Former Vermont Governor Howard Dean made waves when he spoke at an AFL-CIO conference in Iowa last month. Gov. Dean also has another speech scheduled for September 23 at the Saint Anselm College New Hampshire Institute of Politics.
The speaking engagements have many speculating as to whether Dean might be considering another run for President of the United States.
Dean says that’s unlikely, but did have several comments about the Affordable Care Act and the Health Care Exchange right here in Vermont. He says the system that will be put into place has problems:
“I don’t believe that rate-based regulation or even individual budget-based regulation is going to work. I think we have to get rid of fee-for-service medicine,” said Dean.
Dean penned an Op-Ed in the Wall Street Journal in July, and was critical of the Independent Payment Advisory Board. VPR’s Hamilton Davis responded to some of Dean’s thoughts in a conversation with Mitch Wertlieb on August. 7th.
Dean says that Vermont is doing a better job than most states, but there are still problems with a system where the more procedures physicians perform, the more they get paid. He took to Twitter to continue the debate:
@CitizenCohn I want to end fee for service medicine because it creates global budgets, encourages investment in wellness, not illness
— Howard Dean (@GovHowardDean) July 30, 2013
Dean explained that he feels the incentive should be on long-term wellness rather than treating patients after they are already very sick.
“What we should be incentivized to do is keep people out of hospitals, out of MRI machines, out of ICUs. If you got rid of fee-for-service and pay people by the patient, then the whole emphasis would be to keep people healthy. And finally, we’d have a wellness system. But we don’t get paid to keep people well in this system that we have. We get paid when they get really sick,” said Dean.
As for future political aspirations, Dean says a Presidential run is unlikely, but didn’t rule out the possibility.
“I’m intending to support Hillary, assuming she runs. So the answer is it’s unlikely. I often not-so-jokingly say it’s easy to get in the first time because you don’t know what you’re getting into. But the second time you should see a psychiatrist, hopefully not on a fee-for-service basis,” said Dean.