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Former Vermont Gov. Howard Dean is a genius. You do not have to like him, but he designed the 50-state strategy that won the House majority and helped get President Obama elected. Everyone thought his scream scene in Iowa would write him off, and it did for president. But it did not stop his becoming chairman of the Democratic National Committee. His supposed confrontation with now-White House Chief of Staff Rham Emanuel is legendary, and there is much speculation that it prevented him from getting a plum job in the Obama administration.
However, Howard Dean has made his mark again and has penned his thoughts in a new book “Howard Dean’s Prescription for Real Healthcare Reform” published by Chelsea Green. (I must make full disclosure here: Chelsea Green has also published one of my books.) He successfully makes his case and shoots down the naysayers. He does it in few words, and he makes his arguments elegantly.
Most important is his argument that “reform without a public health insurance option is not real reform.” He is 100 percent right on this. Many from my side of the fence are fearful that the Democrats are going to cave on this, and then we will be left with a partial solution that will take the country nowhere in the long run. Yes, the public option may look somewhat like Medicare, says Howard Dean, but the advantages in administrative expenses and cost control outweigh the negatives. The insurance companies are camped out on Capitol Hill trying to make sure there is no public option. They don’t want the competition and would like to be able to run their operations in the inefficient manner they have for decades. A public option where everyone, public and private, plays by the same rules would ruin their silent conspiracy. Contrary to the “socialist” health care mantra, it would provide for real competition.
There are other areas that Howard Dean, a physician, knows from experience. One is that we can cut costs of health care by prevention. One statistic he cites is that in one year $132 billion was spent on diabetes but only $70 billion on the prevention of all diseases. If all children were to receive recommended vaccinations then the costs of health care would fall by $40 billion over time. These kinds of interventions are easy to implement, and the savings could insure millions of people.
The other factoids that Howard Dean cites are nothing less than staggering. “Approximately one-third of individuals seeking medical care is likely to experience a medical error such as a medication mistake or the wrong lab results.” He also points out that only about half of the time does an American get the appropriate care.
Most of the readers of this column would never believe the above figures, but I have had direct experience with those numbers. I headed up an effort to get an alcohol and drug treatment center accredited by the hospital and treatment facility accreditation agency. It was an eye-opening experience.
There are a mind-numbing amount of rules and standards. However, real and innovative measures of outcome and treatment protocols are not the main focus of their accreditation procedures. This needs to be the focus if we are going to see differences in costs and be able to exact health care reform.
Dr. Dean also addresses what other countries have done and the results they have obtained. He is honest about wait lists and what the United States can do to not have a repeat of its mistakes. He also points out 11 myths that we are hearing over and over again from those opposed to real change in our system. He points out that citizens will have more choice, not less, that we will strengthen our employer-based system, and that research into treatment effectiveness will mean that health care will not be rationed. He takes on the biggest boogey man that the GOP has been using: that health care reform will eliminate jobs. Not so says Howard Dean, Massachusetts corporations have not dropped coverage, and most large companies already provide coverage.
Boogey man by boogey man, Dean dissects the arguments. It is worthwhile to read what he has to say as he understands the arguments from both provider and political side. Just like he took on the 50 states to provide a win for the Democrats, he takes on the health care lobbies in the only way he knows how: clearly and concisely.