Howard Dean gave Bill Press an interesting interview yesterday, the kind that makes you want to put Dean back in charge of -- at least -- getting health legislation passed. He may not agree with all of us, but at least he has an action plan! Part of the interview has already been transcribed here.
The rest follows below.
Bill Press: They got the Bush tax cuts through in like six weeks or two months, right? -- and through reconciliation.
Howard Dean: That's right.
Press: He didn't play around with Democrats. He didn't try to get any broad consensus or anything. He just shoved it through.
Dean: As you know, Bill, inside the Beltway it's just a snake pit! Inside the Beltway, those who say don't know and those who know don't say. So all this nonsense you see on cable TV -- it's just ridiculous. First of all, the blame-game is silly. It's like that book by Mark Halperin. Who cares about all this gossip about who did what to whom during the campaign. People don't have jobs. There's a train wreck in Haiti going on which we've involved with and we need to be helpful there. And people here don't have health care and we've got two wars going on. There's no focus in Washington. That's what this is really about.
Press: Let's try to provide some focus here. What do you think the options are? What do you think the best option is? What should Democrats now (forget the Republicans!) to go forward?
Dean: Here's what we ought to do. I agree with the president that we ought to pass a stripped-down bill, but I don't agree with the president in terms of what should be in it and how it should be done. You've got to pass something that's understandable and comprehensible to the American people. The bill that passed the Senate certainly isn't! That's first of all. So the idea that the House is going to pass the Senate bill -- I think even if the speaker wanted to do that, she couldn't. There's too much division in the House and too much disarray in the Democratic party. That's not a bad option: pass a Senate bill and fix it in reconciliation. But I don't think they're going to get the votes to get that. The second option ...
Press: Let me stop you on that. One advantage of it is they could do it right now and have the president sign it before the State of the Union if they trusted the word of the Senate that they'd fix it in reconcilation.
Dean: Yes. And I think that's an enormous problem. Here's the problem with the Senate bill. There are a few good things in the Senate bill. But for one thing, supposedly it gets rid of the pre-existing conditions problem, but you charge older people three times as much for their insurance as younger people. I read something and I don't know if this is a factor. It was by somebody who knew what was in the bill. They said they'd discovered a piece in the bill saying that if you had more than 100 employees gender (inaudible) doesn't apply. You could charge companies with a lot of women in the workforce much more than you could charge companies with men in the workforce.
Press: I wouldn't be surprised.
Dean: If that kind of stuff is in the bill, you can't blame the House members for not wanting to pass it! That's problem number 1. So, the second option is to do nothing. That's not a good idea. That's not going to help. It makes the president look weak, it makes the Democrats look weak -- which we have been so far. The third option is the one I think we ought to do. We ought to abandon insurance reform for right now because there really isn't very much in the bill right now. You don't really have guaranteed (inaudible) if you can charge people three times as much for their insurance if they're older.... There are some things I'll get to in a minute about what we should do. But that's where the problem is -- insurance reform that's mixed up with insurance company giveaways. Then we ought to stick in a reconciliation bill two very simple things. Expand Medicare as the Senate was talking about before Joe Lieberman got his hands on it. You can't have a whole insurance program based on Medicare though I know a lot of people in this listening audience would like to do that. But it's not going to happen this year. Too much of a mess, too expensive, too complicated. But you could push it down to 55 and run the House and Senate's expansion of Medicaid. I think the House's is better than the Senate's, but they're both good and they both are improvements. If you do those things, those are extensions of existing programs. Yes, there'll be lots of points of order and a lot of ugly mess, but just do it. Just get it done.
Press: When you said "abandon insurance reforms," are you including things like the pre-existing condition?
Dean: For now, yes. But wait a minute. I haven't finished yet! You're going to get the insurance expansions. This will be incremental but it will be a serious increase. Essentially, you're going to have universal health are through Medicare for everyone over 55 (instead of 65), and you're going to expand coverage to people at the lowest end of the income scale -- including single working people who aren't covered now. That will cover a lot of young people getting out of college, too. It's far from perfect. It's not comprehensive health care reform. But it's a big step towards adding more people through well-known, well-proven government-run insurance policies. Then: put the insurance reforms that everybody agrees on in a bill. Make the Republicans vote on it. By this I mean allowing 28-year-olds to stay on their parents' policies; getting rid of the ability to discriminate against pre-existing conditions; tightening up the restrictions on what insurance companies can charge older people. Do the reforms everyone can agree on, not the insurance give-aways that are buried in the bill. Do just the basic stuff. Bring that to the floor and let the Republicans vote "no" and kill it. Let them go explain, then, in time for the election, why they killed the pre-existing conditions deal and allowing kids to stay on their parents' health care. Now, I'm not quite done yet! The last thing I want to say is that if we were to do this ... There's a huge political problem with this [proposed] bill as Massachusetts voters pointed out, and that is: if we pass the bill the way the Senate has it, it doesn't go into effect until 2013. Well, that means you have to defend -- just the way we had to defend in Massachusetts -- a bill that creates all the problems but doesn't give anybody very many people much in the way of benefits for three election cycles! The president's got to defend himself in 2012. This is an insanity from a political point of view! Congress has to defend it in 2010. If you used an expansion of Medicare/Medicaid, you could do that with people signing up two or three months after the president signs the bill. Then -- all of a sudden -- all this crap that Republicans are putting out, which is basically lies, about how terrible the bill is and how bureaucratic... All of a sudden some 56-year-old in Texas says, "Well, you know, I have health insurance under that bill and I haven't been called to see the 'death panel' yet!"
Press: Exactly!
Dean: It all goes away! Axelrod said this himself the other day. It's very true. Once you pass the bill and get people in the insurance system, all of a sudden, Voilà! All the complaints go away! Those are the three things we've gotta do. 1) Expand Medicare/Medicaid in reconciliation. 2) Put insurance reforms up for a straight vote in the Senate and the House and let the Republicans kill it if they dare. Put them on the defensive. 3) Get people signed up right away so, when we're in the election, people have already been in the program for six months and everybody understands that the stuff Republicans are saying is not true.
