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Howard Dean: GOP's 'Replace' Won't Work Because Reality

Howard Dean and Stephen Brill knock down Republican "innovation" on healthcare. It's all old ideas that don't work.
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Howard Dean and Steven Brill (author of America's Bitter Pill) sat down with Lawrence O'Donnell last night to talk about Trump's promise of "Healthcare for Everybody!"

Which is a joke. Just like the Republican "ideas" on replacing Obamacare. They get to that, too. Note their contempt for Kellyanne Conway throughout.

PS. I expect Lawrence O'Donnell and other MSNBC prime timers are contractually obligated to mention Greta Van Sustern's show at least once an hour. Whatever.

-- transcript --

CLIP, SEN. COREY BOOKER (at ACA Rally): Healthcare is a right! ....There's no justice with no health care. We know if there is no justice, there is no peace! .

LAWRENCE O'DONNELL: Joining us Dr. Howard Dean, former governor of Vermont and MSNBC political analyst and Steven Brill, journalist and author of "America's Bitter Pill." First to Dr. Dean, we have a set of principles laid down by Donald Trump which might amount to either what he delivers or basically attack lines for Democrats to use on what he doesn't deliver. For example, now telling the "Washington Post," health insurance, health care for everybody. That's, of course, the slang for universal coverage, as they say. That's the standard he's laid down now. If he doesn't deliver that, then he is not delivering on his promise.

HOWARD DEAN: Yeah. We say things about Trump that are unattractive, he does have political instincts and he does know where people are headed. He said something that was smart politically but I suspect he has no -- first of all, I suspect he didn't consult with anyone in the administration and I suspect he has no idea how he will deliver this and it will be quite a spectacle to see what happens as this goes down the line.

O'DONNELL: Kellyanne Conway was on Greta Van Sustern's show earlier tonight and laid down some of her items she believes will be in the Trump plan. Buy health insurance over state lines. What does that do?

STEVEN BRILL: Have you ever heard of a company called Aetna, United Health Care?
They sell insurance in more than one state.

O'DONNELL: Yes, Kind of everywhere. I looked.

BRILL: What they are suggesting is if you live in New Jersey you can buy insurance in South Dakota because South Dakota has the loosest regulations and therefore will charge a price that reflects the fact it is not real insurance. So they are fleeced.

O'DONNELL: There are dozens of states all over the country that would be willing to allow health insurance policies to be sold but that the state of California would never allow because they would say it is sub-standard.

BRILL: It's ridiculous. Besides the issue with health care, as Dr. Dean knows, is not the insurance companies because they pay for health care, the issue is the price of health care that we pay as patients and that insurance companies pay. The other thing I think they're gonna do and I think we need to educate everyone in the country though, beware of three words "high-risk pools." That's what they are going to sell. They are going to provide "insurance for everybody" by putting people who are sick and with pre-existing conditions into high-risk pools. That's exactly what was done before Obamacare. There were waiting lists. There were caps on coverage, $50,000 a year, $100,000 lifetime, depending on the state. Everybody had to pay premiums of 150, 200% more than everybody else. If you take all the sick people and put them into one pool and the healthy people in another pool, the healthy people get lower premiums because they are in a pool with just healthy people but sick people suffer and that's the opposite purpose of insurance which is to spread the risk. That's the scam of high-risk pools. It never worked.

O'DONNELL: Dr. Dean, I'm going to ask you a governor's question now. Kellyanne Conway mentioned block granting Medicaid to the states. What's your reaction to that?

DEAN: It depends how it's done. The trouble is when Republicans talk about doing it, they are usually talking about eliminating care for poor people. When Democrats talk about this, they are doing it as a budgetary model. It's not a crazy idea but it can be a crazy idea and it was a crazy idea when Reagan tried to do it. I'd say it is a mixed bag. Let me say, Steve is 100% right. If we buy insurance across state lines it will be a race to the bottom. Texas has 22% of its children with no health insurance. We've had universal health insurance for kids for 20 years in Vermont. I don't want anyone in Vermont buying the crap they sell in Texas for health plans. It is a terrible idea put together by people that love free markets but don't know anything about health care.

O'DONNELL: Other items on the Kellyanne Conway list (which doesn't mean it is on the Trump list!) but... "create health savings accounts"

BRILL: That's nice!

DEAN: Those are fine for small items but don't work when you are trying to decide whether to have a $250,000 heart operation!

BRILL: You know, they talked today about health savings accounts, you know, four or five thousand dollars or having a tax credit of $5,000 per person. Health care in this country costs an average of $10,000 plus per capita. If you have a family of four, if you are going to buy insurance, do anything, someone, somewhere has to come up with $40,000. Having a health savings account for $5,000 or a tax credit for 5,000, $6,000 per person sounds nice. You could then have a press conference and say we are providing insurance for everyone but you are actually providing insurance for no one other than those in the upper middle class and above who can afford it.

O'DONNELL: We will have to leave it there.

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