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The Evolution of the Public Option

Monday, on Dylan Ratigan's "Morning Meeting," I had the opportunity to chat health care with Gov. Howard Dean. Dean's point was simple: "If you're not going to have a public option, don't have health-care reform, and strip all the money out of the bill." That means no Medicaid expansion. No subsidies for people up to 300 percent of poverty. Dean was open to leaving some of the insurance regulations alone, but if the public plan was to be sacrificed, Dean wanted every dollar meant to help Americans afford health insurance cut as well.

I asked Dean how he could believe this, given that his 2004 health-care plan didn't contain a public plan but did contain a lot of dollars to fund expanded health coverage. He replied that it did contain a public plan. "It actually did have a public option. It allowed everybody over 55 to sign up for Medicare if they chose to. It allowed everyone under 25 to sign up for a Canadian-style system. It was optional."

I don't think that's quite right. If anyone remembers the term "public plan" being uttered in 2004, I'd be surprised. I certainly never heard it. The idea didn't really exist. Dean is arguing that expansions of public programs are the same thing. But this year's health-care reform expands Medicaid to 133 percent of poverty, and Dean isn't terming that a public plan. Max Baucus's original white paper proposed allowing people between 55 and 65 to buy into Medicare, at least for a time, and that never caught on in the political debate, and isn't being offered as an alternative by Dean.

The argument behind the public plan -- the argument Dean is using now -- is that it competes with private insurance companies and transforms the entire insurance market. But this is, as Mark Schmitt says, a very new idea. Credit for it goes, as far as I know, to Berkeley's Jacob Hacker, who was the first to persuasively articulate it; to the Economic Policy Institute, which fleshed out the specifics; and to the Campaign for America's Future, which took the lead in selling it to advocacy groups and the presidential campaigns. John Edwards picked it up and made it central to his proposal, and the other candidates followed suit to protect their left flanks.

The reason the idea managed to catch the liberal establishment's imagination was that it was sold as a way of achieving single-payer, or something close to it, within the current constraints of the political system. Schmitt explains:

It was a real high-wire act -- to convince the single-payer advocates, who were the only engaged health care constituency on the left, that they could live with the public option as a kind of stealth single-payer, thus transferring their energy and enthusiasm to this alternative. It had a very positive political effect: It got all the candidates except Kucinich onto basically the same health reform structure, unlike in 1992, when every Democrat had his or her own gimmick. And the public option/insurance exchange structure was ambitious.

But the downside is that the political process turns out to be as resistant to stealth single-payer as it is to plain-old single-payer. If there is a public plan, it certainly won't be the kind of deal that could "become the dominant player." So now this energetic, well-funded group of progressives is fired up to defend something fairly complex and not necessarily essential to health reform. (Or, put another way, there are plenty of bad versions of a public plan.) The symbolic intensity is hard for others to understand. But the intensity is understandable if you recognize that this is what they gave up single-payer for, so they want to win at least that much.

If you look at what Dean proposed in 2004, or what he's arguing now, the constant thread is not the public plan, but the path toward single-payer. But as Schmitt says, the public plan being considered isn't a particularly good vehicle for that transition: The relatively liberal version in the House bill can't bargain with Medicare rates and is limited to the few Americans eligible for the exchange. Even so, it's still the part of health-care reform that single-payer supporters identify with their cause, and so it has a unique resonance, even though at this point, the Medicaid expansion and the insurance exchanges and the subsidies are arguably more important.

By Ezra Klein  |  August 18, 2009; 12:44 PM ET
Categories:  Health Reform  
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Comments

"If anyone remembers the term "public plan" being uttered in 2004, I'd be surprised."

And if anyone remembers the name "Lenovo" being uttered in 2004, I'd be surprised. They started marketing IBM Thinkpads under that name in 2005.

Come on, Ezra, this is really a lame argument! It's totally irrelevant how it was called in 2004. The point is, did Dean propose a government run plan then? Obviously, he did.

Posted by: Gray62 | August 18, 2009 12:59 PM | Report abuse

"as Schmitt says, the public plan being considered isn't a particularly good vehicle for that transition"

You don't have to consider a public option the stalking horse for single-payer to want an alternative to BCBS or UnitedHealth or Your State's Insurance Behemoth.

You can talk about the exchange all you like, but most people see their state's health insurance market dominated by one or two giants, whose prices right are remarkably similar. It's hard to imagine that changing quickly. Then you throw in the prospect of an individual mandate.

It's one thing to have mandatory auto insurance run through private companies-- you can live without a car. It might be conceivable to have the megainsurers offer an equivalent to the state-mandated minimum auto coverage, as long as there's a sufficiently robust regulator.

But I'm not giving the b'stards my money. There are some people who won't do it because those insurers have been crap. There are others like me who refuse to feed a pack of vultures. Simple as that.

Posted by: pseudonymousinnc | August 18, 2009 1:05 PM | Report abuse

Look single payer has existed as an idea for decades. But it has never been possible politically. Your best hope is to move incrementally toward it. What I will say in Dean's defense is that if we aren't going to have a public plan we should have fairly bare bones insurance here. That is what Dean campaigned on in 2004. Bare bones coverage with no public plan and a lot less in the way of insurance reform. It didn't even include an individual mandate.

Posted by: CraigMcGillivary1 | August 18, 2009 1:07 PM | Report abuse

Maybe insuring children up to 25, letting people over 50 buy into Medicare and people under 50 buy into Medicaid (with some subsidies) are better ideas. One problem could be that Medicare controls costs through minimal administration and lower reimbursement, but not by limiting care. Would things like effectiveness research and better IT control costs enough? Don't know. And the Blue Dogs fight caps on reimbursement. As you have said, denying (ineffective, or not-cost-effective) care is what controls costs, but people hate it.

It does seem that if the public option had been billed and sold as "guaranteed choice" it would have done better.

I see Dean's remarks on stripping costs as throwing down the gauntlet to the insurers--how much do they really want that big new pool of customers and how much are they willing to give up to get it?

Posted by: Mimikatz | August 18, 2009 1:13 PM | Report abuse

Also part of what is happening here is that politicians don't believe what they said they believed. Its not just that a good idea died because it was unpopular. Its being killed because politicians in Washington feel comfortable killing it.

Posted by: CraigMcGillivary1 | August 18, 2009 1:14 PM | Report abuse

Pseudonymousinnc what do you do if you get sick? I think that a individual mandate is not bad because you SHOULD get health insurance. True if they didn't have insurance reform with it that would be a bad idea. I guess my political calculus is a little different. I think once we have universal coverage nobody will want to go back. Politicians will have to choose between dropping coverage for a bunch of people, cutting costs or raising taxes. I think they will cut costs.

Posted by: CraigMcGillivary1 | August 18, 2009 1:21 PM | Report abuse

Ezra: "The reason the idea managed to catch the liberal establishment's imagination was that it was sold as a way of achieving single-payer, or something close to it, within the current constraints of the political system."

Schmitt: "It was a real high-wire act -- to convince the single-payer advocates, who were the only engaged health care constituency on the left, that they could live with the public option as a kind of stealth single-payer, thus transferring their energy and enthusiasm to this alternative.

In other words, it was a Trojan horse. Thanks for that bit of honesty.

Posted by: tbass1 | August 18, 2009 1:23 PM | Report abuse

Shorter Ezra: I got mine, too bad about the rest of you.

Posted by: kmblue | August 18, 2009 1:23 PM | Report abuse

"But I'm not giving the b'stards my money. There are some people who won't do it because those insurers have been crap. There are others like me who refuse to feed a pack of vultures. Simple as that."

Hear, Hear! pseudonymousinnc

The thought of being forced to pay these vultures sickens me. If no public option, then there better not be a mandate. What the insurance companies do and have done is immoral, plain and simple. I will not be forced to reward them.

Posted by: Melinochis | August 18, 2009 1:25 PM | Report abuse

The fact that people are not allowed to buy insurance from the government means that the health insurance companies are just extorting money from the the country's citizens. This translates into higher extra premium money used to fund lobbyists and buy or intimidate politicians so that the insurance companies can write law by proxy and capture regulators to make it easier for them to make money and expand their political power, so that the cycle can start all over.

Posted by: bcbulger | August 18, 2009 1:30 PM | Report abuse

I think Dean is full of it. I do not really care what he proposed in 2004. In the health care world we always say that five years is long term planning. So five years ago is ancient history.

To throw out reform for the lack of a public option is just plain foolish when we can get consensus on and get passed: no pre-ex, no underwriting, no recission, community rating, exchange based purchasing, expanded Medicaid, an individual mandate and subsidies to buy it. Sure this ain't perfect, but you'd pitch it for lack of a public option?? Insanity.

Posted by: scott1959 | August 18, 2009 1:30 PM | Report abuse

When will all the vultures let us have what we all really want: fair access to health care without making a few people obscenely rich? Never if they can help it. The rest of this fuss is just window dressing.

Posted by: janinsanfran | August 18, 2009 1:35 PM | Report abuse

The righties really like the effectiveness of adding the word 'forced' to something to make it 'teh evil'. Forced bussing. Forced death counseling.

Insurance reform without the public option should be positioned by the Dems as 'forced private insurance' with insurance bureaucrats forcing your health care options.

As for the public option as a surrogate and path toward single payer:

it is far better to get the camel's nose under your tent flap (hoping for a warm camel to snuggle on cold nights), than to get the camel's ass under your tentside passing camel gas and forcing you out of the tent.

Mandating that people buy private health insurance is forced wage capture by the greedyist, immoral people on the planet.

Posted by: JimPortlandOR | August 18, 2009 1:46 PM | Report abuse

Hmm, Ezra... I think you're being a little (uncharacteristically) intellectually dishonest. Just because he didn't use the term "public plan" that means he didn't propose it? Political terminology changes. You know that.

I'd say he offered a limited public plan, as we would have it in today's terms.

That aside, I'm in complete agreement with you that it would be utterly foolish to chuck reform if there's no public plan. In my mind, the public plan has always been a vehicle for achieving other things - lower costs, universality, etc. If you can achieve those goals directly, as in the WH's eight guidelines, perhaps, then yahoo.

People that want to throw reform overboard if there's no public plan are really just single-payer supporters. That's a fine position to have, but I wish they'd just say it.

Posted by: roquelaure_79 | August 18, 2009 1:47 PM | Report abuse

"People that want to throw reform overboard if there's no public plan are really just single-payer supporters. That's a fine position to have, but I wish they'd just say it."

Actually, I don't think that's true. What I want is an alternative to paying an insurance company. I think their practices have been despicable and I do not want to support a single one of those companies financially. A lot of different things are being hung on the public option - this aspect hasn't really been much discussed. But I really just loathe these organizations. I am presently uninsured - pre existing condition - and certainly don't want to be forced to pay them because the government decided to reward them with a bunch of new customers they rejected before. I agree, I'd rather see some improvements over none, but if no public option then there better not be a mandate.

Posted by: Melinochis | August 18, 2009 2:10 PM | Report abuse

Ezra quotes Dean as saying, "It actually did have a public option. It allowed everybody over 55 to sign up for Medicare if they chose to. It allowed everyone under 25 to sign up for a Canadian-style system. It was optional."

What of those between the ages of 25 to 55? Does there exist an archived webpage of Dean's proposal in 2004 that we can look at or ourselves, so we can decide whether Ezra is playing terminological games or identifying a real change in policy approach?

Posted by: JonathanTE | August 18, 2009 2:19 PM | Report abuse

I think that the public plan would make more sense from an argument point as a ceiling of price rather than a floor. Just say "we realize that because of pre-existing conditions and other risk factors that some people are basically uninsurable in the private market. We do not believe that it is fundamentally fair for anyone to pay more than 15% of their pretax income to healthcare. If you cannot find a suitable private insurance policy then we are the insurer of last resort. No one is getting free care- these people are paying a large portion of their income to be healthy and we have a moral responsibility to do something. This is strictly voluntary and only people who wish to participate will buy in."

I don't particularly see how republicans could argue against that type of public plan. I think that would be wildly popular politically.

Posted by: spotatl | August 18, 2009 2:20 PM | Report abuse

Why not try buying into Medicare as the public option? Medicare would get premiums, which would help its financial condition. There would have to be Obama's eightfold consumer protections, so that it would not just get the sickest people, but also some healthy younger people who hate insurance cos. The administration is all there, and would just have to be scaled up a little. The public option supposedly needed to have higher reimbursement rates, but maybe this could be dealt with. It would also make it harder to demonize it. I suppose it would inflame seniors, who would see it as leading to watering down their care or more restrictions, but really it would increase the base support for Medicare. I think Weiner is really on to something.

Posted by: Mimikatz | August 18, 2009 2:20 PM | Report abuse

"Pseudonymousinnc what do you do if you get sick?"

I deal with it. (The euphemistic term these days is apparently "self-insure.")

And if healthcare reform turns out to be a polished turd built upon extortion for the benefit of private health insurers, then there are plenty of other countries where I'd be welcome.

Posted by: pseudonymousinnc | August 18, 2009 2:21 PM | Report abuse

OK Ezra,but what if we get the universal mandate and the consumer protections,and a president who appoints regulators the way that Bush did at the EPA? Changing the public plan is going to be harder politically than hiring deliberately toothless regulators.

Posted by: julie18 | August 18, 2009 2:38 PM | Report abuse

tbass1, that "bit of honesty" only pertains to *some* on the left. Personally, I could care less if it leads to single payer or not; I just want some competition if I will soon be forced to buy insurance. That sounds awfully conservative to me. And, it's politically smart if Obama is once again portrayed as giving away taxpayer money to big business.

I mean, the campaign ads write themselves: "Mandating that people buy private health insurance is forced wage capture by the greedyist, immoral people on the planet. Vote out Democrats and Big Business" Yes, that’s unfair but it’s what the Dems seem to want on their TV screens come 2010.

I'm tired of the message discipline trying to make everyone feel okay about the direction health care reform is taking. The constant defensiveness does nothing to *push back* against insurers. Is Dean 100% right about this? No. Is his impulse on this politically (and arguably, policy-wise) a good thing? YES.

We keep moving back, Obama/the blogs/Max Baucus say it's all okay, then we move back some more in response to "new political realities." The problem is that you guys are all part of this process! Absent an aggressive White House and an opposition party with an actual plan, I'm beginning to think this:

http://www.google.com/#hl=en&q="common+purpose+project"

is doing more to kill health care reform than anything else. It's like everyone has a stake in moving the goal posts back for sake of "getting something done." Unified support of the White House's defensiveness/ambivalence over Baucus makes the politics of this totally awful.

When Obama gives confusing signals or say nothing about this, and then Baucus holds up talks (with Obama’s approval), Obama only becomes more unpopular because he's seen as weak. It makes activists upset, and certainly doesn’t appease the opposing party. I understand it's difficult to support something that will likely fail. But, how unpopular will he get in the mean time? Every blogger in the world repeating the same exact message as the President does nothing to address the fact the fact the White House refuses to "take the fight" to the Senate.

In an alternate world, Obama would be seen as pushing back against special interests by pushing for a public option. He'd likely fail, but fail with a good bill. He'd still have some credibility as being against dumping tax dollars into big business, and it'd save face for 2010/12. In the process, the bloggers' "common purpose" wouldn’t be to make Dems feel "a little less depressed."

Posted by: Chris_ | August 18, 2009 2:43 PM | Report abuse

"Pseudonymousinnc what do you do if you get sick?"

I deal with it. (The euphemistic term these days is apparently "self-insure.")

And if healthcare reform turns out to be a polished turd built upon extortion for the benefit of private health insurers, then there are plenty of other countries where I'd be welcome.

Posted by: pseudonymousinnc | August 18, 2009 2:21 PM | Report abuse


how's the old saying go, don't let the door hit you in the "a_s" on the way out?

While you're at it don't come back when you get real sick to go to the Mayo clinic, Sloan Kettering or any of these US based medical practices. They're the devil remember.

Oh and if you choose to stay I hope you've got a million or so stashed up to pay your healthcare expenses.


I love these Senators like Kennedy, Dodd that bash the US system but make sure when they get terminal cancer they go right to the best places in the world. Right here in the good ole USA.

Posted by: visionbrkr | August 18, 2009 2:55 PM | Report abuse

Oh, visionbrkr, you pathetic little healthcare parasite, it doesn't take much for you to show your true colors, does it?

I only hope that you'll eventually have to find gainful employment as a burger-flipper. One thing's for sure: you'll never see a red cent from me.

Posted by: pseudonymousinnc | August 18, 2009 3:20 PM | Report abuse

Ezra, I don't recall Obama proposing a public option throughout the campaign. The central piece of his reform was the national exchange and subsidies for those who couldn't afford coverage--no public option. And I don't think Clinton did either--a public option would've been a huge issue.

A better way to achieve a single payer would be to use one of the for-profit or non-profit insurance behemoths as a stalking horse: weaken anti-competitive trade provisions in order to encourage further consolidation in the industry; once a company gets big enough it'd have enough pricing power to finish off most of its competitors (in a "free market" way). You then regulate the monopolist much like an electric company (ie set its profits, mandate its actions, etc.)

Posted by: ernanijdearaujo | August 18, 2009 3:21 PM | Report abuse

I think Ezra mischaracterized Dr. Dean's comments. Listen to the video. Dean said more than once that without a public option, then the sole focus of the bill should be insurance reform and 60 billion dollars should be stripped from the bill. He's advocating real incrementalism, not some patchwork with a mandate to fork over money to private insurance companies. Looking at the comments above, it seems lotsa people here agree with the sentiment not to reward private insurers with the mandate for everyone to purchase private insurance. Yes, this is at the expense of expanding accesss through Medicaid and providing other subsidies to the poor. But, another incremental bill could address that; how priceless would it be to see Republican Senators rail against a bill that just expanded access.

Posted by: goadri | August 18, 2009 3:32 PM | Report abuse

"I don't recall Obama proposing a public option throughout the campaign."

Obama also argued strenuously against an individual mandate during the primaries.

Posted by: tomtildrum | August 18, 2009 3:33 PM | Report abuse

Oh, visionbrkr, you pathetic little healthcare parasite, it doesn't take much for you to show your true colors, does it?

I only hope that you'll eventually have to find gainful employment as a burger-flipper. One thing's for sure: you'll never see a red cent from me.

Posted by: pseudonymousinnc | August 18, 2009 3:20 PM | Report abuse

pseudonumousinnc,

i really didn't mean any disrespect. Even though we disagree I'd hope we could still be civil. If i end up at BK that's fine by me. Just remember what the public option and single payer would do is put another 1-1.5 million out of a job. Is that what we want to do in THIS economy or would we rather FIX the system that as we all see 75% of people like??

I'm guessing i can count you in the 25%? And i partially take back what I said. Who am I to say you can't go to the best hospitals in the world.

Posted by: visionbrkr | August 18, 2009 3:55 PM | Report abuse

This is a pretty reductive position for Ezra to be taking. Either you support the current, divorced-from-policy-reality patchwork OR you are a single-payer zealot?

I think the focus on the public plan is simply that it is the one part of this bill that seems susceptible to growth. It's the one part that you could actually tweak over time to improve, rather than waiting for another Grand Political Moment in twenty years. There's a pretty clear limit on how far you can push Medicaid or Medicare expansions; and subsidies will always be games of whack-a-mole (especially if linked to an individual mandate).

For what it's worth, I think the right co-op could also fit this criterion. That is, leftie Dems might actually be willing to accept them, so long as it looks like they incorporate values held by people actually interested in reforming healthcare. A co-op plan that includes those values, even a mild one, would provide a longer-term platform for growth. But a plan written by Baucus and Grassley while sidelining Rockefeller, Kerry, etc... is not going to be trusted.

Posted by: NS12345 | August 18, 2009 4:24 PM | Report abuse

psuedonumousinnc....a couple of years ago I had my gallbladder out. Pretty routine all in all. Nothing special given my age. Problem was it was septic. Cost without insurance $32,000.....so, not having insurance, not giving the bloodsuckers any money is a luxury few of us can afford.

Don't get me wrong, I am not an apologist for the industry. But we need to find a way to get healthcare for all.

Posted by: scott1959 | August 18, 2009 4:54 PM | Report abuse

visionbrkr.....not sure where you get the jobs figure you cite, but no matter. I would gladly have that short term disruption in exchange for doing what is right, regardless of what today's economy looked like (and yes, I backed universal single payer health care even when I was a health care consultant)

Posted by: scott1959 | August 18, 2009 4:57 PM | Report abuse

"how priceless would it be to see Republican Senators rail against a bill that just expanded access."

I don't think that republicans are at all worried about opposing that bill. If all that was happening was medicaid was being expanded then the republicans would just be talking about fiscal irresponsibility.

This is the core of the democrats problem- they think the US has a horrible healthcare system and something must be done. But 75% of people are happy with their current situation. But the democrats also are petrified of passing things that will actually keep costs down because they are afraid of the backlash from voters.

Until democrats can convince the general population that they are getting something out of this bill then I do not think that Republicans will pay a price for opposing it.

Posted by: spotatl | August 18, 2009 5:10 PM | Report abuse

visionbrkr has a point - also never discussed - which is that changes in the system will lead to/could lead to some/all people in the health insurance industry losing their jobs. Now, frankly, I have no problem with that.

Those folks should be offered the same kinds of help other people are offered when they lose their jobs: unemployment benefits, etc.

On a larger scale, though, I think as a nation it would behoove us to develop a better, more comprehensive and deliberate set of programs/policies to deal with the inevitable end of industries which occurs periodically. Millions have lost their manufacturing jobs over the last 30 years. We've dealt with them in a variety of ways - some better, some weaker. And we should at least have a discussion about the following: are we obliged to continue to support an industry that provides no actual useful service, but DOES provide a large number of jobs?

I say NO, but a lot of people's first instinct is to feel that the price would be too high and instead we just have to keep the industry alive.

But! there are conceivably several ways to move these folks into other walks of life. It's about time we figured out a way to deal effectively with dislocations because there will always be more coming. Instead of a policy of denial, why can't we be proactive?

Posted by: Melinochis | August 18, 2009 5:15 PM | Report abuse

visionbrkr: agreed, chill pills all round.

The reason I'll leave is twofold: I'm lucky enough to have the option, and I have no fear of what Scary Foreign Healthcare means in practice. Most people in the US aren't in my position. I'm well aware of that.

The problem with your 75% number is that, as Simon Johnson has noted, most people don't come close to testing the limits of their coverage. Those who do, as Taunter's number-crunching makes clear, suffer rescission at a very high rate:

http://tauntermedia.com/2009/07/28/unconscionable-math/

If something fails you when you need it most, then it's not insurance, it's just a somewhat arbitrary staggered payment plan.

That's something of an aside. I have seen private insurance as constituted in the US from both sides. I have no faith in its capacity to be reformed to the point where it ceases to do systematic harm.

While I reserve my real anger for the architects of the system, but it's hard to feel sympathetic for the clipboard-brandishing billing clerks and insurance company phone-drones, other than to wish they were doing useful jobs.

Posted by: pseudonymousinnc | August 18, 2009 5:20 PM | Report abuse

(Oh, and having the 'best hospitals in the world' doesn't count for much when you have people lining up at 4am in Inglewood. Unless you're happy with mansions in the slums.)

Posted by: pseudonymousinnc | August 18, 2009 7:39 PM | Report abuse

pseudonumousinnc,

i never said the system was without flaws. I know we need to get everyone covered but those that want to benefit from the system (universality) but don't want to pay into the system (individual mandate) i have no sympathy for.

I agree the issue in Inglewood shows that it needs to be fixed and its a shame it came to that to prove that point.

I'm just against making radical changes to the system that jeopardizes for those without coverage. I'd rather pay a little more or adjust costs a little more to ensure everyone was covered via subsidies etc.

as far as the jobs figures its obviously a random estimate. The figures i've seen show that there are 2.5 million jobs in the healthcare market. maybe the estimate is off but who knows how much its changed either high or lower from what i estimate.

Posted by: visionbrkr | August 18, 2009 9:09 PM | Report abuse

Dean is just saying that if Democrats are going to be held responsible for this plan, it better be a good one that has the possibility of evolving into a better one. I agree 100% with that sentiment.

And if you go back to 2004 what Dean said was, "We'll establish an affordable health insurance plan people can buy into." To me that means a public plan. Especially since some ambiguities are inevitable in the heat of the campaign.

@scott1959: "no pre-ex, no underwriting, no recission, community rating, an individual mandate" - the above are an industry wish list

"exchange based purchasing, expanded Medicaid, subsidies" - the key question here is "how much?" and if we get down into that level of detail the public tunes out and the lobbyists win.

The public option (or national co-op) is where we must draw the line.

Posted by: bmull | August 18, 2009 10:02 PM | Report abuse

Here is a study I think we all should be aware of. It reveals Medicare for All (Single Payer) Reform Would Be Major Stimulus for Economy with 2.6 Million New Jobs, $317 Billion in Business Revenue, $100 Billion in Wages.

Unlike visionbrk, I will give a URL where you can find it.

http://www.calnurses.org/media-center/press-releases/2009/january/first-of-its-kind-study-medicare-for-all-single-payer-reform-would-be-major-stimulus-for-economy-with-2-6-million-new-jobs-317-billion-in-business-revenue-100-billion-in-wages.html

Posted by: lensch | August 18, 2009 11:01 PM | Report abuse

This is what Dean had to say in 2000/2004:

"As a physician, I do not like the idea that Congress or the President think they should practice medicine. "

"I don't see how a government regulation that tells doctors how to practice medicine can be supported. "

"I just don't think the government ought to be making personal medical decisions for Americans. "

"A woman and a family have a right to make up their own minds about their health care without government interference. "

"I believe that the government should stay out of the personal lives of families and women. They should stay out of our lives. That's what I believe. "

Of course he was talking about abortions, but if he feels this strongly that the government should stay out of health care, why the sudden change?

Posted by: TomFromMclean | August 19, 2009 1:48 PM | Report abuse

TomfromMclean--All of those quotes have to do with the government interfering in peoples' personal medical decisions, not offering them insurance.

Posted by: julie18 | August 19, 2009 2:23 PM | Report abuse

Why spend precious media time cross-examining Dean? Aren't you on the same side ultimately? Don't we need to really the troops, not attack each other?

Posted by: BoardAgent | August 19, 2009 4:08 PM | Report abuse

I meant rally the trooops, sorry.

Posted by: BoardAgent | August 19, 2009 4:09 PM | Report abuse

Guess it has been a looooong day.

Posted by: BoardAgent | August 19, 2009 4:10 PM | Report abuse

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