This past Saturday, February 4, former governor of Vermont and 2004 presidential candidate Dr.Howard Dean spoke at the Providence Public Library for the kickoff of ‘Shape Up RI’.

He was introduced by Brown graduate, Dr. Rajiv Kumar, founder of ‘Shape Up RI’. Dr.Kumar said, “I was a Deaniac, knocking on doors in New Hampshire for Governor Dean’s presidential campaign. Howard Dean had a commitment to health care for all Americans as a human right, and we are the only industrialized nation not providing that care.”

Howard Dean, author of ‘Howard Dean’s Prescription for Real Healthcare Reform: How We Can Achieve Affordable Medical Care for Every American and Make Our Jobs Safer’ was a passionate advocate for health care reform during his tenure as governor of Vermont, and left the state with near-universal health care coverage for pregnant women and children under 18, a model for the country. Vermont is also a model for affordable health insurance for adults.

Howard Dean started with thanks to the bipartisan effort to engage Rhode Islanders in taking charge of our health. He was realistic about the challenges, “it’s incredibly hard from a medical perspective to lose weight.’ but optimistic about our capacity to improve our health “we have an empowered generation on the internet.”

He was critical of the present state of health care, “we have an illness-based system, not a wellness-based system. If you want to focus on preventive care in the present economy, “you are swimming upstream against your wallet. Instead of fee-for-service we have to have a different way of doing this–an incentive to create wellness. Accountable Care Organizations (ACO) vertically integrate care. Financial incentives are beginning to align with wellness.”

Howard Dean took a heavy political hit for his plain-spoken advocacy for universal access to health care. He was at times critical of the ‘Affordable Care Act’ (known by its opponents as Obamacare) for not going far enough, particularly in failing to provide a public option as an alternative to private insurance companies. At Providence Public, he defended the Act as a move in the right direction toward universal health care. He noted that the Affordable Care Act is modeled on MassHealth, which covers 98% of Massachusetts citizens.

Dr.Dean spoke about end of life care and advance directives, and addressed the ‘death panel’ slur that clouded the debate. “Seniors fear loss of control of their dying process. Most will want to die at home.” He said that the seniors who want ‘everything done’ can have their wishes respected, that we have the means to provide that care for those who choose it. I have worked in geriatric care for about 30 years and the vast majority of patients I’ve talked to want to maintain the power to tell their doctors when to stop. The current system will ‘do everything’ unless there is a document or responsible person to say otherwise. That is the reason for an advance directive. “The answer is not rationing–it is to change the incentive to reward wellness. It is to return power to patients at really important parts of their lives.”

Dr.Dean continues to bring common sense and decency to a debate too often muddied by partisan politics.

If our wealth is our people, we cannot continue to waste health and lives by denying health care, especially preventive care, to those who need it the most.

About a hundred people came to hear Dr.Dean speak on Saturday, we’ll continue to hear his message, because this is the future of health care.