i am fortunate enough to not need dean's coverage AT THIS TIME. notice i stress that. dean's plan provides care for those of us who might fall through the cracks in the future. he also make a good point which is being missed: a patients bill of rights will not ensure one more american. under dean's plan, the most needy (the poor and seniors) get the coverage they need. under dean's plan, young people are covered. see, there's this really nifty thing that dean understands: PREVENTION IS THE KEY. get everyone in the system, get them health care, and you will save money in the long run. i fail to see how matthew and max missed that very important point.

i'm sorely disappointed with matthew's analysis. i would have expected better of him, especially considering he was one of the four original contributors to this blog. i wonder, has he sold himself to the establishment already? do you hear me, matthew?
anna | Email | Homepage | 05.06.03 - 10:59 am | #

Someone (Joe Rospars?) should summarize this article and post it in MaxSpeak and Big Media Matt's comments.
Luke Francl | Email | Homepage | 05.06.03 - 11:07 am | #

you know, on second thought i might have been too harsh on matt. at least he seems willing to listen, which is better than most folks. if matt doesn't understand it, perhaps there are other folks who don't as well.

::sigh:: i guess i'm just the knee-jerk girl this morning. need... more... coffee...
anna | Email | Homepage | 05.06.03 - 11:09 am | #

I know people who seem confused by Dean's plan. As I have tried to explain it Dean is separating the question of coverage from reform. He admits that the health care system as a whole in this country is screwed up. But reforming it is a major battle that should be separate from the question of coverage.

In other words, let's first get everyone on some kind of plan and THEN try to make those plans better. At least then we can eliminate the truly embarassing statistic about the number of uninsured people in this country.

I like this approach. It gets to the biggest problem in health care today (the fact that so many people have no coverage), forcse the opposition to discuss the issue on the matter of coverage alone instead of getting bogged down in the details of any particular reform proposal, and lays the groundwork for more comprehensive reform in the future.

After all, once everyone has a stake in the health care system, everyone will have an interest in making it better.

Tell me if this is an incorrect assessment of Dean's proposal.
Chris Andersen | Email | Homepage | 05.06.03 - 11:14 am | #

I agree Chris. I think the measured and incremental nature of Dean’s healthcare plan is its strength - and the perfect argument for his wide appeal.

If I might be so indulged, (not to be disruptive to the thread) but one more comment on Dean and the debate: it seemed VERY WEAK and muddled to me watching it when Dean - speaking to the wrongheaded Iraq policy - declared that a Shia fundamentalist regime could likely result from this military adventure.

While I admire the depth and complexity of the opposition to the war, he needs to TRANSCEND the what ifs. Because what if they DO find WMD, what if a true democratic country does result, what if all the Cassandra cries turns out to be just that…Dean can’t put himself in a position where the terms of the opposition need to be redefined every week.

I do not accuse Dean of changing his position. I admire his steadfast behavior. But in rationalizing it to the public it must be defined more by higher truths than specific possibilities…or he could be trapped by what seemed in the debate to be predictions of doom and gloom. And nobody wants to follow a Cassandra, it’s a bummer. Who knows what will happen? So please stop talking like it’s about to happen.

For the argument to be truly forceful and compelling to me, the argument needs to survive the possible finding of WMD, the establishment of a link to Al Qaeda and the establishment of democracy in Iraq. And if in fact no WMD are found etc… it will only reinforce the unshakable argument.

The big notions - to recite what we all know: Bush is exercising RECKLESS foreign, economic, energy, environmental, and social policy. He is taking UNNECESSARY risks, GAMBLING with American power, finances and prestige for the sole purposes of POLITICS in the service of GREED (with the multitude of examples) and claiming the Constitution as the sole justification for this wanton behavior.

The exposition of these themes and how they in fact contravene the Constitution, The Bill of Rights, yes, The Gettysburg Address (perhaps the archetypal transcendent political document aptly quoted by Dean), and the progressive nature that makes America great, is where ongoing, transcendent, forceful arguments opposing the war are to be found - not in what ifs.
Ken L | Email | Homepage | 05.06.03 - 11:22 am | #

Sorry about the outburst. Please, back to healthcare....
Ken L | Email | Homepage | 05.06.03 - 11:25 am | #

The big notions - to recite what we all know: Bush is exercising RECKLESS foreign, economic, energy, environmental, and social policy. He is taking UNNECESSARY risks, GAMBLING with American power, finances and prestige for the sole purposes of POLITICS in the service of GREED (with the multitude of examples) and claiming the Constitution as the sole justification for this wanton behavior.

Amen Ken, fantastic stuff. Sounds like the closing remarks to a future general election debate.
Scott G. Medford, MA | Email | Homepage | 05.06.03 - 11:30 am | #

Ken L.: I agree. But if Bush's gambles wind up paying off (i.e., if Iraq sets up a stable, nonviolent government, if WMDs are found, etc.) then he looks like a visionary and the only one with the brass to take those risks, while Dean looks like a nervous nellie. I don't know how to get around that problem.
leenie | Email | Homepage | 05.06.03 - 11:31 am | #

I think Dean is making the move to inherit the incrementalist approach that Bill Clinton used. I happen to agree with this approach, but I know many on the left who hate it. They think it provides to many opportunities to compromise important principles for illusory results. They may be right in that, but if it is the only approach that actually gets us on the road to where we really want to be then I am all for it.

In a way this is also a steal from the Dubya/Rove playbook. Remember how Bush dealt with the abortion question during the 2000 campaign? He essentially said that while he personally supported banning abortion he didn't feel the political climate was such that such a proposal could ever get passed (I agree with that). He then said it was more important to devote your energies for what could be done rather than waste time on leaps towards the ultimate goal right away.

Of course, in his usual way, he said this in different ways depending on the audience he was talking to. If he was talking to mainstream audiences then he would emphasis the "I'm not going to push for a ban on abortion" message while if he was talking to the red meat crowd he would emphasis the "we need to work towards the ultimate goal of banning abortion" part of the message.

I think Dean could take the same approach to discussing health care. When talking with more liberal audiences, emphasis the fact that he DOES support a more simplified universal health care system. But when talking to more mainstream audiences talk about how he supports covering those who are currently uninsured.

It is possible to sell yourself to both constituencies without pissing either off (just so long as the the left version of the red meat crowd understands that they won't always hear what they want to hear in the more public dialog on the issues).
Chris Andersen | Email | Homepage | 05.06.03 - 11:37 am | #

Probably too complicated for the general electorate, but the US (Bush) succeeding in setting up a secular government in Iraq could be the worst case for the US.
Why? Muslims in the mid-east would see this THE evidence that the US is on a crusade against Islam, by forcibly preventing the formation of an Islamic country. Major terrorist recruiting tool!
thx | Email | Homepage | 05.06.03 - 11:41 am | #

leenie, I agree - that's the tough nut to crack. And that's why Dean's argument needs to work given that eventuality. If he needs x y and z to happen for the argument to be persuasive, then it really doesn’t work. If on the other hand his argument still carries, it is unbeatable. I don’t despair. I think it’s totally doable.
Ken L | Email | Homepage | 05.06.03 - 12:02 pm | #

sorry about the double posting....
Ken L | Email | Homepage | 05.06.03 - 12:02 pm | #

Dean has a plan for the young and the old, but as far as prime-age workers are concerned, there's no there there. You can't have it both ways -- say incrementalism is good and then say you've covered the whole enchilada. You haven't.

In my post I noted that on this issue, all but Kucinich and Gephardt have done worse than Dean. I also acknowledged there is a case for incrementalism. But the fact is that the Gov has yet to specify anything remotely resembling a plan for universal coverage.

As far as Gephardt's plan and the young are concerned, he proposes to expand SCHIP. This is easy and cheap to do, so I think it's fair to say he has this base covered, even though he provides no details.

I would certainly work for and vote for Dean over Bush (or any other Republican), so I hope you'll take all criticism as constructive. If you're going to do health care, don't punt on the uninsured.
Max Sawicky | Email | Homepage | 05.06.03 - 1:07 pm | #

Are we having problems with the word "Universal" then? Who doesn't covered? Are we talking about the 23 to 64 year old range? I thought he said in the debates that he implied implementing a part of Gephardt's plan to help small businesses get tax breaks and incentives to provide health insurance to employees? Under 23 would be covered by some form medicaid while over 65 would be under medicare. Am I mistaken? I believe he goes into great detail about this in a radio interview (available on-line) a few months back. The only thing not evident at the time was the middle tier which I think he finally divulged more information on in the debates. Of course, I could just be greatly mistaken.
Pfb | Email | Homepage | 05.06.03 - 2:47 pm | #

Pfb -- All I could find on the web site, which Joe says is all you need to know, is: "Finally, to cover those between the ages of 23 and 65, we should use the present employer-based system with refundable tax credits and federal subsidies to cover low- and moderate-income Americans who lack insurance."

I'm sorry, but this is not a plan. On a general level, it's no different than Gephardt's. So why does Dean call G's plan "pie in the sky"? I guess because G would require a bigger, more comprehensive set of benefits. What would Dean do? What kind of subsidy? At what cost? Who knows?

I suppose we'll see the difference when Dean releases an actual plan. Then people will have something to compare with Gephardt beyond rhetoric. Until Dean unveils his plan, it's fair to say he has not offered a plan.
Max Sawicky | Email | Homepage | 05.06.03 - 3:06 pm | #

Listen to the radio nation interview, he goes into more detail about his health care plan about five minutes into it.

http://stream.realimpact.org/rih...30312.rm&start=
Phil | Email | Homepage | 05.06.03 - 3:24 pm | #

Ah, beat me to it, Phil.
chase | Email | Homepage | 05.06.03 - 3:45 pm | #

"So why does Dean call G's plan "pie in the sky"?"

Because it has zero chance of getting passed. After trying for comprehensive health care reform himself in 1993, with the same results Clinton had, Dean is very pragmatic when it comes to health care. Dean's plan is like what he did in Vermont, which resulted in universal coverage for kids and 92% for adults under 65.
CA Pol Junkie | Email | Homepage | 05.06.03 - 3:48 pm | #

BTW, Graham now has his web site up and running, grahamforpresident.com . Under issues, it describes his health care platform as pragmatic. His proposal is summarized as follows:

" * First, expand the Children's Health Insurance Program (CHIP) and similar programs to guarantee that all children have health coverage.

* Next, permit an affordable "buy-in" to the Medicare program for those nearing age 65 and retirement who have lost coverage from their employer.

* And finally, modify the Medicaid program to offer coverage to the so-called working poor, who currently make too much money to qualify for subsidized health insurance but not enough money to afford coverage on their own."
CA Pol Junkie | Email | Homepage | 05.06.03 - 4:01 pm | #

Chris, again I think you're right on. Universal health coverage is NOT HAPPENING out-of-the-gate. The incrementalism of Clinton/Gore while not sexy gets the job done. And the one area they abandoned incrementalism, health insurance, they failed miserably. Nader and the rest are always calling for revolution but let's face it, progress in this country has been evolutionary and evolutionary it will continue to be. The only question for me is how big a step backward are we going to have to take before progress, again, gets to march forward on one step at a time.
Ken L | Email | Homepage | 05.06.03 - 6:18 pm | #

Bravo, Ken (and, by extension, Chris)! Incrementalism IS the reality in this country. Americans are easily scared off by anything that seems to be even the slightest bit revolutionary. How else to explain people actually being convinced by those heavy-handed Harry & Louise ads (I think those were their names)?
Allan Todd | Email | Homepage | 05.06.03 - 7:04 pm | #

Tell G. Bush about incrementalism.

Who is it that's scared?

Seriously, I wish Dean luck, but if he is going to play the triangulation game like Clinton, he'll be in for a bumpy ride.
Max Sawicky | Email | Homepage | 05.06.03 - 7:24 pm | #

Max, thanks for your input and suggestions. We value your input, regardless of whether we are a little protective of our candidate. =)
anna | Email | Homepage | 05.06.03 - 9:57 pm | #

I guess the difference between Gephardt's and Dean plan (from my limited understanding) is the use and stricter boundaries of Medicare and Medicaid.

Max, I guess the problem that we have with your statement is semantics of no plan. From statement from Dean campaign, they do have a plan, more so than anyone else other than Gephardt. They do give specifics but not all of the nut and bolts. It might be better to say that the Campaign has not laid out definitive detailed plan or they have tangible skeleton plan based on the Vermont model.

I guess if you really want insight to the plan contact the campaign directly or look into the Vermont model. Either, I think you brought a good points, but we also need to give the Dean campaign to iron out the details also.
Pfb | Email | Homepage | 05.07.03 - 12:43 am | #

As team Dean irons out the details, I just hope they resist the urge to make the plan more and more expansive to potentially accommodate Gephardt supporters.

The appeal of Dean to me is not only his willingness to headbutt W. but is also his courage to say no to the Left when appropriate.

Universal health coverage or anything that smells of it is just such an occasion to say: No, let's alleviate the worst of the suffering first, period. The clear difference between Dean and the republicans is that he would actually do it! Then a new reality would exist for further and further improvements to the situation moving - finally - again forward.
Ken L | Email | Homepage | 05.07.03 - 8:13 am | #

The web site needs to explain a bit more about working people health coverage. Not a 200 page bill, but a paragraph or two. As it stands, Dean would subsidize health insurance for those whose employers didn't provide it. That would result in massive numbers of employers dropping coverage while telling their employees,"Don't worry the government will give you a voucher to buy a private policy". The only thing that makes sense is some variation of the old "pay or play" proposal. Say an employer tax to provide health insurance with a credit for premiums paid. The tax should be structured to incentivize the employer to provide insurance rather than pay. In the long run, some sort of national health insurance is needed. Health costs have risen largely because those who order service (the employees) do not directly pay. Do you want hamburger or filet mignon? Your boss is paying either way. I don't pick a doctor based on what he charges because whatever it is, it still costs me only $10. So the doctor charges high to get the maximum from the insurance company. In the long run this must be fixed. But in the short run, Dean's plan is good if doesn't cause employers to drop coverage.
Anthony Segredo | Email | Homepage | 05.07.03 - 8:59 am | #

Also, I'd really like to know who the 8% without coverage in Vermont are. Are they 50plus unemployed whose COBRA has run out like me? Are we supposed to stop eating and not get sick for the next ten years until SS & Medicare kick in? I guess we sleep on gratings until then. Everyone worrys about new grads and H1B's having to go home. Old fossils like me and my friends are supposed to just die, while waving the American flag and cheering Saddam's statue falling.
Anthony Segredo | Email | Homepage | 05.07.03 - 9:05 am | #

Kerry´s announcing his plan on May 15th, according to the Boston Globe and the Note. Dean´s got to do his first, if it´s humanly possible.
Katherine | Email | Homepage | 05.07.03 - 1:32 pm | #