrats against letting the perfect get in the way of the good. He did not, for example, entirely dismiss the notion of paying for reform by ending tax benefits for employers who provide coverage for their employees -- a proposal championed by John McCain during the 2008 election and ridiculed by Barack Obama as a tax hike.
"I don't think it would be a bad thing to break away from the employer-employee link," he said, "But I don't think you get anything by doing that forcefully. A lot of innovation in the health care industry came from that link."
In the end, Dean added, the main focus right now should not be on funding. "I do think that it is a bit premature to discuss this," he said. Instead, the focus should be on getting a system in place that would provide access to coverage for the 47 million individuals who are without health care insurance. On this front, Dean believes that the White House and President Obama have the right priorities. Though he admits that, at this juncture, the administration is holding its cards close to its chest.
"I think it is very hard to understand what their position is, and they have been very careful and are giving the Congress some wiggle room," said Dean. "I'm not criticizing the Obama administration, I just think they are parsing their words carefully... At the end of the day, if it comes down to a choice, I'm confident they will push a real public option."