Howard Dean is annoyed. He wants his own arguments to be evaluated on their merits, regardless of where he works these days. “I do work part-time for a law firm. And a law firm has clients,” he told TIME on Monday, after publishing a Wall Street Journal op-ed criticizing a key part of ObamaCare. “I dare say some of the clients think [the op-ed] is great, but I don’t write stuff because the clients like it. I write stuff because I believe it.”
Dean’s critics are not so sure. The Journal piece praised Obamacare but condemned a controversial cost-control board created by the law, the Independent Payment Advisory Board (IPAB). Supporters of the law, mostly on the left, charged that Dean, far from an independent observer of health care policy, is a shill for various elements of the health care lobby.
Jonathan Cohn, a health care writer for The New Republic, accused Dean of writing his op-ed on behalf of Big Pharma. Writes Cohn:
Since his career in politics ended, Dean has found a home in the K Street establishment he once held in such disdain. He’s a strategic adviser to McKenna, Long, and Aldridge, a major Washington lobbying firm whose clients have included health care and pharmaceutical companies. Dean has never registered as a lobbyist, as far as I know, but the distinction is largely illusory. In 2009, one CEO told the publication BioCentury that Dean was “very helpful” in their efforts to loosen federal regulations on drug development.” Another said that “Dean has been a great addition to our team.”
It looks like he still is.
Jonathan Chait, of New York magazine, was no kinder to Dean. Writing under the headline, “Howard Dean, Concerned American and Non-Shill,” Chait wrote:
Dean’s op-ed notes his affiliation in the tagline, but it doesn’t say what his clients think about IPAB. For that matter, Dean has refused to disclose which firms he’s representing on behalf of McKenna Long & Aldridge. It seems to be regular practice at the Journal editorial page to let retired Democrats lobbying for the health-care industry write op-eds calling for a repeal of parts of the law that reduce the industry’s profit margin.
Indeed, Dean’s work for McKenna, Long and Aldridge (MLA) has cast a long shadow over his public health care views—especially when they seem to run counter to his previous public stances. Dean was a huge supporter of health care reform’s ill-fated “public option,” a government-run insurance plan that would have competed with private insurers and which was beloved by liberals. IPAB, which Dean wrote in his Journal op-ed should be eliminated, is another Obamacare provision favored by liberals. The board would be charged with keeping Medicare spending growth within certain parameters, tied to inflation. If Medicare spending grows too fast, IPAB will be empowered to reduce Medicare reimbursements to physicians.
Dean says IPAB is a “rate-setting” board that would ration care by reducing Medicare physician reimbursements so drastically certain medical services would no longer be available. “If you had to go see a physician and make some complicated decisions about a serious illness, would you want a board in Washington making the decisions about what you could have and couldn’t or would you rather have your physician making those decisions?” asks Dean.
One of the most powerful interest groups vehemently opposed to IPAB is the American Medical Association. Asked if he wrote his Journal op-ed on behalf of the AMA or MLA clients, Dean said, “To the best of my knowledge the AMA is not a client of our firm. “ (MLA did not return a request for comment about its client list.) Deans says he is paid a flat annual fee by MLA for “giving political advice to whoever wants it.”
And does MLA have clients who dislike IPAB? “I’m sure we do,” says Dean. “What annoys me is that everything you say comes down to who’s paying you to say it. You can talk like that if you want to but I don’t think it helps the general discussion. We ought to argue on the merits.”