Remember when Howard Dean was a rabble-rousing progressive, the one who ran for president railing against special interests? Remember when he insisted health care reform include a public insurance option, at one point suggesting that a plan without a government-run plan was “worthless”? Ah, good times…

Now Dean is back talking about health care. But this time he’s doing it on the opinion pages of the Wall Street Journal, in an essay called “The Affordable Care Act’s Rate-Setting Won’t Work.” As the venue and title suggest, he is making a different sort of argument this time. It's enough to make those of us who defended Dean during his 2004 campaign wonder what the heck we were thinking.

Oh, Dean says he still supports health care reform—or, at least, its goals. And, despite his well-known qualms about Obamacare, he continues to think it will make America a better place. “When fully implemented the law will move America closer to universal health coverage—something many progressives have sought for years,” Dean writes today. But, he goes on to say, “the law still has its flaws, and American lawmakers and citizens have both an opportunity and responsibility to fix them.” The rest of the article focuses on one particular “flaw”: The Independent Payment Advisory Board, or IPAB.

Read Jonathan Cohn on the right's latest scheme to sabotage Obamacare

IPAB is the commission that, under Obamacare, has the power to adjust Medicare payment policies in order to hold down the program’s cost. It’s been controversial from the get-go, with conservatives crudely claiming that it would ration care and Sarah Palin famously calling it a death panel. It was a ridiculous accusation. As a briefing from the Kaiser Family Foundation explains, Obamacare explicitly prohibits IPAB from “submitting proposals that would ration care, increase taxes, change Medicare benefits or eligibility, increase beneficiary premiums and cost-sharing requirements, or reduce low-income subsidies under Part D." (This Kaiser Health News briefing has more on the basics and the political controversy over it.)