Dean, who is also the former chairman of the Democratic National Committee, was in Hamilton on Tuesday night to deliver the annual Harry T. Wilks Lecture Series address. His topic was “RX for Real Healthcare.”
Dean, a family physician before he began his political career, served six terms as the governor of Vermont, where he introduced a universal health care program.
“In our state any adult can buy health insurance and can only be turned down for two reasons,” he said. “That is if they’ve been a resident of the state for less than two years or because they don’t pay the premium.
“We’re not bankrupt,” he said. “We’re not out of business. This stuff works.”
He said that his biggest objection to the Affordable Care Act is that someone who is 55 years or older and loses their job would not be able to be hired again because no employer will want to pay their health care insurance premiums.
“I favored a much more government-oriented bill,” he said. “But they voted to keep insurance in the private sphere, so the idea that this is a government takeover of health care is just silly.”
But now that the bill is in place, he said the best thing to do is to just let it run its course and fix problems that crop up along the way.
“One of the advantages of this bill is that the private sector has a bigger capacity for innovation,” he said.
One of the flaws of the current system is that physicians get paid for “how much they do to you,” Dean said.
“If you pay me to do procedures, I’m going to do them,” he said. “It has nothing to do with if people need medical care or not.”
The Accountable Care Organizations set up by the law, however, will encourage doctors to keep people from getting sick, which will discourage unnecessary procedures and tests, Dean said.
“They’re going to figure out they can charge you a flat fee for your health care every year,” he said. “It gets the insurance company out of the middle and they will make more money by doing less stuff for you if you pay the health care providers and make them responsible for the work.
“The whole system flips around,” he said.
Dean said that he favors a system that was first proposed by John McCain to do away with employer-paid health care, which would be better for the economy.
“I think that’s exactly what is going to happen with Obamacare,” he said. “How many people are stuck in jobs because they can’t afford health care without it?”
Taking the burden off the employer, he said, would “liberate the small business community.”
Another big problem with the medical system is that doctor training costs so much that a physician begins a career with $250,000 or more in student loan debt, and therefore don’t go into primary care.
“I believe that most doctors don’t go into medicine to make a zillion dollars, but because they like people and they like science,” he said.
The future of health care, then, will rely more on nurses and nurse practitioners than doctors.
“My advice for anyone wanting to go into health care would be to go into nursing for a long, well-paying career,” he said.
The Harry T. Wilks Lecture Series began in 1998 with former New York Governor Mario Cuomo. Other speakers have included Stephen Jay Gould, Mark Shields, Jane Bryant Quinn, Pat Buchanan, Leonard Pitts Jr., Lee Hamilton and Eleanor Clift. Last year, ABC News correspondent John Quinones was the featured speaker.
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