03/18/2010 05:12 am ET | Updated May 25, 2011

A Rebuttal to Howard Dean: I Am a U.S. Senator, and I Will Vote For This Bill

Chairman Dean deserves enormous credit for all the good work he did for the Democratic Party. But, his opinion piece begins by saying "If I were a Senator, I would not vote for the current health-care bill." He goes on to argue that the bill does not bring "real reform."

Signing his article as a "former chairman of the Democratic National Committee," I am sure, made Howard's comments particularly newsworthy, and I note that he is a guest on one of tomorrow morning's talk shows.

After reading many erroneous statements in the article that led him to his faulty conclusion, as they say in the world of health care--"we better get Howard a second opinion!"

As a former Chairman of the National Democratic Party myself, let me begin where Howard began, but by taking a contrary position. I am a United States Senator, and I will vote for the current health-care bill precisely because it does bring "real reform."

I hope Howard is reading, because I believe with a better understanding of the real reforms this bill does bring to America's health care system, he will join me as a forceful advocate for its enactment.

Let me first explain why I believe this bill is, in fact, the kind of "real reform" that Chairman Dean rightly seeks.

What is "real reform"?

Real reform would create competition in insurance markets. The Senate bill does precisely that by establishing insurance exchanges that will create competition for enrollees, and by requiring that all insurers provide standardized information to consumers so that they can comparison shop for the best insurance product available at the most affordable price.

Real reform would redirect funds from administrative expenses to investment in quality health care benefits. The nonpartisan Congressional Budget Office has already found that the insurance exchanges created by the Senate bill will lower administrative costs. In addition, the Senate bill will force any insurance company that doesn't spend enough of its premium dollars providing benefits to rebate the difference to its customers.

Real reform would significantly lower costs. Here too, the CBO has found that the Senate bill will reduce existing premiums for the insured, and reduce the deficit by cutting federal spending on health care. One way it achieves these savings is by finally focusing our health system so that it rewards the quality and value of outcomes instead of the quantity and volume of tests and procedures provided.

Real reform would improve the delivery of health care. The Senate bill contains delivery system reforms that the Business Roundtable has concluded could save up to $3,000 per employee.

Real reform would give all Americans a meaningful choice of coverage. That is precisely what the health insurance exchanges created by the Senate Bill are designed to do. These exchanges will provide competitive options to people who today have no health insurance choices.

Real reform would eliminate discrimination against those needing insurance based on their preexisting medical conditions. The Senate bill does precisely that, and it also eliminates insurance company policies designed to end or decrease coverage when a customer gets sick.

Real reform would bring transparency and accountability to the health care system when it comes to excessive salaries and insurance company profits. The Senate bill requires insurance companies to publicly report and justify how much they are spending on administrative costs relative to medical care. Insurance companies that cannot justify their premium charges will not be allowed to offer their plan in the exchange.

And on one important point, with all due respect to my friend Chairman Dean, he is just plain wrong. He states that few Americans will see any benefit under this bill until 2014. In fact, as early as 2010 the Senate bill will do the following:

  • Establish a high-risk pool that will give uninsured Americans with a pre-existing condition access to coverage;
  • Prohibit insurance companies from dropping coverage for Americans because they get sick;
  • Prohibit the imposition of lifetime limits on coverage;
  • Require insurance companies to report the percentage of premium revenues that they spend on medical benefits for their enrollees, and force them to rebate any excessive costs or profits;
  • Require insurance companies to provide free preventive services;
  • Require insurance companies to cover dependents up to age 26;
  • Provide a discount on drug costs to seniors who fall into the Medicare Part D doughnut hole.
  • Provide a tax credit to small businesses that provide health insurance for their employees.

In these and other ways, the Senate bill is immediate and real reform.

For a senior citizen who cannot afford the drugs she needs, it is real reform. For the thirty one million people who will obtain life insurance, it is real reform. For families who worry that hospital bills will wipe out their life savings, it is real reform. For a system that fails to serve the needs of the American people, it is real reform.

I know there are many well meaning progressives who oppose this bill because it does not go far enough. They argue that if this bill is defeated, we will somehow rebound and pass still better legislation in the near future. Secure in that belief, they say they will not settle for a bill they view as imperfect.

I admire their optimism and idealism, but that is not the world in which we live. This fight must be won now. To be sure, there will be more to do. There will always be more to do. But this historic piece of legislation will be a giant step forward towards a health care system that finally and truly will begin to serve the needs of the American.

President Kennedy offered two profound statements that have stayed with me throughout my life.

The first was, "Wisdom requires the long view".

The second was, "Democracy is never a final achievement. It is a call to an untiring effort."

Those two statements apply to the work of health care reform and to the legislation that we will pass in this Senate within the next several days.

We must exercise our wisdom and take the long view of history. We must also realize that this legislation is not a final achievement; it is a first an important call to an untiring effort to continue our responsibility to do what is right- to provide affordable, accessible, quality health care for all the American people as a matter of right.

I am old enough to recall the Civil Rights Act of 1960, and the Civil Rights Act of 1964, and the Civil Rights Act of 1968. Each of those pieces of legislation was incomplete. There was always more to do. But each of those bills was a landmark that began the march of progress toward equality under our laws. And each created an environment in which we could continue to move forward so that our country's laws better fit our national character and the principle of equal justice.

The same is true of this bill. The bill before the Senate is not the bill I would write, and it's not the bill Chairman Dean would write. It is neither perfect, nor is it the final product. But make no mistake. It is real reform, and it will provide enormous benefits to American workers, American seniors, American small businesses and American families.