Former DNC Chair Howard Dean strongly endorsed on Wednesday the Senate's newest incarnation of health care legislation, declaring that it met the most fundamental definitions of reform.
In an interview with the Huffington Post, Dean acknowledged that he had problems with some of the emerging proposals in the Senate. But legislation, he argued, is neither a seamless process nor a perfect product. And there was much to hail about the compromise that had developed.
The former Vermont governor called the decision to allow consumers between the ages of 55 and 64 to buy Medicare coverage "a big step forward."
"It opens up Medicare and gives people a real choice," he said. "And secondly it does something that should have been done the whole way along: instead of creating a new bureaucracy it just uses the one we already have."
And while the public option for insurance coverage seemed, essentially, dropped from the legislative language, Dean had a positive take on the Senate's alternative approach.
"I'm not a fan of the private market, as you know. However, the private market does work in two countries, Switzerland and the Netherlands, and the way it works is by substantial regulation... If, in fact, this is basically going to be run as if it were the federally employee benefit plan, than this can work. The [Office of Personnel Management] knows how to run this plan and I've almost never heard anything bad of the federal employee benefit program."
"There doesn't have to be a public option in the bill because I'm some sort of ideological socialist," he said of his support for a government-run insurance provider. "There had to be a public option because the private sector doesn't work. And if they can make it work [without a public option], then let's see."
"The criteria that I use to evaluate the various proposals is; 'Is it reform?'" Dean concluded. "And this is reform."
An endorsement from the former DNC chairman could prove to be a big boost for reform's prospects in the Senate. A leading progressive voice and (more importantly) a respected thinker on health care matters, Dean has already played a large role in shepherding progressive support for the latest round of compromises. Sources in the Senate say Dean was the one who pushed the idea of expanding Medicare as a trade-off for watering down the public plan.
"I'm disposed towards this," he said. "It was part of my platform when I ran for president. But look at this. It makes sense. Why have two bureaucracies, including one who hasn't run this before [the Department of Health and Human Services]... when you can use Medicare?"
It wasn't just the policy of the Senate's version of health care reform that Dean liked. It was the politics. Democratic leadership is set to allow those 55 to 64-year-olds in high-risk insurance pools the option of buying Medicare coverage beginning in 2010 (three years before a proposed public option would come into existence). Which is vital for Democrats, he stressed.
"Because you have got to have people sign up for this thing in 2010 for political purposes. Otherwise we will take it on the chin in the election," said Dean. "If people are actually in insurance they can say, wait a second I'm on this insurance and haven't been brought before the death panel... Actuality is always the best antidote to propaganda."
There are aspects of the bill that Dean lamented and those which he hoped the Senate would improve. The former DNC chairman said that there need to be additional subsidies for those between the ages of 55 and 64 who want to buy into Medicare. He also worried that not enough regulatory reform will be put in place to compel serious changes in the private market. More than anything else, he was concerned that those under 55 will be left without sufficient options for insurance coverage.
"My view is that you try to convince more people as the process goes on that access should be broadened out," he said.
And then there was the question of whether even this type of reform would have the votes to pass. Dean said he did not expect Sen. Olympia Snowe (R-ME) to back the bill even though Democrats have jettisoned the public plan. Though he did say he thought conservative members of his own party would be on board.
"I have kept very close tabs on it and have been very straightforward with some of the senators about not getting hung out to dry on this," he said. "And I don't think they will. I don't think that is their intention."
As for the progressive community to which he is closely associated, Dean urged it to accept the fact that while reform may be delivered more incrementally than they desired, it was "incrementalism in the right direction."
"There will be people disappointed with it. There are parts that I'm disappointed with," he said. "But this is real and a big step forward."
Greg Sargent, who interviewed Dean as well, has more.