A few months ago one of the founders of Physicians for a National Health Program (PNHP), the main group of doctors advocating Medicare for All in the United States, called Howard Dean a liar for saying that for the average American should think of the public option as a Medicare opt-in.
"He’s a liar," Himmelstein says.
"He knows that the public option plan is not single payer and he says it is to try and confuse people," Himmelstein said. "He goes on Democracy Now and other shows and says that people can buy into Medicare when he knows that what is in the plan is not that."
"Medicare doesn’t have to compete," Himmelstein said. "That’s why it’s so efficient."
Himmelstein says that the Obama plan would mandate that people buy insurance from competing private plans – and one denuded public plan.
The private health insurance companies would cherry pick the young healthy patients, while the sick older patients would opt into the public plan – making the public plan unsustainable.
The article was from Single Payer Action. It did not include a whole lot of detail and seemed somewhat hastily written, so I went to the transcript on Democracy Now for more.
Here's the section in question.
AMY GOODMAN: Explain what is the public option, as it’s been presented.
HOWARD DEAN: For the average American, they should best think of it as Medicare. Now, there’s an upcry. You know, the administration doesn’t want us to talk—but just, we’ve had a single payer in this country for forty years; it’s called Medicare. The Republicans didn’t like it then. We’ve had what the Republicans call "socialized medicine" in this country for forty years; it’s called Medicare. Everybody over sixty-five has it.
The only other group besides the disabled people and those over sixty-five that have socialized medicine is Congress. All these people who are yelling and screaming about socialized medicine have it themselves. They go downstairs, and they see the doctor, they don’t get a bill, there’s no line, and it works great for them. So—and veterans. So, the truth is, this is all nonsense, all this posturing and this spinning and all so forth.
This is an attempt to bring order to the healthcare system. We have no order. This is a chaotic, quote-unquote, "system." The reason for the public option is it—like Medicare, it’s certainly not perfect, but the cost has gone up much less rapidly than the private sector costs, and their administrative costs are four percent, and administrative costs in the private sector are 20 percent, sometimes more, depending on the return on equity these public healthcare insurance companies get. And so, Medicare is just a lot more efficient than the private sector healthcare is.
It appears that Howard Dean is indeed implying that the public option would be a single payer system. That is no distortion.
By the way, the next response shows that Howard Dean is actually opposed to a universal single payer system (as opposed to one just for the elderly, like Medicare) of the kind that exists in Canada and Australia. That seems to be a point of widespread confusion here on Daily Kos, so I will post it here for emphasis.
HOWARD DEAN: Well, it’s hard to define—here’s the—you get into a very sort of a delicate game about single payer. I think what single-payer advocates mean is that everybody should be in a government-run system. But if you’re going to argue, as the book does, that we shouldn’t have politicians and bureaucrats and insurance companies making this decision, this decision belongs in the hands of the American public, which is why this movement for—to change the healthcare system is so much more powerful this time around than it was fifty years ago, if you’re going to make that argument, then it’s pretty hard to turn around and say, "Well, on the other hand, the government can make a choice and put you all in their system."
The other problem is, nobody really knows what a single payer is. Single payer, I said, is Medicare. But there are a lot of private insurance and private dollars in Medicare. The British, which have arguably the most, quote-unquote, "pure" single payer or socialized system in the Western world, 15 percent of all the dollars in healthcare in Britain are private dollars. So there is no such thing as a pure single-payer system.
And what the President is arguing, what I argue, is give people a choice. Let them choose whether they want a government system, or they would like what they have, they can keep it.
This is quite interesting because perhaps 47-59% of the public supports Medicare for All in polls, so Dean is not in the more left wing half of the US public on health care.
Dean has also come under criticism lately for lobbying for the Biotechnology Industry Organization.