ESQ: One thing I've never seen before is when you say, "Much is made of the 47 million without insurance, but nothing of the 25 million who have insurance but don't go and see the doctor." I've got one of those high-deductible catastrophic plans myself, so I don't go to the doctor unless I'm bleeding. Why have I never seen this argument before?

HD: Because 99 percent of the discussions among reporters, policy wonks, and politicians focus on the uninsured — which is, frankly, why nothing is passed. They don't focus on the majority of Americans who have health insurance that doesn't work.

HD: Because there is no feedback in the private health-care system. When I was practicing medicine, nobody with substernal chest pain ever got off my examining table and said, "The guy down the street does it for $2,000 cheaper, I'll see you later." That's why we've had 40 years of costs that increase between two and three times the rate of inflation every single year. It's breaking our economic system. People are yelling and screaming about jobs going to China, but they're not yelling and screaming about jobs going to Canada. But they are. Because the right-wingers can scream and yell about rationing if they want, but economically their system works much better than ours does.

ESQ: But isn't that a threat to the insurance companies? Especially at a time when we want to keep businesses healthy and people employed?

HD: This is one of the many problems the Senate is now having. They are focused on anything but the American people. But the insurance companies will be fine. It won't happen overnight, and they'll make plenty of money. But this is not a matter of making the insurance companies happy. This is a matter of making the 72 percent of the people who want a public option happy, including the 50 percent of Republicans who want a public option.

ESQ: Fifty percent of Republicans want a public option?

HD: Yeah. That's in a Kaiser poll and in a New York Times/CBS poll last week. The Senate is in the process of self-destructing. They are talking about managing health-care reform to make sure that a relatively small sliver of American industry is satisfied at the expense of 72 percent of their constituents. That's unbelievable.

The star of the show Thursday was Dean, the former Vermont governor, who took the stage to raucous cheers. Dean fired a shot across the bow to Democratic lawmakers not committed to including the public option as part of healthcare reform.

“We are here; we’re not going away. We voted for change a few months ago. We expect change. And if we don’t get it, there’s going to be more change,” said Dean.

Success on healthcare reform is a must for Democrats, Dean told The Hill. “I think it’s going to be a catastrophic problem for the Democratic Party if they can’t get this bill out.”