Howard Dean appears to be the favored candidate of the netroots to replace Tom Daschle as either HHS Secretary or White House health-care czar. Over at the Huffington Post, Cenk Uygur goes as far as to write, “At this point, if Howard Dean is not selected for at least one of these positions, it is a clear snub.” Based on what I’ve seen of President Obama thus far, I can’t imagine that he’d be so stupid as to pick Dean, because it would be an absolute gift to opponents of government-run health care. For one thing, Dean is an arrogant, brash and undisciplined figure who is more likely to alienate lawmakers than win them over. But beyond that, many of Dean’s health-care reforms in Vermont were similar to what Obama wants to do on the national level, and they demonstrably failed.
Dean passed regulations known as “community rating” and “guaranteed issue,” which force insurers to cover everybody who applies for insurance and charge everybody the same rate, regardless of age or other risk factors. Dean also expanded Medicaid eligibility (something that Obama’s proposed stimulus bill would do at least on a temporary basis). In the end, premiums skyrocketed, healthy people exited the market, and private insurers left the state in droves. I know what you might be thinking: the number of uninsured Vermonters shrank, right? Actually, that would be wrong. A 2004 review of the Dean record by the Heartland institute noted that the state’s uninsured rate went from 9.5 percent in 1992 to a 9.7 percent average in 1999-2001, according to U.S. Census Bureau data. More recent Census data showed the rate jumping to an 11 percent average in the 2005-2007 time period.
Meanwhile, below is a chart from an August 2004 PowerPoint presentation from the Vermont’s Joint Fiscal Office showing the relative growth of the state’s Medicaid spending (red line), total health spending (green line), personal income (blue line), and the gross state product (pink line). Notice how Medicaid spending growth accelerated at an alarming rate.
The bottom line is that by giving Dean a prominent role in his administration’s health-care push, President Obama would be providing conservatives with a big fat target, and opponents of the effort would be able to run ads demonstrating the disastrous real world implications of some of what Obama has proposed at the national level.