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Candidates’ Rx: Howard Dean

May 22, 2003 at 12:00 AM EDT
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JIM LEHRER: Finally tonight, the second of our conversations with the Democratic presidential candidates on health care, and to Ray Suarez.

RAY SUAREZ: Former governor Howard Dean of Vermont unveiled his health care plan earlier this month. He proposes providing near universal health care coverage by extending federal assistance to those without insurance. Under Dean’s plan, the existing state-administered children’s health insurance program would be extended to every child and young adult under 25. Employees not covered by that program or Medicaid or Medicare could buy into a universal health benefits program which would offer a choice of private insurance plans like federal workers currently get. They would receive tax credits to keep it affordable. Small businesses would get federal subsidies to provide insurance. The dean campaign puts the price tag for all these programs at $88 billion in the first year. Governor Dean is with us now. Welcome to the program.

HOWARD DEAN: Thanks for having me on.

RAY SUAREZ: It’s said that any given time, 40 plus million Americans are without health insurance. How would your plan address their needs immediately?

HOWARD DEAN: Well, our plan essentially covers everybody, and it’s modeled after what we did in Vermont where 99 percent of our kids under 18 are eligible for health insurance. It’s simply builds on the programs in place, covers every child under 25, covers every working person whose family makes $33,000 a year in a family of four, and then lets everybody else buy into a private plan, the same plan that your congressman has, for seven and a half percent of their adjusted gross income. It covers everybody. Everybody is automatically signed up; they can opt out if they want to. So we think this is about as close to university health care as the United States is going to get.

RAY SUAREZ: So, see if I understand this. The biggest chunk of the advances in insuring those 40 plus million come from broadening the eligibility for already existing programs?

HOWARD DEAN: They all come from that. There is nothing new, no reform in this package, and I did that on purpose. When the Democrats have tried to reform the system in the past, they argue among themselves about how to reform the system and then the Republicans and special interests come in and kill the bill. And the victims are the 42 million people with no held insurance that go for another ten years until we wait for another Democratic president. This is built on our experience in Vermont, where we have near universal health insurance for everybody under 18, and university health insurance for those under 150 percent of poverty. I know it will work, and I know it will work because it doesn’t antagonize all the people who have killed this program in the past.

RAY SUAREZ: One group that maybe isn’t antagonized quite yet but has a voice misgivings are organized business lobbies who say that your requirement that business provide health care for workers is a government mandate that simply won’t fly.

HOWARD DEAN: Well, there is no requirement that business provide health care for workers. There are two things that affect the business community, three things actually. The first is we do require that businesses pay the COBRA costs, the uninsured costs, for workers who have been laid off for two months, to allow uninsured people who are only uninsured between jobs, that would cover that problem, it’s a low cost item. We also give $9.2 billion to the small business community, even those who have insurance to help lower their costs. And for larger businesses that do give insurance, they no longer have to pay for all the cost shifts or for a great men their kids so, they save money and so do their employees.

So this is a plan that benefits everybody except for those people who lose their tax breaks. This plan is paid for by rolling back the majority of the Bush tax cuts for people who make more than 200,000 a year. On the other hand, those people made a lot of money during the Clinton years, at Clinton’s tax rates and the economy was much better off under Bill Clinton than it was under George Bush. So I really believe that’s a good way to finance the plan, is to return to Bill Clinton’s tax rates, begin to balance the budget, which I feel very strongly about, but also to join every other country that’s industrialized country in the world, the Canadians have it, the British, Germans, French, even the Costa Ricans have held insurance for all its citizens, and I don’t know why we shouldn’t have health insurance you can’t take away.

RAY SUAREZ: So your plan does not penalize businesses that don’t offer their employees health care?

HOWARD DEAN: Yes, it does. For those large businesses who could give health insurance but don’t, they lose some deductibility for executive pension plans and for executive salaries. And the reason for that is that there are a lot of good corporations outs there now who are giving health care — some part of their health care package to their employees and it seems to me that it’s unfair competition for those companies that don’t give health insurance to be able to have all that extra cost benefit over the — or excuse me, competitive advantage against those competitors that do supply health insurance. So we’re going to remove some of the tax deductions that those folks get. There’s no reason taxpayers should pay for executive salaries to be deducted, and benefit packages to be deducted from a company that’s a large company that doesn’t provide health insurance.

RAY SUAREZ: A lot of the people who are uninsured in the country are hard to find, they’re hard to reach in conventional social service agency ways. You hold Vermont forward as a model, but Vermont doesn’t have a lot of the problems that big metropolitan areas have, large immigrant pools, central cities with down economies. Can you use Vermont as a model for the rest of the country, and the rest of the uninsured population?

HOWARD DEAN: We think we can, because we’re using existing programs that exist in every state in the union, first of all. Second of all, we have an enormous amount of experience with reaching out to people and trying to get them enrolled. And the reason that we put the program together the way we did is that we automatically enroll anybody, everybody, we automatically enroll everybody in the program, they can say they don’t want to be enrolled, particularly for those who have to pay something out of their own pocket, they have a choice not to be insured, but they’re automatically enrolled and that’s the best way to deal with the problem of recruiting folks who are hard to find.

RAY SUAREZ: What would you say the biggest difference is between your plan and those offered, for instance, by Senator Kerry, which emphasizes cost containment a little more, by Congressman Gephardt that emphasizes using employee based programs more?

HOWARD DEAN: Well, I like Dick and Senator Kerry and I’m pleased they’ve joined me in offering a health care plan. The criticism I’d have of Dick’s plan is it won’t pass because it costs more than the Bush tax cuts, and there’s no real way to pay for that. And I don’t think we can get the votes to do it. Senator Kerry’s plan concerns me because although it’s based on a lot of the same things that we based ours on, the insurance rates stops at 100 percent of poverty.

So there are a lot of working families that don’t get covered without significant expense to themselves. We’re not talking about wealthy people or even middle class people. We’re talking about people who are barely above the poverty level, having to go out and get their own insurance, so I think our plan is a little bit more generous to the low income working people and moderate income working people; families that make $33,000 a year I think need that extra help, and that’s present in our plan but not Senator Kerry’s plan.

RAY SUAREZ: One feature they all have in common is that they infer that all or part of the Bush tax cuts are going to have to be rolled back. Is that now –

HOWARD DEAN: I don’t think that’s right. If you give American people, if you tell the American people let’s roll back the tax cut they’re going to say no. But if you treat the American voters as adults and say look you have a choice, you can keep the tax cuts you got or you can have health insurance that never will be taken away, you can keep the tax cuts you’ve got or you can fully fund special education so that your property taxes will go down instead of having your income taxes go down a little bit, your property taxes go way up. I think people are going to choose education and health care and roads. I think most people in this country didn’t get much of the Bush tax cut. I remember a guy from New Hampshire once said, well, Governor, I remember the president’s $600 check, but my 401-K went down $60,000, I think I was better off before the president’s tax cut.

RAY SUAREZ: Governor Dean, thanks for joining us.

HOWARD DEAN: Thank you very much for having me on.

JIM LEHRER: We’ll hear from more of the Democratic presidential candidates next week.