The New Health Dialogue

Howard Dean is apparently not done screaming.

The outspoken former chairman of the Democratic National Committee begins his op-ed in Thursday’s Washington Post boldly stating: “If I were a senator, I would not vote for the current health-care bill.”

The op-ed is the latest in series of increasingly hostile, and generally unhelpful, proclamations from Dean on health reform, leading the Post’s Ruth Marcus to ask, “Have you lost your mind?” Marcus continues:

This is self-defeating lunacy. The Senate bill would extend coverage to more than 30 million Americans who would otherwise be uninsured. It would protect people against being denied coverage because of preexisting conditions, from having their coverage summarily dropped if they get sick, from being charged more on the basis of their gender or their health status. For the first time, childless adults living at or near the poverty level would be assured coverage under Medicaid. Children could remain on their parents’ insurance policies until age 27. …

The bill isn’t perfect, although my worries about it are more about whether it does enough to drive down costs and whether it will turn out to be affordable than about whether it gives too much to insurers. The alternative is not, as Dean would have it, starting from scratch and getting it through the Senate with 51 votes; Senate rules, for better or worse, will not let lawmakers get much done that way. The alternative is squandering this opportunity -- leaving millions of Americans uninsured and without the prospect of getting coverage far into the political future.

Marcus is not alone in her criticisms. “"It's nonsense and it's irresponsible and coming from him as a physician, it's stunning,” Sen. Jay Rockefeller said. Nate Silver has 20 questions for would be bill killers, the first and foremost being, “Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?”

Dean captures the frustration of many on the Left, but his prescriptions for real health reform, ignore not just political realities but also what’s really in the bill. For progressives trying to make sense of the latest compromises and the current bill, we’d suggest listening to someone who’s actually been in the room and whose vote will help shape the final outcome. In an interview with NPR earlier this week, Sen. Sherrod Brown, a well-credentialed progressive from Ohio, also expressed his disappointment with some of the compromises. But he did so while reaffirming his commitment to improve the bill, because at the end of the day it's what the bill accomplishes that matters:

We were insuring 30 million people. We are getting these insurance reforms. We're saying that a young man or woman who is 23, 24, and 25 years old can stay on their parents' insurance, when, now, generally they're cut off. We have prevention and wellness things. We have breaks for small business. So, they can do what they want to do -- insure their employees. And in no way should we just give up on the bill and pass nothing. We won't get another chance for a long time to do something this significant.

That historical context the president put in, you know, keep in mind, 40 years ago when Medicare passed, there was very little Republican support for it. It was very difficult to do. This is difficult -- of course it is, but it's something that we're elected to do. It's what I ran on in my state in Ohio in 2006. And this is our chance - best chance we've had in a generation.

President Obama's senior adviser David Alexrod on MSNBC this morning made a similar case, saying it's all very well for people who are "hale and hearty" and well-insured to complain about the health reform bill's shortcoming, but that it's a whole different story for people who are uninsured, or underinsured, or too poor or too sick to get covered. Missing this opportunity, he said, would be a mistake and a tragedy.