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Dean's Record on Health Care Access
“As a physician, I've seen the suffering caused by this nation's health care crisis, and as Governor, I know it can be solved.”
Health Care – 96% of Vermont’s children have health care coverage thanks in part to Governor Dean’s Dr. Dynasaur program, and an additional 3% are eligible for coverage.
Access – Governor Dean expanded health care for children in low to middle income families. Children 18 or under, whose families are at or below 300% of the Federal Poverty Line, are eligible for insurance at virtually no cost.
Mental Health – Howard Dean was the first Governor in the nation to sign the Mental Health and Substance Abuse Parity Act. This bill guarantees coverage for mental illness and substance abuse at the same level as severe illness.
Women’s Health – During Governor Dean’s tenure, the breast and cervical cancer rate went from slightly above average to below the US average, thanks to Vermont’s comprehensive screening system. Vermont’s Medicaid program was also expanded to cover treatment for women diagnosed with breast and cervical cancer.
Teen Pregnancy – Under Governor Dean, teen pregnancy rates dropped 49%, to the lowest rate in the country.
“Healthy Families Visionary Leadership Award” – Presented by Prevent Child Abuse America.
Dean's Record on Children's Health Care
“Give children hope by investing in prevention.”
Success By Six – As a doctor, Governor Dean has placed a strong emphasis on early childhood prevention and health care, which is why 89% of pregnant Vermont women enter prenatal care in the first trimester of pregnancy. In Vermont, 91% of families with a birth received a community visit, and those parents who wanted assistance and support received it.
Dr. Dynasaur – Governor Dean has expanded children and pregnant women’s access to health care. Currently 58,903 children are covered under the program. Dr. Dynasaur covers children up to the age of 18 within families up to 300% of the Federal Poverty Line.
Child Abuse – During Governor Dean’s tenure, Vermont was the first state to institute a statewide protocol for abuse investigations. In return, Vermont saw a 45% decline in physical and sexual abuse of children. This included a 64% decline in physical abuse victims ages 0-3 and a 43% decline in physical abuse victims ages 0-6.
Child Sexual Abuse – 84% decline in sexual abuse victims ages 0-3 and 70% decline in sexual abuse victims ages 0-6.
Immunization – 81.1% of children are fully immunized by age 2 and 97% by the time they start kindergarten, which makes Vermont second in the nation in child immunizations.
Dean's Record on Serving the Elderly
“We can provide higher quality of life by avoiding institutional services whenever possible.”
Prescription Drugs – Governor Dean understands the importance of access to prescription drugs in preserving the health and avoiding unnecessary institutional care of our seniors and people with disabilities. While in office Governor Dean expanded pharmaceutical assistance to these Vermonters. Vermont has three pharmacy assistance programs with the level of benefits for each program indexed to household income. Seniors and people with disabilities can have incomes up to 225% of the federal poverty line and receive assistance with their prescriptions.
Nursing Homes– Governor Dean decreased the state’s reliance on nursing homes by mandating that funds be shifted from nursing homes to other services, such as home health care where people can live with independence and dignity. Over $30 million dollars has been shifted from paying for nursing homes to paying for in-home and community based services.
Home Health Care< – Between 1996 and 2000, there was a 161.3% increase in individuals receiving a home based waiver and services, while there was a decrease of 13.5% of individuals living in nursing homes. [br />
Dean's Record on Prescription Drug Costs
“As a physician, I've seen the suffering caused by this nation’s health care crisis, and as a Governor, I know it can be solved.”
Drug Patent Reform – Governor Dean was founder of Business for Affordable Medicine (BAM), a coalition of governors, business and organized labor with one objective - closing loopholes used by brand name drug manufacturers to prevent or delay lower-priced generic drugs from reaching the marketplace when patents expired. Governor Dean created and coordinated unanimous passage of NGA policy on the need to reform the Hatch-Waxman Act. Thanks to his leadership with other governors, the U.S. Senate and House have included provisions that would close some loopholes in the currently pending Medicare prescription drug bill.
Preferred Drug Lists and Supplemental Rebates – Under Governor Dean, Vermont has been a leader in lowering drug costs in the Medicaid program. Dean wants to expand these measures nationally:
Preferred Drug Lists (PDLs) to ensure that doctors and patients use less expensive medications where clinically possible. Vermont started with one class of drugs - Gastric acid reducers – which includes the highly-advertised drugs Prilosec and Nexium, and put a less expensive therapeutically equivalent alternative drug on the preferred list. The results have been remarkable: Vermont’s Medicaid expenditure on gastric acid reducers has been slashed by 43%.
Forcing Pharmacy Benefits Managers (PBMs) to have transparent contracts with the manufacturers to disclose any financial incentives they might receive from drug manufacturers. Vermont was one of the first states to implement such an agreement, and this is another step that Governor Dean wants to take nationally.
Finally, Vermont last summer expanded the PDL and began to negotiate supplemental rebates with drug companies, in addition to those the companies provide in accordance with federal Medicaid law.
The Pharmaceutical Research and Manufacturers of America, a trade group known as PhRMA filed suit against the U.S. Department of Health and Human Services, questioning HHS’ authority to grant states the ability to use PDL’s. Governor Dean organized 22 other Governors who sent a letter of support to Secretary Tommy Thompson on August 12, 2002. In addition, Governor Dean organized a press conference on this suit with other Governors at the National Governors Association summer meeting.
Disclosure of Gifts to Doctors – Last June, Governor Dean signed a bill into law which, among other things, made Vermont the first state in the nation to require pharmaceutical manufacturers to disclose the value, nature, and purpose of any gift, fee, subsidy, or other economic benefit provided to any physician, hospital, nursing home, pharmacist or health benefit plan administrator in Vermont.
Re-importation for personal use – Governor Dean has endorsed the strategy of United Health Alliance’s Medicine Assist program, enabling U.S. citizens to obtain prescription drugs from Canada via fax. Canadian drug prices are, on average, half those in the United States. Governor Dean has held numerous press conferences encouraging people to take advantage of the plan to make their prescription drug costs more affordable.
A Strong Record of Protecting Victims of Domestic Violence
"Domestic violence impacts every aspect of a victim's life and is a problem that requires a community response. – Howard Dean, MD"
Child Custody – Governor Dean signed a law that requires judges to consider evidence of abuse when determining parental rights in divorce cases.
Child Support – Governor Dean signed the Abuse Prevention and Child Support law which requires abusers to pay child support and living expenses to spouses who request court protection and have no other means of support.
Confidentiality – Governor Dean signed a law entitled the Address Confidentiality for Victims of Domestic Violence, Sexual Assault and Stalking, known as the “Safe at Home” program that offers victims of domestic violence, sexual assault and stalking a free and confidential mailing address through the office of the Secretary of State.
Government Involvement – Governor Dean signed an executive order enhancing state assistance to victims of domestic violence. Efforts include raising awareness of domestic violence in local workplaces, providing state employees access to a 24-hour domestic violence resource hotline, and granting state employees who are victims of domestic violence time off from their jobs to seek counseling, medical assistance or alternate housing.
Public Education – Governor Dean included information about domestic violence on the paycheck of every state employee.
Improving Community Response – Governor Dean created the Domestic Violence Fatality Review Commission to examine domestic violence fatalities, identify strengths and weaknesses in the community response to domestic violence, educate the public about intervention and prevention, and recommend policies to reduce fatalities due to domestic violence.
Child Abuse – During Governor Dean’s tenure, Vermont was the first state to institute a statewide protocol for abuse investigations. In that time the incidence of physical and sexual abuse of children declined 45%, including a 64% decline in physical abuse of victims younger than 4 and a 43% decline in physical abuse victims younger than 7. The decline in child sexual abuse was even more dramatic, with a 72% decline in victims younger than 4 and 84% decline in victims younger than 7.
“Healthy Families Visionary Leadership Award” – Presented by Prevent Child Abuse America to Governor Dean in March 2002.
A Strong Record of Accomplishment on Issues Important to Women
Dean's Record on Supporting Women
Women Appointees - Governor Dean appointed more women to positions of leadership during his tenure than any other state. At one point, the percentage of women appointees in his Administration was higher than the percentage of women in the state. Also, about 50% of his judicial appointments were women.
Pro-Choice - Gov. Dean is a strong supporter of abortion rights. He believes that government should not interfere with medical decisions. He stood against legislative proposals that would require parental notification and ban late-term abortions.
Fair Pay - Vermont passed legislation that expands federal wage discrimination laws into state jurisdiction and toughens the law so that the federal standards apply to all Vermont businesses.
Family Leave - Governor Dean is in favor of paid family leave, similar to the legislation that passed in California.
Dean's Record on Health Care
Health Coverage - 96% of Vermont’s children have health care coverage through Governor Dean’s Dr. Dynasaur program, and an additional 3% are eligible for coverage.
Child Immunization - 81.1% of children are fully immunized by age 2 and 97% by the time they start kindergarten, which makes Vermont second in the national in child immunizations.
Prenatal Care - More pregnant women get early, comprehensive prenatal care. Currently about 89% of pregnant women enter prenatal care during first trimester of pregnancy.
Breast Cancer - More Vermont women are being screened for breast cancer, and the death rate from breast cancer is significantly down. It’s now below the U.S. rate thanks in part to Ladies First, the state’s comprehensive breast and cervical cancer screening system.
Teen Pregnancy - During Governor Dean’s tenure, pregnancy rates for young teens dropped 49%. Vermont has the lowest teen pregnancy rate in the country.
Contraceptive Coverage - In 1999, Governor Dean signed a law that requires insurance plans with prescription drug coverage to cover FDA-approved forms of contraceptives. As a doctor, Dean knows that affordable access to family planning is essential for women. Insurance plans that do not cover contraceptives are unacceptable and discriminatory. Vermont is one of only eight states to receive an "A" grade from NARAL for access to contraceptives.
Dean's Record on Children and Families
Child Support – Under Gov. Dean, Vermont’s Office of Child Support has been very successful in meeting the challenge of collecting child support. In 1999, Vermont achieved a rating of 65% of cases with collections. This is the second highest collection rate in the country — in spite of increasing caseloads. The national average was 37% of cases with collections, a figure that Vermont has nearly doubled.
Success by Six – As a doctor, Governor Dean has placed a strong emphasis on early childhood prevention and health care, which is why 89% of pregnant Vermont women enter prenatal care in the first trimester of pregnancy. In Vermont, 91% of families with a new birth received a community visit, and parents who need it, get help and support.
Child Care – Our investment in Child Care Services has increased by 176% since 1991. Unlike some other states, there is no wait list for working parents with young children who are eligible for a childcare subsidy.
Child Abuse – Vermont was the first state to institute a statewide protocol for abuse investigations. In return, Vermont saw a 45% decline in physical and sexual abuse of children. This included a 64% decline in physical abuse victims ages 0-3 and a 43% decline in physical abuse victims ages 0-6.
Welfare Reform – Vermont was the first state to implement a statewide time-limited welfare program. In 1994, two years before federal welfare reform, Vermont reformed its program. Over the course of the 7-year project, caseloads declined by more than 48% and employment and earnings of participants rose more than 42%.
A Record of Commitment to Serving the Elderly
“We can provide higher quality of life by avoiding institutional services whenever possible.”
Prescription Drugs – Governor Dean understands the importance of access to prescription drugs in preserving health and avoiding unnecessary institutional care of our seniors and people with disabilities. While in office Governor Dean expanded pharmaceutical assistance to these Vermonters. Vermont has three pharmacy assistance programs with the level of benefits for each program indexed to household income. Seniors and people with disabilities can have incomes up to 225% of the federal poverty line and receive assistance with their prescriptions.
Nursing Homes – Governor Dean decreased the state’s reliance on nursing homes by mandating that funds be shifted from nursing homes to other services, such as home health care where people can live with independence and dignity. Over $30 million dollars has been shifted from paying for nursing homes to paying for in-home and community based services.
Home Health Care – Between 1996 and 2000, there was a 161.3% increase in individuals receiving a home-based waiver and services, while there was a decrease of 13.5% in individuals living in nursing homes.
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