Where the Devil is Dr. Dean?

On Tuesday night, in a tele-town hall meeting with Organizing For America, the online group headed by now-President Obama's organizing guru, David Plouffe, a dialogue on politics lumbered forward. Plouffe and others on the call described how they hoped to harness a political machine, the one they helped build, to propel "outside-Washington" politics into the city's hallowed quarters.

But on Facebook the organizing had already begun. Two groups, "Howard Dean For HHS" and "Appoint Howard Dean to HHS!" were tussling over how to combine the two. By Wednesday morning, both groups had informally merged. The one with the exclamation point was more popular (gaining over 2,000 fans overnight), and its de facto leader, Ilya Sheyman, e-mailed members with concrete instructions:

Conventional wisdom sets in pretty quickly in DC so we only have a small window to get the ball rolling. Right now, all of us need to make two phone calls:

1 :: Call the White House Comment Line at *** 202-456-1111 *** and ask President Obama to appoint Gov. Howard Dean MD as Secretary of Health and Human Services

2 :: Then, call Sen. Max Baucus of Montana *** 202-224-2651*** - he chairs the Senate Finance Committee that needs to approve of the nominee. Ask him to support of Gov. Howard Dean MD as Secretary of Health and Human Services.

That's it. Just take 2 minutes to make these two phone calls right now. Then, come back to the Facebook group and post on the wall about how your call went. I'll keep you posted on next steps.

Thanks, and remember, in the words of Gov. Dean, You have the power!

I'd been rueful Tuesday, watching the Daschle fiasco unfold. Perhaps I was waking from the Obama spell I'd been under. "What's going on over there?" I wondered. Loyal follower that I am though, I pushed the thought aside.

Then I saw the email from the Dean people and thought - but where the devil, after all, is Dr. Dean? He's the man who, indirectly anyway, blazed the trail getting a Democrat elected to the White House. He'd managed it in stages- first, through his efforts as a candidate, and then through his work as Chair of the Democratic Party. He'd coined his fans the "democratic wing of the Democratic party," a redundancy we grew to love as his unofficial cabinet members and supporters. So, where the devil was he?

While I was wound up in Obama fever, had I forgotten my all-time favorite hero politician, Governor Dean? Had I, along with so many others, spent such little time thinking of him lately, that now he wasn't chosen for the health care post he so rightly deserved? What more could any one of us have done? What can we do now? We elected one good guy President - and it took years, folks. Years.

After learning more about Mr. Daschle's decision to pull out, I posted an OpEd, published weeks earlier in The Nation, to my Facebook page.

It was titled, "Missing Howard Dean." The central premise was that the Vermont doctor had become "a virtual stranger to the Democratic Party he helped revive". I'll say. And let's be clear, President Obama's no longer an outsider; he's the quintessential Democratic insider (as all his cabinet picks have shown).

President Obama usually gets what President Obama wants even if this means meeting his loftiest targets. On Wednesday, he signed a children's health bill into law that had bounced around the House seven times, and for several years, after Bush refused to comply and vetoed it twice.

More generally though, as good as one-off stuff like this sounds, reality may set in soon. It's something Governor Dean uniquely understood - he saw status quo for what it was - the power not to allow things to change because you're there on the inside where things are complicated.

What does status quo mean for health care? Too much, unfortunately. The status quo when it comes to health not only restricts solid proposals from Democrats but from Republicans too. And since President Bush was so resistant to differing views, moderate plans have been waiting in the wings for some time.

Senator Olympia Snowe, a Republican from Maine, is hoping the interest the President has in her views might help push reform she's been advocating. Snowe co-sponsored a bill in April of last year called the SHOP Act to bring health insurance costs down for small businesses. The bill was shepherded by Senator Dick Durbin of Illinois, a former colleague of Senator Obama's, the one who helped the new president get a spot at the 2004 Democratic Convention where he delivered his historic speech on "red" and "blue" America.

Where's this bill now?

Hasn't made it to committee (that's the second stage; there are five) despite having a list of unlikely co-sponsors. Senators Klobuchar (D-MN), Bingaman (D-NH), Collins (R-ME), Coleman (R-MN), Salazar (D-CO), Kohl (D-WI), Specter (R-PA), Lincoln (D-AR), Bond (R-MO), Pryor (D-AR), Lieberman (I-CT) and Casey (D-PA) have all endorsed it. The thing these senators have in common is their understanding that rising health insurance costs for small businesses will sink them.

What would Governor Dean have done were he Secretary of Health and Human Services? For starters, perhaps he'd have found the public support to fast-track such bills, something that's sorely needed. Senator's Snowe's office seemed to indicate she was willing in a statement released by her staff; the question I asked was whether health reform would be part of the stimulus package:

Senator Snowe believes that Congress should move health care reform legislation by regular order, which President Obama has signaled as his preference.

There's only one President Obama, unfortunately, and if health reform is not part of the stimulus/recovery effort there will be many more bills to pass. Governor Dean's experiences running health initiatives for the state of Vermont would be a discrete asset, and his extensive political history rallying people wouldn't hurt. At first glance, the bills can overwhelm and someone needs to clarify them.

Indeed health reform chatter can be so elusive these days that even those defending it have found themselves caught off-guard. A bill introduced two weeks ago by a tiny coalition of senators and advocates has had marginal attention but warrants more. It's a small initiative, launched by Senator Wyden, a Democrat from Oregon that seeks to expand the services of rural hospitals.

Why does this matter? Rural health remains an area of pressing concern for the country. In May 2007, a policy institute found that among rural children in low-income families private health insurance has steadily declined (from 45 percent in 2000 to 37 percent in 2005). In rural areas, a third of children also rely on the State Children's Health Insurance Program (which on Wednesday, rather swimmingly, the House finally passed and President Obama signed.)

Incidentally, in Vermont, Governor Dean insured most of the children in his state by 1989, a measure that put him ahead of his colleagues by, oh, about twenty years. Dean came up with the plan himself, merging public and private sector avenues. And he implemented it to benefit 56,000 of Vermont's children.

On the "Critical Access Hospital Flexibility Act," introduced on January 22, despite its impact on rural communities, it needs to be rolled into a larger bill which, according to advocates, could take another year before it's passed.

But "Critical Access" community hospitals , which exist in rural areas (and are the ones outlined in Senator Wyden's bill) remain wanting. They provide basic care in situations where there are few alternatives. The hospitals, as a result, are subject to Medicare reimbursements.

People who live in remote areas now can be made to go elsewhere should the hospital need to break its federal quota on the number of beds patients can occupy with federal support. Veterans groups are expressing support for the new bill because they say it would have a "small but dramatic and profound effect" on people, including veterans, who live in rural areas by doing away with federal quota clauses.

Imagine someone being turned away when they go to the hospital... If you're a veteran in places like rural Maine or west Texas, the VA hospital is six or seven hours away

noted Chief Legislative Counsel of the Iraq and Afghanistan Veterans of America (IAVA), Patrick Campbell. IAVA is a group that has seen a bevy of legislative successes in the recent past. He continued by saying

rural health care is extremely important to all veterans and we believe this is legislation that would help.

But even Campbell admits he wasn't familiar with the legislation till I inquired about it. It's the reality many of us are faced with - too much legislation surrounding health and nobody out there to parse it for us - and it's a role that desperately needs to be filled. Governor Dean is the man for that job.

The economics around the uninsured in rural areas of the country is daunting to say the least. A study this past October found rural hospitals lack sufficient emergency care and rely on volunteers to do much of it.

To get a sense of what this means, it turns out one in five of those uninsured across the country live in rural towns; and as compared with urban areas, workers are far more likely to be earning lower wages (33 versus 19 percent according to the Kaiser Foundation).

Furthermore, Republicans and even some Democrats aren't making change easier. Grumpy ol' McCain has railed against the stimulus bill for inane reasons, making him his party's latest, most dangerous distraction. How many of these guys are there among Republicans anyway? Check out former House Majority Leader Dick Armey, by the way, who seems to have a thing or two against women who speak their minds. In the meanwhile, Dems are stuffing the package with, excuse me for saying, but expensive trinkets, the kind you may love to look at an antiques market, but given the harsh circumstances, may not be viable in the long term. And I'm not speaking about the national mall or the National Endowment for the Arts (which are infinitely useful for reasons I will not expound on here).

Governor Dean's strengths as a man who understands Washington but who's learned to operate outside of it, would be a boon for health. If he'd been HHS Secretary today, he'd instantly have recognized that while lawmakers in Washington foist over clauses, stimulus plans and tax caboodles, outside Washington, stuff that relates to health has pretty much stayed the same.

Oh, excuse me. It's gotten worse. (Hate being pessimistic post-election but it feels true.) People are still losing jobs and hospitals are drowning under the weight of their own costs. Several are closing now and restricting service; and rural hospitals are most at risk.

So, once again, health, which should be dealt with alongside the stimulus agenda, has been put off while vetting in the White House begins for a new HHS candidate. In the end, all of it just makes the recovery/stimulus package feel wrong even if it isn't; and it's because people are losing health care and suffering for it as days pass.

In terms of the SHOP Act, had someone drawn our attention to it the very first day President Obama took office, millions could have jump-started careers after being laid off; as the bill targets those self-employed or in small firms (the bill would have granted them access to federally-endorsed care). The same goes for the Critical Access bill. So, after seeing some of this, the question remains -where is dear Dr. Dean?

Even Paul Krugman agrees health is important to tackle at the earliest stages. In a recent OpEd, he ended his column demanding health care reform be delivered "now!" Guess a lot of us are getting tired rehashing the same old arguments when lawmakers don't always hear them out.

Except for members of the "Appoint Howard Dean to HHS!" Facebook group. They seem pretty energized. Last I checked the group had nearly 4,000 members; and it's only Day 2.

So bring back Dr. Dean, President Obama. He will help. Besides, without his boundless passion and expertise we may not succeed in finally fixing American health care.

 

Comments

[kotexbarbie]

THERE CAN ONLY BE ONE STAR ON THE TV SHOW.-- Obama needs a marquee name and a super hero -- guess who that is? HOWARD DEAN.. But it's not gonna happen. Again,there can only be one star on the TV Show and that star is Obama.

[Antifascist-08]

If, in fact Dean does NOT support a single payer or Medicare for all system, he should only be appointed if he will agree to move in that direction.

Enough of putting profit before health.

[bigorangefish]

Howard Dean does not support single payer health care.
I want Medicare for all Americans. That is the best solution to
provide quailty health care fore all. Medicare drastically reduces
health care costs. They are so effective that if every American
had Medicare the private health insurers would go out of
business in five years because they are so inefficient and greedy.

[pinkseven]

"It's something Governor Dean uniquely understood - he saw status quo for what it was - the power not to allow things to change because you're there on the inside where things are complicated"

Ms. Sawhney, You have articulated the attribute that makes Dr. Dean so unique and so desperately needed in government today. Perhaps other officeials will join Sen. Harkin in endorsing the good doctor for HHS secretary.

[Computer Geek]

I agree! I was one of the first 200 to sign the petition. He has shown to be a brilliant strategist and he would make an excellent choice for head of HHS.

Make the effort - sign the petition - we can use anyone competent and as forward-thinking as Howard Dean!