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Howard Dean: The Vermont Years

03/30/04 7:00PM By Steve Delaney
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AP Photo/Alden Pellett

Howard Dean

(Howard Dean, from announcement speech) "You
have the power! You have the power! You have the
power!"


(Steve Delaney) That's Howard Dean stirring the
crowd at the formal launching of his candidacy
for president last summer before a hometown crowd
in Burlington. Months later it seems that Howard
Dean has the power. And some experts are saying
the nomination is his to lose. How did that happen?
And how did Vermont shape the young doctor from New
York into the front runner among challengers to
the President.

I'm Steve Delaney. In the next hour, we explore the record Howard Dean
has left in Vermont, as physician, lawmaker and governor. "Howard Dean,
the Vermont Years," continues right after the news.

One of the recurring legends of American politics is about the candidate
who comes from nowhere to grab the brass ring, to the astonishment of
political experts. Abraham Lincoln and Harry Truman are the classic
examples of men who rose from obscurity to the presidency. More recently
Jimmy Carter and Bill Clinton rocketed off the improbable launch pads of
small and rural states, to win it all.

How did Howard Dean move to the front of the pack in a Democratic Party
nomination process initially dominated by better known names from bigger
places?

He started by making a mark in Vermont. Vermont also made a mark on him,
as his thinking evolved over twenty years in office, more than half of
them as governor. In 1991, when Richard Snelling had a fatal heart
attack, everything changed for Lieutenant Governor Dean.

(Dean swearing in, 1991) "I, Howard Dean, do solemnly swear that I will
faithfully execute the office of Governor for the State of Vermont, and
will therein do equal right and justice to all men and women, to the
best of my judgment and ability according to law, so help me God."


(Delaney) The new governor did have experience in politics, but he also
had something else that would serve him well in his years as governor,
his background as a physician. The record for that part of Howard Dean's
life is less public and harder to access. But there are still former
colleagues around, and former patients. Some of them talked with Lynne
McCrea about "Doctor Dean."



(McCrea) It's a weekday morning at Vermont's largest hospital, in
Burlington. Medical residents are on rounds, just as Howard Dean was
when he was a resident here almost 25 years ago.

(John Gennari) "He didn't come across as someone who was 'I'm gonna
really be the best doctor in the world.' He was just an ordinary
resident, basically."


(McCrea) Dr. John Gennari was a professor of medicine when Dean was a
resident at the hospital. Gennari says he didn't have daily contact with
Dean but, overall, saw him as an average resident who interacted well
with his patients.

(Gennari) "I wouldn't say he was a superb diagnostician, for example, or
someone who knew all about rare diseases and what the right tests were
to do. And you see that in certain physicians, they're really good with
patients, they're not so good with the body of medical knowledge. And he
would sort of fit into that category."


(McCrea) Dean was part of an innovative primary care track - one of the
first in the country. Dr. Mark Levine, who was a year behind Dean, says
the program appealed to a certain kind of student:

(Levine) "One thing that you're really passionate about is that
connection with patients. So I think early on, Howard recognized he
liked that connection, as opposed to being in a laboratory and
discovering some new finding, or even being in a specialty where he
might be doing procedures all the time and learning new things that
way."


(McCrea) In spite of the rigorous schedule of a medical residency, Dean
found time to work at a community health clinic in a small underserved
area of Burlington. Dr. Gennari says Dean sought out the opportunity -
not all residents did. Dean also occasionally worked nights at a local
Planned Parenthood clinic. Judy Wechsler is a physician's assistant who
worked closely with Dean:

(Wechsler) "Working there, working with the women that came to see us at
Planned Parenthood, was a real eye opener for many of the young
doctors."


(McCrea) Wechsler says not only was Dean interested in learning about
women's healthcare, he stood out as a doctor who was willing to work as
an equal with nurses and physician assistants.

(Wechsler) "I give him a lot of credit for that because that was
certainly back in the early days with nurse practitioners and PA's. And
even to this day not every doctor is willing and is able to be as
comfortable with working with nurse practitioners and PA's as
colleagues."


(McCrea) In Wechsler's view, the Planned Parenthood experience sharpened
Dean's interest in the health issues of women, and adolescents. He would
go on, as a doctor and then as governor, to push preventive health care
and reproductive rights.

By the time Dean set up his practice in Shelburne in 1981, he was
straddling the worlds of medicine and politics. In 1982 he became a
state representative, a part-time job that allowed him to continue
seeing patients.

(Holly Miller) "He definitely was not the typical physician, in my mind.
He's kind of a force to be reckoned with! And it's positive."


(McCrea) Holly Miller was a patient in Dean's Shelburne practice, where
she called him "Howard." She remembers his casual but direct style.

(Miller) "As a physician he was pretty much the way he is as a
politician, in that he had a lot of energy - exuberant, optimistic, very
strong opinions. So I think it's his persona that I liked as a
physician, is pretty much the way he is right now."


(McCrea) Today, Dean himself also sees parallels:

(Dean) "My bedside manner is kind of the way I treat voters. In
general the way I treat patients and voters is with respect. If you
listen carefully to what they say, in both cases they're your boss. But
there's a deeper metaphor. The truth about medicine is that, in large
part, patients heal themselves. I write the prescription or a surgeon
does the operation, but if the patient has a positive state of mind
about getting over their illness, they're going to do it."


(McCrea) While Dean could be forceful, other stories tell of his
willingness to listen. Dr. Glenn Englander remembers a time when Dean
was a supervising resident and Englander was a medical student handling
his very first patient:

(Englander) "He was on a ventilator and he looked absolutely miserable
and Howard was rounding and I begged Howard - as a medical student who
knew nothing, essentially! - saying, 'Can't we get this guy off the
ventilator? He's just miserable.' And Howard at the time said, 'Well, we
probably really shouldn't but okay we'll give it a shot.' And we took
the guy off the ventilator and he did fine."


(McCrea) Years later, as Dean's political stature grew, he developed a
reputation for being direct - even brusque, which Dean attributed in
part to his medical training. In Dr. Englander's view that training
serves him well:

(Englander) "We as physicians are to some extent are trained to be
brusque. We have to be quick, we're making thousands of decisions on a
daily basis. And sometimes we're right, sometimes we're wrong but in
medicine - you know, we see patients on a daily basis and what was the
right decision yesterday, we may decide the next day is the wrong
decision. That's how medicine is, and I think that that would actually
serve him well, rather than sticking to an ideology that doesn't
necessarily serve the nation's interests when all is said and done."


(McCrea) Teresa Randall served as a sergeant at arms during Howard
Dean's tenure as governor. Though he no longer saw patients, Dean would
occasionally step in as doctor. Randall remembers a moment here in 1994,
when Dean was in the middle of a formal address and a young Statehouse
page fainted:

(Randall) "And all of a sudden I heard, 'Howard!' And I thought, where
but in Vermont would somebody call out to the governor with their first
name?! And uh, he took off his jacket and came running over." (Archival
sound from Dean, attending to Statehouse page) "She's fine, she's fine."


(McCrea) Howard Dean, the doctor. By accounts here, he was a regular
guy, a "people" doctor, a forceful decision-maker. And perhaps more
significantly, he was constantly driven to do more. From Dr. John
Gennari's perspective, it's not surprising that Dean had higher
aspirations - many young doctors do.

(Gennari) "A lot of physicians have a lot of ideals. He wasn't the only
one who was volunteering and doing those kinds of things, but they sort
of usually wash away. You get immersed in your practice, raising your
family, or your own personal issues and you lose all that as you grow
older. Whereas, he didn't lose that - it actually became the primary
part of his life."


(McCrea) For most, the demands of medicine take over, and other
ambitions fade away. But for Doctor Dean, the medical practice wasn't so
much a career as it was a stepping stone to a stronger urging: political
office.



(Delaney) Because he's a physician, Governor Dean was considered in
Vermont to have an edge in debates over health care issues, and those
issues are now a key part of his national campaign as well. Dean's
record on health care forms a major part of his Vermont legacy. John
Dillon examines those health care issues, and how the governor dealt
with them:

(Dillon) The early 1990s were a heady, optimistic time for health care
reformers. In Washington, the Clintons hoped to design a system of
national coverage. In Vermont, Governor Dean tried to push a very
ambitious universal health program though the Legislature.

But the plan proved too expensive - and Dean couldn't sell it
politically. As the Clinton plan imploded, so did Vermont's. At a news
conference in 1994, Dean conceded defeat.

(Dean) "This is a short term setback. I will take this on the road
during the campaign, I will again push for a universal access program
for Vermont, and a program that controls costs."


(Dillon) But Dean didn't try again. With his big program dead, he turned
to a much more incremental approach.

(Con Hogan) "That's when he then asked me to go over to the Health Care
Authority and pick up the pieces, because it had really fallen apart."


(Dillon) Con Hogan, who had a distinguished career in corrections and
human services, became Dean's health care czar. Hogan and Dean took an
existing program that covered children age six and under and greatly
expanded it to cover kids through the age of 17. They did it by
leveraging Medicaid money to create the most ambitious publicly funded
children's health insurance plan in the country.

This fall, the Children's Defense Fund - a nonprofit advocacy
organization - reported that Vermont has the best record of all 50
states in providing health care to kids.

Hogan says Dean's interest in children's health went far beyond
traditional insurance coverage. Hogan has dredged through old files to
list some of the accomplishments of Success by Six, Dean's preventive
health care plan. The program combined pre-natal care, visits to
families with newborns, intervention efforts to detect abuse, and early
childhood education. The results, says Hogan, were profound.

(Hogan) "Fifty percent reduction in lead levels in children's brains, 44
percent reduction in teen pregnancies, 22 percent improvement in early
pre-natal care, 27 percent reduction in smoking during pregnancy, 34
percent improvement in immunization rates. Every one of those speaks
directly to the health of our lives, and every one of those in a sense
is an avoided short- to mid-term tremendous cost to the system and an
improvement in somebody's life."


(Dillon) On the campaign trail, Dean makes health care his signature
issue. At the first Democratic debate in South Carolina debate, Dean
said Vermont provides an example for the rest of the nation to follow.

(Dean) "We've actually done this, a lot of this in Vermont. In Vermont,
everyone under 18 has health insurance. What I want to do is this, and
it costs about half of the Bush tax cuts: first everyone under 25 gets
Medicaid if they want it. It worked well for us under 18 in our state,
and it's not expensive."


(Dillon) Under Dean's tenure, the state also extended coverage to
adults, through a program called the Vermont Health Access Plan that
covers people up to 150 percent of the federal poverty level.

Tom Pelham served as Dean's budget manager though the 1990s. He says
Dean managed to extend coverage while also cutting taxes and erasing a
$65 million deficit.

(Pelham) "I think you have to look at the result. The result is that in
1991, 10 percent of Vermonters were covered by publicly funded health
insurance, which is around the national average. By 2000, 25 percent of
Vermonters were covered by publicly funded health insurance, which was
the highest in the nation."


(Dillon) Although Dean worked hard to extend coverage to the working
poor, he had much less success in controlling the cost of health care.
And near the end of his 11 years in the governor's office, the state was
rocked by a major health care scandal. It started here at a huge
construction site at the state's largest hospital in Burlington.

(Contractor) "If you draw a line in your mind's eye sort of a straight
line down, if you sort of connect the top of the I-beams here, this is
the furthest eastern edge of the parking garage."


(Dillon) The cost of its redevelopment project - including this
four-story, underground garage - ballooned more than three times, from
$116 million to $364 million.

(William Sorrell) "We'll be looking at any violations of Vermont law,
civil or criminal. We have many more questions than answers at this
point."


(Dillon) Attorney General William Sorrell stood side-by-side with
Governor Dean more than a year ago and announced a sweeping
investigation. The hospital eventually admitted that its executives
misled regulators about the true cost of a multi-million dollar
expansion plan. The hospital president was forced out and the
institution paid a $1 million fine.

The huge overruns will ultimately be reflected in higher health care
costs. Critics say Dean was warned about the problems early on, but took
little action. Jeanne Keller is a health policy analyst who followed the
case closely.

(Keller) "We heard stony silence from the Dean administration when we
tried to raise this. We tried everything we could to get people's
attention. So he seemed to be deliberately distancing himself the worse
it got."


(Dillon) Yet Keller says that Dean also wrote the hospital president a
letter that said he would support its permit for the huge expansion
project if the hospital agreed to build a mental health ward that would
accommodate some patients then in state custody. Keller says that letter
shows that Dean was closely involved in hospital oversight.

(Keller) "Now that kind of language doesn't say to me he's hands off the
regulations. He was trying to use that as leverage."


(Dillon) Hospital insiders also went to the Dean administration and
urged that the governor pressure the hospital trustees to get their
president to step down. Kathy Hoyt, who was Dean's administration
secretary and oversaw all of state agencies, acknowledges that the
governor was asked to intervene. And she says Dean did apply pressure
privately.

(Hoyt) "But he had to be careful, too, in terms of where the governor
acts as opposed to the regulatory agency. You have to be careful; you
have to do it right. And unfortunately, it just took a long time."


(Dillon) While the Fletcher Allen scandal broke while Dean was in
office, problems at the state's mental hospital that ultimately led the
federal government to deny funding came to light after he left. Within a
span of six weeks, two patients committed suicide. A federal inspection
cited serious deficiencies in the quality of care. Chronic understaffing
at the institution has exacerbated the problems. With the hospital in
crisis, lawmakers wanted a tour. Director Paul Blake gave the overview.

(Blake) "Ninety-three percent of the admissions that come in here are
involuntary. What that means is that probably the person did not seek
treatment on their own. They come in as unwilling participants."


(Dillon) Blake explained that the hospital is an aging facility that
must handle forensic cases - people charged with a crime and sent there
for evaluation by the courts - as well as people with severe mental
disorders. It's a sometimes volatile mix. Just two days before the
committee's visit, a patient attacked and severely injured a female
psychiatrist.

Dean maintains his administration wasn't aware of the quality of care
problems.

(Dean) "There's not much I can say. Certainly none of the problems at
the state hospital came to my attention during the time I was governor,
otherwise we would have done something about it."

(Anne Donahue) "I would find that extremely hard to believe because what
it would mean was that his administration was not informing him."


(Dillon) State Rep. Anne Donahue is a Republican from the central
Vermont town of Northfield. A longtime mental health advocate, Donahue
closely followed the state hospital.

(Donahue) "There was no question his administration knew about it.
Advocates had been in there for several years saying that conditions
were deteriorating."


(Dillon) In another area of mental health, Dean gets high marks for his
support of Vermont's parity legislation that requires coverage of mental
health in the same way as physical health.

Those who had a ringside seat during Dean's tenure say that as
president, Dean would focus on kids, and would try to extend Vermont's
model of preventive health care to the rest of the nation.



(Delaney) Vermont almost defines the phrase "small state." It's a place
where a lot of people had ringside seats to watch the governor at work,
close-up. And so a lot of voters thought they knew Howard Dean pretty
well. He was a brusque, fast-talking, cerebral governor, not known for
dynamic oratory.

But on the Presidential campaign trail, there has emerged a side of Dean
that no one had seen in Montpelier. Bob Kinzel has covered Howard Dean
for the entire time Dean's been in public office. He hosted a special
call-in program from Iowa.

(Bob Kinzel, hosting call-in show) "Let me ask you a question about
campaign style. You've developed quite a campaign style in the past few
months. The most common reaction I get from people in Vermont is, 'What
has gotten into Howard Dean?' Now to understand why they're amazed,
here's a clip from your State of the State address to the Legislature in
January of 1999-"
(Dean, from archive) "We have taken pride in the
notion that all of Vermont is one community and that our political
disagreements need not take on the partisan tone of the debate in our
nation's Capital. We have shown an extraordinary record of
investments."

(Kinzel) "Now let's play a cut from your announcement speech, just a
month ago-"
(Dean from announcement speech) " You have the power to take
our country back! And you have the power to take the White House back in
2004! And that is exactly what we're going to be doing! Thank you very
much! "
(Dean, responding to sound bites) "That's almost a little
embarrassing isn't it? I don't talk like that in Iowa either."


(Delaney) While Howard Dean may not have arrived at the top office in
Vermont as a great orator, he did arrive with a pretty well developed
set of political principles. During an early radio call in show more
than a decade ago, he stated them for the record.

(Dean from September, 1991) "I think basically the role of government is
to regulate and to make sure that society provides fairness and justice
for those who aren't able to fully avail themselves of all the
benefits."


(Delaney) Eleven years later, the political philosophy he arrived with
was remarkably intact.

(Dean, 2002) "The purpose of government in this country is to smooth off
the rough edges of capitalism. And so government is essentially a
redistributive body which makes sure that everyone who works hard is
able to at least have some hope of achieving the American dream of
sending their kids to college and so forth."


(Delaney) In his new autobiography Dean says, "I've always felt
comfortable in the middle; it's where the most reasonable solutions are
found." The middle, the political center, was where Dean stood for one
budget fight after another, while the Democrats in his own party cried
that he was spending too little, and the Republicans in opposition cried
that he was spending too much. As Bob Kinzel recalls, the center usually
held.



(Kinzel) In his four and a half years as lieutenant governor, Dean did
not stake out a strong position on many fiscal issues. But as reporters
from throughout New England crammed around a wooden conference table on
the afternoon of Aug. 14, 1991, the new governor outlined a financial
blueprint that would become a hallmark of his administration throughout
the 1990s:

(Dean, August 1991) "I intend to support Richard Snelling's fiscal
policy 100 percent. And I think he did an outstanding job and I hope
that I will be able to continue on those policies which I think are in
the best interests of all the people of the state, regardless of whether
we're Democrats or Republicans."


(Kinzel) The Snelling fiscal plan had two key components - raising new
revenue and controlling spending. Snelling stunned lawmakers during the
1991 session when he proposed creating a three-tiered income tax system
to help pay off Vermont's $65 million deficit. He agreed to this plan
with the clear understanding that the tax rates would revert to their
previous levels once the deficit had been paid off. Snelling also wanted
to put the state on a "sustainable spending track" that would help
maintain essential services when revenues fluctuated.

Dean's strict adherence to these policies resulted in a major battle
with Senate Democrats during the 1994 session. After two years of
virtually no budget growth, the Democrats wanted to boost spending on a
number of social programs. They wanted to pay for these programs by not
retiring some of the tax increases that had been part of the Snelling
budget deficit package. The Senate Democratic caucus summoned the
governor to a special lunchtime meeting in the Finance Committee room to
make their case. State Senator Cheryl Rivers offered a blunt assessment
to Dean:

(Rivers) "We feel that the responsible thing to do here is not to just
pass the bill onto local property taxpayers but for us to directly
confront our obligations and responsibilities to the people of the
state."


(Kinzel) Dean wouldn't budge and told the caucus that he would actively
oppose their plan:

(Dean) "And I think we have to control spending and the only way to
control spending, apparently, is to be very hard-nosed about the tax
situation. Because if you extend the taxes, you're clearly going to
spend the money and we're going to be right back here with the 1995
budget with a huge deficit in the General Fund. And that's not
acceptable. That's not the way to manage Vermont."


(Kinzel) In order to win that fight, Dean had to solicit the support of
Senate Republicans - something he did on numerous occasions.

Dean's fiscal philosophy has also emerged as key issue in the Democratic
presidential campaign. Dean believes that President Bush's tax cuts will
bankrupt the country. Dean wants to rescind all of the tax cuts in order
to pay for his health care plan, boost spending on special education and
reduce the federal budget deficit. He outlined his plan to a gathering
of 1,500 labor delegates in Iowa last May:

(Dean) "I talk to Democrats all over this country and I find that
Democrats are almost as angry at the Democratic Party as they are at the
Republican Party. We have got to understand that the only way that we
can beat this president is to take him on directly. Don't vote for any
tax cuts of any kind. Let's explain to the American people that tax cuts
are killing our jobs and making it impossible for us to have a decent
health care system."


(Kinzel) Dean's plan to rescind all of the Bush tax cuts has become an
important issue with several of his Democratic presidential opponents.
Massachusetts Senator John Kerry says Dean's proposal will result in a
significant tax increase for middle income families. And Connecticut
senator Joe Lieberman says Dean's policies will hurt traditional
Democratic voters.

(Lieberman) "Howard Dean has said that he want s to repeal all of the
Bush tax cuts well that would mean that he would repeal the Bush tax
cuts for the middle class Americans and therefore raise taxes on the
American middle class. At a time when they are so stressed and
squeezed already that it would be very unfair.


(Kinzel) Dean defends his position by saying that 60 percent of all
taxpayers will receive on average a $300 tax cut under the Bush plan.
But in order to support this assertion, Dean has to include the millions
of lower and middle income Americans who don't pay any federal taxes and
therefore don't benefit from a tax cut. Senators Kerry and Lieberman say
Dean's statistical approach is very misleading because it masks a higher
tax burden that will affect many moderate income families.

Jeff Fothergill is a certified public accountant in Montpelier whose
firm prepares thousands of tax returns every year. Fothergill says Dean's
plan to rescind all of the Bush tax cuts would
have a significant impact on a family of four with a gross income of
$50,000:

(Fothergill) "Their total income tax would increase from about $1,600 to
about $3,900. It's pretty substantial, and there's a $2,300 - $2,400
difference in tax there."


(Kinzel) In a recent interview, Dean reluctantly acknowledged that a
number of moderate income families would experience a tax increase under
his plan, but he argues that the payoff is worth it:

(Dean) "You cannot promise everything. There's going to be some tough
medicine when we balance the budget in this country, and getting rid of
the president's tax cuts is one of them. Those tax cuts were
irresponsible because they were put on a credit card for our children
and our grand children to pay."


(Kinzel) As the Democratic presidential campaign intensifies, Dean's
opponents are raising the tax cut issue in an effort to discredit Dean's
front runner status.



(Delaney) Front-runners, especially upstarts like Dean, get attention
focused on all aspects of their lives, and a look at the record is only
part of it. The media have also noticed that for Dean, the political
road has always been one that he travels alone.


For example, here's no such thing as a political wife in the Dean
household. Dr. Judy Dean, who practices medicine as Dr. Judy Steinberg,
went to work treating patients almost every day while Howard Dean was
governor, showing up for his inaugurations, otherwise hardly at all. She
talked about that in a rare interview last summer with Bob Kinzel.

(Judy Dean) "I love my practice. I like what I do day to day. I think I
have a responsibility to my patients to my staff, to my partners. You
know it's not something you can't just up and leave, and it's nothing
that I really want to up and leave, and I think Howard understands that
clearly. And he's very supportive of that. And I don't know that I'd
like campaigning or not, but it hasn't really been an issue yet."
(Kinzel) "Is that an understanding that the two of you had as he
embarked on his political career, that you both would have separate
careers?"
(Dean) "I think it was an unstated understanding. It was
nothing we specifically talked about, saying you'll do this and I'll do
that. But I've always done this and he's always been proud of what I've
done. But I think it was clear from the beginning that he would support
whatever I do and I would support whatever he does as long as it doesn't
have a bad effect on the family."


(Delaney) It's difficult to know how the personal relationship between
Judy and Howard Dean has affected the governor's choice of political
battles to fight. Did he become deeply engaged in women's issues through
her influence?

These days, campaigning for the presidential nomination, he courts women
voters, saying he's pro-choice, saying that as governor he appointed
more women to leadership positions than other governors anywhere. He
talks about his efforts to improve pay for women, and expanded
child-care, and health care, and welfare. But how did women fare in
Vermont during the Dean years? Here's reporter Nina Keck.



(Keck) Whether or not women in Vermont are better off because of Howard
Dean is difficult to answer. But there are definitely more support
services available to women thanks to his administration. Former Vermont
Health Commissioner Dr. Jan Carney says the governor played a vital role
in improving women's health care through prevention and education.

(Carney) "One of the most striking areas where progress was made over
the last decade was breast cancer. And the number of Vermont women who
were screened with clinical breast exams and mammograms rose
dramatically. And during that same time frame the death rate from breast
cancer declined."


(Keck) Today, 90 percent of women in Vermont have a primary care
provider. Dean has always said he was strongly pro-choice. While
governor, he pushed for legislation that required private insurance
companies to cover women's contraceptives. And for women who do become
pregnant, Jan Carney says near nine out of ten now receive early
prenatal care.

(Carney) "That's one of the fundamental services that helps ensure that
babies born in Vermont have the best chances of a healthy start."


(Keck) Another thing that helps babies is good day care. But demand for
child care has skyrocketed and Vermont, like most states, has had a
difficult time keeping up. Today, for every 100 children that need care
there are only 65 slots available in registered centers or licensed
homes. But that's still better than what it used to be.

Kathy Hoyt, Howard Dean's longtime chief of staff, says the governor
knew that if women were going to succeed in the workplace, quality
childcare had to be affordable and available.

(Hoyt) "We increased childcare support something like 176 percent from
1991 until Howard Dean left office."


(Keck) That funding was used to boost subsidies and provide cash
incentives to child-care centers that received national accreditation.
Terry Edgerton, executive director of the Parent Child Center in
Rutland, says the extra money greatly improved the quality of care.

(Edgerton) "The last ten years in the state of Vermont there's been a
very strong movement to recognize child care. It's not babysitting. That
child care is a way to build our future through our children. And I
think there was a real strong investment in dollars and in time and in
real good thinking about what kids need."


(Keck) But Edgerton admits more needs to be done. There's still a
significant shortage of care, especially for infants and toddlers. And
while salaries have increased, Edgerton says they're still too low. For
instance, she says employees at the Rutland Parent Child Center start at
$7 an hour and top out at around $12.

Elaine McCrate, associate professor of economics and women's studies at
the University of Vermont, says low wages across Vermont are a huge
obstacle for women. While Howard Dean likes to point out that the wage
gap between genders is less here than in many other states, McCrate says
that doesn't mean Vermont women are better off.

(McCrate) "Nationally, the earnings of full-time women workers relative
to men full-time workers is about 75 percent and in Vermont it's running
at about 80 percent. And that sounds good. The problem is Vermont is
such a low wage state.


(Keck) And with salaries so low, McCrate says it's difficult for women,
especially single mothers, to make ends meet. While she says Howard Dean
did do many positive things for women in the state, reforming welfare
back in 1994 wasn't one of them.

(McCrate) "Both Howard Dean and Bill Clinton supported welfare reform
that was designed to push women into the paid labor force, almost
without regard to the kinds of jobs they were getting - whether the
hours were flexible enough to accommodate their families, whether they
were going to have some really important benefits and that sort of
thing. And for women who are stuck in low wage, dead end jobs, there has
really been no improvement."


(Keck) Howard Dean disagrees. His campaign Web site promotes the fact
that welfare caseloads in Vermont dropped by almost half during the
1990s and that participants who found jobs did much better economically.
Still, welfare offices across the state remain busy and the majority of
their clients are women.

The welfare office in Middlebury, is now known under the acronym PATH.
That stands for Prevention Assistance Transition and Health Access.
Vergennes resident Kathy Palmer is one of four single mothers in the
waiting room.

(Palmer) "I was receiving benefits for a while, and I found a job and it
is 20 hours a week at minimum wage, basically. And I'm here to see if I
can get food stamps, because I'm having a hard time buying groceries."


(Keck) Palmer likes to work but the needs of her developmentally delayed
son make holding a job difficult. The other women in the room nod their
heads in understanding. When I ask each of them turn if they are doing
better than they were five years ago, not one says yes.

The system is by no means perfect admits Suzanne Hopkins. She's a Reach
Up Case Manager at the Department of PATH. But she believes the work
requirements begun by Governor Dean and now continuing under federal
mandate are making things better for women.

(Hopkins) "In terms of self-esteem, confidence, a role model for their
children. And it's leading women to at least look at their lives and
say, This isn't enough for me. I want more than this."


(Keck) Dean says improving opportunities for women worldwide should be a
priority, one he calls a matter of national security.

(Dean) "The hallmark of our national security policy in the long term
ought to be creating middle class democracies where women fully
participate in the economic and political decision making of those
countries. Because those countries don't go to war with each other and
they don't knowingly harbor groups like Al Qaeda."


(Keck) But how much can Howard Dean really do for women in countries
like Afghanistan, Iraq and Bangladesh? It may be a tough sell to use his
accomplishments in a tiny state like Vermont as a measure of his
success.



(Delaney) But Vermont could be a good measure on environmental issues,
where the state's many landmark laws have set a national standard in the
past. Dean hopes that pattern still holds, as he talks about wildlands
preserved and environmental protections enacted. Like most of the claims
of accomplishment the governor makes, there's a lot of truth there, but
there's also a lot of complexity that doesn't fit easily into campaign
sloganeering.

John Dillon has been covering the Dean record on the environment in
Vermont for many years.

(Dillon) One of Dean's last acts in office was to broker a deal between
environmental groups and a private electric utility. The agreement calls
for the power company to eventually remove a power dam that now blocks a
river just upstream from Lake Champlain. Taking out the dam will allow
landlocked salmon and endangered lake sturgeon to reach their historic
spawning grounds.

Dean said the agreement showed his philosophy on contentious
environmental issues.

(Dean, from last gubernatorial news conference) "For 11 and a half years
I've have believed that the best way to get to environmental settlements
where everybody wins is to sit everybody down in a room and continue to
work so in fact everybody wins. We've done this with the ski areas and I
think we've put water back in streams that nobody ever though were going
to see water again. We've protected thousands of acres of bear habitat
and we've been able to do this well."


(Dillon) This deal-making approach also came through in Dean's effort at
land conservation. When the state chipped in to preserve 133,000 acres
of remote forest and wildlands in far northeastern Vermont, Dean and his
staff tried to give all sides a piece of the pie. It was the biggest
land deal in state history. Loggers got to work much of the land, but
wilderness advocates got 12,000 acres that was off limits to timber
harvesting. Snowmobile enthusiasts were guaranteed access to a huge
trail network. And hunters and anglers have the right to use the entire
parcel.

The land was owned by the Champion paper company. Elizabeth Courtney,
who heads the Vermont Natural resources Council environmental group,
says the Champion deal was truly historic.

(Courtney) "We wouldn't have made the Champion land deal if it hadn't
been for his very firm stand on the issue. I mean he felt it at his
core."


(Dillon) Under Dean, the state also conserved thousands of acres of
farmland. He backed a regional dairy compact that allowed the New
England states to set milk prices above the federal minimum. Despite
these efforts, dairy farming continued to decline in Vermont during his
tenure.

Dean is not an ideological environmentalist, but he does love the
outdoors. He's hiked the length of Vermont's Long Trail, the footpath
that follows the spine of the Green Mountains. He's paddled a canoe 400
miles down the Connecticut River, and sailed a small boat up Lake
Champlain. His official portrait that hangs in the Vermont Statehouse
shows a casually dressed Dean sitting by a lakeshore. It looks so much
like a cover for an outdoor clothing catalog that pundits have dubbed
the picture "L.L. Dean."

Critics say Dean's deal-making approach made him too eager to
accommodate business interests at the expense of environmental
protection. Mark Sinclair of the Conservation Law Foundation says that
as an outdoorsman, Dean should have known better.

(Sinclair) "Look at Lake Champlain. During his tenure as governor,
pollution permits were not enforced. As a result, Lake Champlain is
dirtier today than it was when he came into office."


(Dillon) Sinclair refers to 1,200 permits that controlled stormwater
pollution. At the end of his administration, Dean pushed legislation
that deals with the pollution permit backlog. But some say the problem
went on too long, and ultimately led to legal action that threatened to
slow development.

Elizabeth Courtney says that on balance Dean did great things for the
Vermont environment, including attempts to steer development to
Vermont's going downtown.

(Courtney) "He was really very successful and very instrumental in
creating the marriage between conservation and smart growth. He
conserved over half a million acres of wildlands in the state at the
same time he was making visits to Arkansas to talk to the folks at
Wal-Mart about bringing Wal-Mart into the state, but doing it in a
reasonable way: getting small and going downtown."


(Dillon) In Vermont, environmental issues loom larger than in many other
states. Much of the state is rural and relatively unspoiled. Billboards
are banned and the state has a lengthy history of environmental
protection.

Dean's record shows his essentially centrist approach to government. He
believes in regulation, but also wants to protect business. As he
campaigns around the country, Dean talks up his environmental record. He
advocates renewable energy, land conservation and strong enforcement of
pollution control laws.



(Delaney) While environmental issues are big in Vermont, there's another
issue that was bigger. Much bigger. Civil unions.

Vermont's legislature was told by the state Supreme Court to find a way
to make sure that same-sex couples could be assured of the same rights
granted to married couples. The solution, after the most extensive and
divisive debate in memory, was the civil unions law. Governor Dean
signed it, though not in a public ceremony.

He said then, and has ever since, that marriage is not a federal issue,
that the states ought to determine the rules, as long as those ruled
don't deprive anyone of their rights. Well before the court decision
that led the Legislature to create civil unions, the governor was asked
to speak on gay and lesbian issues, and did so at a high school in East
Montpelier.

(Dean, from speech) "What I'm really here for is to ask for your
willingness to learn. Your willingness to learn new tolerance. It's
fearful, it's difficult, the reason people exhibit, uh, intolerance is
because they're afraid. The problem is that it's incredibly destructive
towards the person you're pushing away or pointing at."


(Delaney) The civil unions issue has now largely receded as an electoral
litmus test in Vermont. But the issue festers, sitting on the cultural
fault line that guides the choices Americans make in stating their
political allegiances. It was the most acrimonious of many difficult
decisions Dean made during his years in Montpelier. There were other
tough calls, and Steve Zind has been sifting the record to assess how
Dean handled them.


(Sharpton, from debate) "You can't bring a Confederate flag to the table of
Brotherhood!"


(Zind) In the debate that followed his controversial remark that he
wanted to be the candidate for guys with Conferderate flags on their
trucks, Howard Dean dug in when his opponents went on the offensive.

(Dean, from debate) "I make no apologies for reaching out to poor white
people."


(Zind) As he watched the debate at home with his wife, the candidate's
close friend David Wolk saw something in Dean's gestures and his body
language.

(Wolk) "I could tell, and I said to Diane, he's rethinking this. And
he's not going to say he's sorry now, but he'll think about it through
the night. He'll call people and tomorrow he'll say that he regrets what
he said or regrets the impact of what he said. And sure enough he did."


(Zind) Friends say the Confederate Flag episode was vintage Howard Dean.
Dean has a brittle temperament and a wide stubborn streak, but in the
end his decisions are those of an analytical and pragmatic politician.

(Wolk) "Part of it's his own intellect, part of its his own medical
training. You know, analyze the situation, provide the diagnosis, move
on to the next patient."


(Zind) Doctor Dean was with a patient when he learned of Governor
Richard Snelling's death. Kathy Hoyt was one of the first people Dean
called. Hoyt became Dean's chief of staff. She says the first critical
decision of the fledgling administration was to stay the Snelling
course.

(Hoyt) "The Democrats didn't like that so well. And that created some
tension but I think it was absolutely the right thing to do in the state
of Vermont, such that for two terms thereafter essentially the
Republicans did not put up very strong candidates. I think it's fair to
say that."


(George Schiavone) "I think that probably is. Nobody would want to admit
it at the time."


(Zind) Shelburne Republican Rep. George Schiavone says his party was
indifferent in early gubernatorial races against Dean because
Republicans found little to complain about.

If the outside perception of Howard Dean as a maverick Democrat is based
on any single event during his administration - it's the passage of
Vermont's Civil Unions law, triggered by the state Supreme Court's Baker
Decision. Within hours of the decision Dean announced that he favored a
solution that was not same-sex marriage, but was a way for the state to
grant equal rights and benefits to homosexual couples. David Wolk:

(Wolk) "And I thought that was very brave because nobody at the state
level - no state office holders at that time - had been courageous
enough to support equal rights in that way."


(Zind) Wolk says Dean's quick response to the Baker decision provided
political cover for the Legislature. George Schiavone sees Dean's
response differently.

(Schiavone) "I think that if it had come out that clearly there was no
desire for civil unions either, I think he would have just backed away
from that. I think he was just looking for what was going to happen. How
does he get through this thing with the least scars?"


(Zind) Euan Bear, editor of the gay and lesbian newspaper Out in the
Mountains, says there were many politicians who risked their careers
working for civil unions. She says Dean stayed on the sidelines.

(Bear) "When the legislation was under consideration he was not out in
public saying yea or nay."


(Zind) Tom Little says Dean stayed in the background because he
understood that, as governor, he should let lawmakers take the lead.
Little chaired the House Judiciary Committee where the legislation was
written. He says he and Dean talked early on and agreed that something
like civil unions was the best approach, and that it was critical for
the Legislature to pass a bill in the current session.

(Little) "The significance of knowing that the governor supported the
direction that the committee and the House, etc, were taking should not
be underestimated."


(Zind) Regardless of how those close to the debate saw Dean's role, the
public clearly saw him as a strong Civil Unions advocate. In his final
statewide campaign Dean didn't shrink from angry confrontations like
this one in Williamstown.

(Protester) "We've seen you down in San Francisco being hugged by all
these gays and lesbians."
(Dean) "That's crap, you haven't seen any such
thing."
(Protester) "That isn't crap. That's right in the Times-Argus.
The people were hugging you and trying to touch you."
(Protester) "Are
you bisexual?"


(Zind) Euan Bear says many in Vermont's gay and lesbian community
enthusiastically support Dean's Presidential campaign because they feel
he is the only contender with a proven record.

Civil libertarians are less enthusiastic about Dean's candidacy. As
governor, Dean expressed impatience with a system he felt favored
defendants.

(Dean, June 1997) "My beef about the judicial system is that it does not
emphasis truth over lawyering. It emphasizes legal technicalities and
rights of defendants and all that."


(Zind) Dean once commented that 95 percent of the people they arrested
were guilty. Saint Johnsbury lawyer David Sleigh says Dean tended to
dismiss important constitutional protections as bothersome legal
niceties.

(Sleigh) "He referred to constitutional rights against unreasonable
search and seizure and confrontation and the admission of otherwise
unreliable evidence as technicalities to reach what he viewed as the
truth."


(Zind) On Dean's watch, Vermont followed the national trend toward more
numerous and lengthier jail sentences and rising prison populations. But
victims' rights advocates are unequivocal in their support of Dean.
Under his administration domestic assault and aggravated domestic
assault became crimes, and bail laws were toughened. Judy Rex is the
Director of the Vermont Center for Crime Victim Services, which was
created under the Dean administration.

(Rex) "He was very, very supportive of victim's rights. He was behind
all the legislation that we introduced. So, I felt like we had a good
ten years with him as governor."


(Zind) Rex says Dean's support for victims did not come at the expense
of civil liberties. Long time Addison County State's Attorney John Quinn
agrees with Rex on that count, but Quinn says Dean didn't walk the walk
when it came to funding beefed up criminal prosecution.

(Quinn) "You can't just be out there saying we're going to pass laws to
make these things felonies or make these crimes have larger sentences or
whatever and then say, 'Oh, and by the way, we'd like you to cut two
percent out of your budget.'"


(Zind) In his 11 years as Governor, Dean's most bitter setback came when
he failed to get his friend and Administration Secretary William Sorrell
named to the Vermont Supreme Court. Sorrell's mother, Esther, was the
governor's political mentor. Many saw Dean's desire to name Sorrell to
the high court as an effort to pay tribute to her. Dean badgered the
Judicial Nominating Board to add Sorrell's name to its list. The board
pointedly refused. Kathy Hoyt:

(Hoyt) "Personally, it was very, very difficult for him. I'll never
forget that it just wore on him. Eventually he had to face that he
wasn't going to get Bill's name from any list."


(Zind) During his years as governor, Dean contemplated another decision:
what to do after he left office. Dean's friend David Wolk:

(Wolk) "We would talk lots of times through the '90s about what he would
do next. At one point he was really serious about being a middle school
principal, thinking that that's a great way to make a difference."


(Zind) Wolk says as Dean began to travel the country as a leader in the
National Governor's Association and as he spent time in Washington
discussing policy issues, he began to realize he'd like to run for
president.



(Delaney) Not everything is known about the home-state record of Howard
Dean. About half of his gubernatorial papers were sealed for 10 years
under the doctrine of executive privilege. That's four years longer than
the previous two governors. As Dean was ramping up his presidential run
last January, he explained why in what he now says was a lighthearted
remark.

(Dean) "Well, there are future political considerations. We didn't want
anything embarrassing appearing in the papers at a critical time in any
future endeavor."


(Delaney) What is known is that the doctor/governor from Vermont has as
good a chance as anyone to be his party's next nominee for president.
And what would he be like, if given a chance to work in the Oval Office?
There's a hint, in his last address, delivered at the Statehouse in
Montpelier.

(Dean, excerpts from Jan 8, 2003 farewell address) "We are in many ways
unique. We have a citizen Legislature, we have growing diversity. We
have a sense of community that many other states never have...

"How lucky we are that we live in a state where you can have a big
argument with somebody at Town Meeting over the school budget, and three
days later if their barn burns down, you're there with a covered dish...

"I think that Vermont is the way that America ought to be. America would
be a stronger country if we valued each other as human beings more.
America would be a stronger country if we admitted that we were
dependent on each other and that we are responsible for each other and
that we are connected to each other, every human being, whether we like
them or not that we are connected to and that we have an obligation to
as fellow Americans and as fellow human beings."


(Delaney) Howard Dean says he will try to apply Vermont values to the
rest of America. Whether America will consent to that is the biggest
political question in the months ahead.

For Vermont Public Radio, I'm Steve Delaney.



"Howard Dean, the Vermont Years," is a production of Vermont Public
Radio. The technical director is Chris Albertine; the production
associate is Patti Daniels. John Van Hoesen is the producer.

Our documentary is a part of The Home State Record, a series that looks
at the political records of all nine of the Democratic presidential
candidates. Funding for "The Home State Record" was provided by
listeners of Vermont Public Radio.

AP Photo/Alden Pellett
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