Public option or bust, Dean says

If the health care bill does not have a public option, it should not pass, Howard Dean ’71, the former head of the Democratic National Committee, said in a Pierson College Master’s Tea on Monday.

Dean, who also served as the governor of Vermont from 1991 to 2003 and ran for the Democratic nomination for president in 2004 — explained to an audience of 50 students that the new health care bill, if it has the public option intact, would allow young adults to have stable health insurance in the future, regardless of the job economy. But he added that the bill, currently awaiting approval by the Senate, continues to funnel taxpayer’s money into the health insurance industry, which does not effectively use the money as government-run health care would.

“The only decent part of this bill is the public option,” Dean said. “If we don’t have choice, this bill is worthless and should be defeated.”

Under the public option, private health insurance companies would compete with a government-sponsored alternative, similar to Medicare. In the form of the bill currently being considered in the Senate, states can opt out of the public option.

He said the public option is particularly important to college students who are about to enter the real world. He said the current bills should allow young adults to opt in to a Medicare program and enable them to have some form of publicly sponsored health care. The private insurance sector does not guarantee this stability, Dean said, because as young people change and lose jobs, they will be uninsured when seeking jobs.

“If you are in a public option, like Medicare, you’d all pay the same, no one can deny you, no one can kick you off,” he said. “You can take it anywhere you want.”

The Senate bill will not by itself affect the health care system significantly, he said. Rather, cost-cutting and other improvements will come from the states and their citizens, who will frame their own insurance policies.

For example, in Dean’s home state of Vermont, he said, legislators have enacted laws to ensure that all constituents pay about the same health insurance rate and that no one is denied health care because of poor health. He added that because of a state program, Vermont families with an annual income of less than $66,000 currently can pay a fee to the state to enable children under the age of 18 to opt into Medicaid. As a result, 99 percent of children under 18 in Vermont have health insurance.

One audience member asked Dean how the federal government will fund the bill amid the economic downturn. Dean said in order to get more services, the American people would need to pay more.

Pierson Master Harvey Goldblatt, a native of Canada, where there is government-sponsored health care, said after the Tea that the thought of Piersonites entering the workforce without health insurance disturbed him.

Still, of the seven students interviewed after the tea, two said Dean’s approach to health care reform did not completely solve the problem.

Edmund Burke MED ’10 said that although the bill shifts government costs to cover health care reform, it does not adequately cut costs in the health care system. Burke said the only way to eliminate excess spending would be through a set of “clear, evidence-based guidelines” for medical practices, which the reform bill does not create.

Justin Berk ’10 added that he is frustrated that the American people require more “knowledge of politics than health care” to understand the bill.

Still, Dean, formerly a practicing physician, said that although the bill does not present many substantial changes to the current health care system, a change is needed, and the bill provides a place to start.

“The only way to have reform is to try something,” he said.

Dean, who recently published a book on health-care reform, currently co-teaches a Pierson College seminar about the daily lives of politicians.


  • Recent Alum

    I really, really hope he means it. Our only hope.

  • Howard Dean


  • appalled

    All I got out of this article is that we must pay higher taxes so everyone else…doesn’t matter if they are employed or not…have healthcare.

    Healthcare is not a right!!! And we should not help pay for someone else’s bills unless WE CHOOSE to do so!

    Government does not have the right to take more money from me and give it to whoever they think!!! Stop the insanity!!

  • Tanner

    Exactly what will the Civil Service Rank be for doctors? hopefully a higher paygrade then White House Czars.

  • Boola

    @ #3,

    Look around – right now about 10% of the American workforce is unemployed. Most of those people would love to be working, but can’t because the jobs just aren’t there. (Having said that, don’t try to change the subject and make this about the economy, because my point is about something a lot more fundamental than that.)

    A diversity of views is important in any society and as an adult I’m willing to accept that many opinions contrary to my own are perfectly valid, but if you can look at that 10% of the American population and their children, and you can tell them that if they get sick or get in an accident they shouldn’t be able to see a doctor if they don’t have the money? Then with all due respect, there’s a special place in hell for you my friend.

    Health care IS a right. Only (some of) the privileged think it’s a privilege.

  • Y11


  • FailBoat

    I am not privileged (and growing up I lived without health insurance).

    Health care is not a right. Saying it is demonstrates a complete misunderstanding of what rights actually are.

  • @5

    If I may reply for @3, I think the issue is not so much about whether people in such situations SHOULD get healthcare so much as the principles behind it.

    Yes, that 10% of the population should get taken care of, but that choice to have a heart shouldn’t be legislated on the populace at large by the government, because while the government has an obligation to take care of it’s citizens, it should not have (arguably) a right to make the decision to care above and beyond a person’s own choice. Such actions should be done through individual charity. Not sure I agree, but I don’t think the issue is always over whether they SHOULD have healthcare; it is an argument about the proper role of government.

  • @Boola

    In my state, more than 12% are unemployed, and that figure does not include those who have used up their UI benefits or new grads who have not yet entered the workforce. In addition, many employed people–like myself–are either not offered insurance by their employers or cannot afford it. Four of the five members of my family are without insurance. Only the youngest, still a student and on his father’s insurance, has it.

    We all want to have good health and avoid injury, but when one is without insurance, it’s not just a matter of health, it’s a matter of avoiding bankruptcy and even death because one cannot afford care.

    No one who likes their insurance would have to change, but those of us without it would at last have an option with a publicly sponsored plan.

  • Boola

    @ #9 – Not sure if you meant to reply to my post or someone else’s, but I totally agree with you.

    @ #7 – Exactly what constitutes a “right” is certainly debatable, but it seems to me that the following is a good principle for society to live by: If you get sick or get in an accident (which typically happens through no fault of your own), your ability to access life-saving care should not be denied on the basis of your income. And if children get sick or get in an accident, they should not be denied on the basis of their parents’ income. If we accept that principle, then we accept that health care is a right. Do you disagree with the principle?

    @ #8 – I can understand that argument, but here’s my question – what if individual charity isn’t enough to get the job done? What if we say we’re going to do it that way and then, either because of lack of funds or lack of coordination, we find ourselves in a situation where people who aren’t rich can’t get access to life-saving care? Given that the government has an obligation to take care of its citizens, wouldn’t it be failing to do so in that situation? And can’t we then say, okay, we’re going to make a decision as a society that such a situation is unacceptable and we are therefore justified in providing a certain minimum social safety net even if some of our citizens would rather not?

  • @Boola

    I agree with you on many points, and I think there are times when the government would be justified in providing life-saving care, BUT in regard to the Democratic plan for universal health care:

    One word: Abortion

    Half the country considers it to be morally wrong. Assuming its legality because of ‘morality shouldn’t be legislated’, does the government really have the “right” to ask people to give up their income to fund it?

    I fear these are the situations that lead to civil disobedience. And maybe justly so.