Howard Dean’s Medicare problem

As regular readers know, I’ve been troubled by Howard Dean’s flip-flops and ongoing problems with policy inconsistencies. To his credit, Dean has shrugged off most of these problems and his followers have been generously forgiving. In fact, Dean has tried to work his policy flips into an advantage by saying it demonstrates a useful flexibility on his part.

“I have changed on some of the issues,” Dean said in a recent interview. “That’s one of the hallmarks of who I am: I am a doctor; I believe that if you have a theory and a fact comes along that changes the theory, then you throw out the theory.”

That’s not a bad line; it might even work most of the time. It seems to me, however, that Dean has one significant lingering problem: Medicare.

When faced with an unpopular sentiment in their legislative or rhetorical record, a political candidate has one of three options. One, they can flip-flop and explain why they’ve changed their mind. Two, they can say they still believe their original position is correct, do their best to be persuasive about it, and hope there’s minimal damage. Or three, they can try and dodge the issue and hope no one notices. (In a presidential campaign with eight rivals, #3 is a little tough to pull off.)

Fortunately for the sake of this discussion, Dean’s campaign has offered us examples of all three tactics in recent months. An example of the first point, for instance, would be his flip-flop on Cuba. Here, Dean said he used to support easing the U.S. embargo, and then six months later, he drew the opposite conclusion. He offered an explanation — Castro’s worsening human right violations — to justify the flip. On point two, Dean continues to stand with the NRA on gun control, but explains that this position will make him more electable.

But when it comes to trying to dodge a controversy, Dean doesn’t appear to know what to do about Medicare.

About a month ago, Dick Gephardt began publicizing Dean’s previous criticisms of Medicare. In 1995, shortly after the so-called GOP “revolution,” Gingrich and the new-found Republican majorities in Congress pushed for shifting Medicare patients to managed care and cutting over $280 billion from the federal program. Dean, at the time Vermont’s governor, endorsed the Republicans’ Medicare proposal. Complicating matters, he called the program “one of the worst things that ever happened,” and a “bureaucratic disaster.”

When confronted with Gephardt’s revelation, the Dean campaign responded by saying it was wrong for Gephardt to compare Dean to Newt Gingrich. That was fine, but it didn’t respond to the substance of the charge. A few days later, the Dean campaign told the Washington Post that Dean “couldn’t remember” which side of the Medicare fight he was on. Two weeks later, at a DNC debate, Dean responded with, “I’ve done more for health insurance, Dick Gephardt, frankly, than you ever have.”

You’ll notice that none of these actually respond to the criticism, they only attack the person who offered the criticism.

I was in DC in 1995 and I remember how Democrats in Congress and the Clinton White House were doing everything possible to oppose Gingrich & Company’s drive to gut Medicare spending. At the time, Dean was chairman of the National Governors Association and he chose to stand with the Republicans. Now, eight years later, Dean seems desperate not to talk about it.

It’s not unreasonable to ask Dean to state his position clearly. He’s either changed his mind about what he believed when he endorsed the GOP proposal or he still believes he was right about the change. Which is it?

The various responses Dean’s offered either aren’t working, aren’t persuasive, or aren’t true.

At the DNC debate, when Gephardt said Dean stood with Republicans in ’95, Dean said this was “flat out false.” Dean wasn’t telling the truth. As the Boston Globe’s Thomas Oliphant wrote, “Actually, [Gephardt’s criticisms] were flat-out true.”

Then Dean tried a different take, saying his position in 1995 was the same as Bill Clinton’s. Standing with Clinton in the primaries may be a good idea, but this claim isn’t true either. Dean endorsed the GOP Medicare cuts in 1995, which Clinton strongly opposed. Clinton eventually did sign some spending reductions in Medicare in 1997, but the cuts were far less harsh than those that Gingrich (and Dean) endorsed two years prior. Dean is trying to mislead people about where he stood, hoping we won’t know the difference. Not exactly the “Democratic Party wing of the Democratic Party.”

In fact, consider the Dean interview on Face the Nation two weeks ago. When CBS’s Bob Schieffer asked why he supported the GOP’s cuts in 1995, Dean said, “I am not going to be compared to Newt Gingrich by my rivals.” When Schieffer noted that he shared the same position on Medicare in 1995 as Gingrich, Dean said, “Look, I want change in this country” and added that his congressional rivals “have been in Washington too long.” When Schieffer asked again whether or not he agreed with the Republicans’ Medicare cuts, Dean said, “I’m just simply not going to take any guff from Washington Democrats who are part of the problem, not part of the solution.”

Watching this was painful. Dean didn’t want to admit the facts, but couldn’t honestly deny them either. What happened to the straight-talking candidate people like so much?

Dean has an annoying habit of accusing any Democrat who disagrees with him of being “Bush-lite.” Kerry voted for the Iraq war resolution? He must be Bush-lite. Clark voted for Nixon in 1972? It’s because he’s Bush-lite.

Well, Dean stood with Republicans on Medicare when Democrats were otherwise united against them. Doesn’t that make him Bush-lite?