Howard Dean on the health care law

[ProSense]

<...>

Do you think Obamacare is actually going to end up being an asset for Democrats?
I do. I think Obamacare might end up being an asset because…there are a couple of things that were never intended to be in the law… we made the decision, which I didn’t support, to keep the healthcare system in the private sector. So, once that decision is made, there are some good things in the law you can work with. One is the accountable care organization and the other is the exchanges. I think the link between employment and healthcare will be broken as a result of the law, even though that was never intended by the people who wrote it, and I think we can start paying providers by the patient instead of by the procedure. Those things are going to make a big difference. So, I do think there are some good things in this law to work with even though they were never intended by the people who wrote the bill.

I get the sense that there are things in the law that haven’t manifested themselves yet and as they do manifest themselves, it will make the law more attractive to more people.
Absolutely. I mean, look, this is still a popular law in Massachusetts and we all know that Romneycare and Obamacare are pretty much the same law. What I’m a little surprised at is that more Republican governors haven’t accepted the expansion of Medicaid. I mean it’s good for Vermont because they’re just paying our bills, basically. And it’ll be great for the deficit because they’re paying taxes into Washington and they’re not getting any of the benefits. But it’s incredibly bad government. Not that I’m surprised that Republicans are engaged in bad government! My wife was just saying tonight, even Rick Scott who is one of the tea party governors, and now his own legislature won’t take the money, I mean that’s just stupidity! There’s no nice way to say it.

It’s happening here in Michigan, too. They did finally take the money here and our governor does support it, but there is a huge faction of tea party conservatives that daily rallying, I’m on their email list, and the are adamant that we don’t take that money for the exchanges.
It’s just lunacy, really. So they’re against helping people getting health insurance, basically, paid for by their own tax dollars. It makes no sense whatsoever. What it’s going to do is hurt their hospitals enormously. Eventually I do think these governors are all going to take it. Texas has one of the best hospital systems in the world, let alone the country but if they don’t take this money, they’re not going to be the best or anything close to it anymore because they’re all going to be under enormous financial pressure.

I find it ironic that the tea party is advocating for not taking the money to set up the exchanges and forcing the federal government to do so which completely takes it out of the hands of the local folks. It seems completely counter to what they say they want which is local control of everything.
Oddly enough, I think that’s actually going to be helpful. I think it’s going to take…the federal government is going to make some mistakes with these exchanges but it makes more sense to have a unified national exchange and that’s what we’re going to get.

http://www.eclectablog.com/2013/03/interview-gov-howard-dean-talks-about-gun-control-sequester-and-more.html

Oh, a lot of us saw the benefits and potential of the health care law. I see single payer coming: http://www.democraticunderground.com/10022553442

Obama Posts: Health Care Anniversary Is A BFD

"Three years later, Obamacare is still a BFD," read a post on President Obama's Facebook page Saturday celebrating the third anniversary of the Affordable Care Act's passage. The line was a reference to Vice President Joe Biden, who told Obama at its signing that the law was a "big f***ing deal."

http://livewire.talkingpointsmemo.com/entry/obama-posts-health-care-anniversary-is-bfd

Still, Republicans are going to continue their belligerence.

Rubio: ‘ObamaCare’s Full Repeal Remains Our Ultimate Goal’
http://www.democraticunderground.com/10022552023

[Cleita]

1. Love me some Howard Dean.

What a common sense and even handed guy.

[loudsue]

13. He would have been a GREAT president. And the republican media KNEW that.

He was good, had common sense, and spoke the truth.

And you KNOW we can't have that kind of thing in government!!!

[Cleita]

14. Sad isn't it. I sometimes think how different things would have

been if he had beaten George W. Bush and he would have had a better chance IMHO than John Kerry. I went out canvassing for Kerry after Dean was tossed from the race, but everyone I talked to said they wanted Howard Dean and what happened! I didn't have an answer.

[kardonb]

18. HD

tea partiers are not known for common sense and rationality , period .

[JaneyVee]

2. First rule of conservatism (besides hate): Absolute hypocrisy.

[patrice]

3. "One is the accountable care organization..." which does not include Ins. Cos. It's patients &

and direct care givers only - research to discover best practices.

The Patient Protection and Affordable Care Act of 2012, a.k.a. Obamacare; Pateint Protection = The Patient Centered Outcomes Research Institute: http://www.pcori.org/

[dsc]

4. It will be interesting to see how this plays out

NC won't be taking the money so our insured and our hospitals are going to be in effect paying twice for the same treatment. Once by paying federal taxes and a second time by paying for our uninsured to be treated at the most expensive places. But that is our own fault and one hopes we will rectify that either by a GOP uturn or even better throwing the gop out. I do have one major concern that was expressed in another thread. I had never thought of it until I saw it expressed there but the percentage spent on care thing could really wind up biting us on the ass. Someone needs to have an incentive to keep costs down and we removed from insurers one of their major reasons to keep costs down.

[ProSense]

6. Actually,

"NC won't be taking the money so our insured and our hospitals are going to be in effect paying twice for the same treatment. Once by paying federal taxes and a second time by paying for our uninsured to be treated at the most expensive places."

...no. The federal government will be running the NC exchange.

[dsc]

7. I meant the medicaid expansion

I also think we went the combo route on the exchange but the gop lege could have changed that. but we have outright rejected the expansion of medicaid.

[ProSense]

10. On the Medicaid expansion

"I also think we went the combo route on the exchange but the gop lege could have changed that. but we have outright rejected the expansion of medicaid."

...I suspect the holdouts will cave.

<...>

It's not just Gov. Brewer who thinks Medicaid will be an economic stimulus. A study conducted for the North Carolina Department of Health and Human Services found that the Medicaid expansion would bolster the state's economy from 2014 to 2021, resulting in new 23,000 jobs and increasing annual GDP by $1.4 billion. By infusing federal money into local economies to support employment, wages and consumer spending, the Medicaid expansion will be a net economic benefit to states and their residents.

http://www.usatoday.com/story/opinion/2013/02/23/state-medicaid-expansion/1939713/

The holdouts are simply shooting themselves in the foot.

[dsc]

11. we are in an unusual situation here

Medicaid is largely a county program in NC which means that the state has relatively little incentive to take the money. I am hoping hospitals will raise holy hell and change that but as of now, the counties who will be hurt the worst are the ones which have been gerrymandered to not have a heck of a lot of say over who gets to be in the legislature.

[ProSense]

12. Regardless

"Medicaid is largely a county program in NC which means that the state has relatively little incentive to take the money. "

...it will be a self-inflicted wound and they will cave.

[dsc]

15. the problem is that they aren't wounding themselves

The places most likely to be hurt by this are Durham, UNC Chapel Hill, and Charlotte none of which send Republicans to the legislature.

[ProSense]

16. Seriously,

"the problem is that they aren't wounding themselves The places most likely to be hurt by this are Durham, UNC Chapel Hill, and Charlotte none of which send Republicans to the legislature."

...do you actually see an upside for Republicans destroying the economy of the state's biggest cities and working to deny people coverage? The federal government will be running the state's exchange, one way or another they're going to lose.

[dsc]

17. I take it you haven't seen the GOP lately

if they have demonstrated nothing else it is that they don't give a damn about anyone but themselves.

[ProSense]

19. So

"I take it you haven't seen the GOP lately if they have demonstrated nothing else it is that they don't give a damn about anyone but themselves."

...you think this is a winning position for them?

[dsc]

21. for McCrory no

but for the legislature, we have the national problem with the House in spades. Our Congressional delegation split 4 D 9 R, with one seat's margin at less than 700 votes, despite the fact a majority of the state voted for a Democratic Congressman. In the legislature they have veto proof margins (over 60% of the seats) having gotten barely a majority of the vote. They also get to draw the seats in perpetuity since it is only legislative wins that earn the right to draw the seats.

[ProSense]

22. Let me

"for McCrory no but for the legislature, we have the national problem with the House in spades. Our Congressional delegation split 4 D 9 R, with one seat's margin at less than 700 votes, despite the fact a majority of the state voted for a Democratic Congressman. In the legislature they have veto proof margins (over 60% of the seats) having gotten barely a majority of the vote. They also get to draw the seats in perpetuity since it is only legislative wins that earn the right to draw the seats."

...go back to a previous point: the federal government will be running the state's exchange, one way or another they're going to lose.

You can continue weighing the political calculations of a bunch of asshole Republicans, but in the end they will be irrelevant.

[Duval]

25. Absolutely correct. n/t

[patrice]

8. Don't the exchanges provide a competitive response to the pressures put on premiums by the MLR?

[dsc]

9. depends on the state

we are close to a one insurer market here. Blue Cross has upwords of 70% of the business. A public option would have helped a great deal but now it will have to be the exchanges.

[Cha]

5. Yeah, f*** the Kochs teabagged hypocrisy.

[xxqqqzme]

20. It is criminal Howard Dean does not

have a larger voice in the Democratic Party or Health Care. Still one of the smartest guys in the room. He understands how to frame a position. The DNC still hasn't mastered that.

[Duval]

23. Corporate MSM

did their best to destroy Dean. "The Dean Scream"..I'll never forget it.

[JDPriestly]

24. I'm happy that we have the ACA.

The big flaw in it is that we have for-profit insurance. That will push the costs up. But at least we are hopefully ridding ourselves of the costs associated with qualifying procedures and individuals for coverage by abolishing the pre-existing condition excuse that insurers use for denying coverage.

The ACA is not the best we could have done, but it is a good program.

And abruptly switching to single payer might have been very, very difficult. It would have involved somehow compensating existing insurance companies and setting up a different, independent bureaucracy that would have frustrated a lot of people with its start-up confusion.

As it is, in a few years, when the insurance companies realize that not all of the business they get is profitable, we will have a parallel public option and some non-profits will ease into the business.

For now, we are in the transition. Eventually, we will get a really top quality system. But it will take time.

It would have taken time, maybe even more time, if we had switched to single payer right away -- and we would have a much worse backlash from Wall Street.

The ACA tries to limit the amount of profit that can be made on healthcare by the insurers. That is a very good start.

Even with single payer, healthcare is not free. (I know that for a fact.) The most we can do to improve our own lives and avoid unnecessary healthcare costs is stay informed and lead lifestyles that are as active and healthy as our bodies and circumstances permit.

Walk. Walk. Walk. Walk. Walk. Leave your car in the driveway as often as you can. Start saving on Medicare costs now no matter how young you are.

[Hoyt]

27. I Agree. I think the exchanges will have a big impact on premiums.

However we cut it, health care is not going to be cheap. Providers want their share, and consumers want everything covered, no matter how expensive. At least there are some controls on insurance company profits and operations.

[ProSense]

34. There are

"For now, we are in the transition. Eventually, we will get a really top quality system. But it will take time. "

...a number of options available to keep improving the law, especially when it comes to cost controls.

[dkf]

26. Howard is counting on the law of unintended consequences to get us where we need to be.

He certainly isn't proclaiming the genius of the planners unless its a 3 dimensional type of play.

[ProSense]

28. Like I said,

"Howard is counting on the law of unintended consequences to get us where we need to be. He certainly isn't proclaiming the genius of the planners unless its a 3 dimensional type of play."

...a lot of people who supported the law, knew the likely consequences because of the way it was structured.

The Affordable Care Act requires states to have exchanges. A state has several options: It can build the exchange itself, or it can collaborate with the federal government to build it, or it can let the federal government run it. The state has to tell the feds what path it has decided to take by mid-November. If the state does not want to run its own exchange, or collaborate with the feds to run it, the feds will begin setting up the exchange themselves in January.

http://www.democraticunderground.com/1002879506

Krugman:

Now, in the end most states will probably go along with the expansion because of the huge financial incentives: the federal government will pay the full cost of the expansion for the first three years, and the additional spending will benefit hospitals and doctors as well as patients. Still, some of the states grudgingly allowing the federal government to help their neediest citizens are placing a condition on this aid, insisting that it must be run through private insurance companies. And that tells you a lot about what conservative politicians really want.

http://www.democraticunderground.com/10022456901

The Bomb Buried In Obamacare Explodes Today-Hallelujah!
http://www.democraticunderground.com/1002894046

[dkf]

29. One thing about Howard Dean...he tells it like it is.

Even if he could have sold it like this, he wouldn't have. The guy is a straight shooter.

Still the man...

[ProSense]

31. Well,

"One thing about Howard Dean...he tells it like it is."

...there is one thing about the health care law: The thing that Dean is stating that a lot of people suspected would be the outcome from the beginning.

It really didn't take much to predict: The structure of the law and the motives of insurers and others who would work to deny people coverage guaranteed the outcome.

[dkf]

32. Why did we need the law to get to this failed outcome?

And it does take failure to move to what people predicted.

[ProSense]

33. You mean

"Why did we need the law to get to this failed outcome?

...the "failed outcome" where it's an "asset"? The "failed outcome" that results in the demise of the insurance companies? The "failed outcome" that leads to single payer?

"And it does take failure to move to what people predicted."

What nonsense. LOL!

Check the predictions again: http://www.democraticunderground.com/?com=view_post&forum=1002&pid=2561213

[graham4anything]

30. Everything President Obama has done is a 10 step ahead BFD and a giant step forward

Glad Howard Dean is 100% aboard Team Obama.

Count all, Dot all the I's, and cross all the T's.

And remember everything President Obama does is with the future eye on the price, and not necessarily instant gratification to please the small minority of loud yelpers, as befits a constitutional scholar and future member of the US Supreme Court (like President Taft).

If we have President Obama agenda for a few decades, the next generation about to be born will find life is nearly perfect in America when they become teens.(all hyperbole aside).

[Hekate]

35. I love the good Doctor Dean

TY for posting this interview.

[ProSense]

36. Kick! n/t