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I think Dean was right, in part. The individual mandate was not necessary if the then Democrat controlled Congress had been willing to fund universal health care by substantially increasing taxes. Even then, "tax increases" in the necessary amounts were in disfavor.

Even with Democrat control of both houses and of the presidency, the individual mandate was seen as the only viable funding mechanism.

Even with the individual mandate, lots of sweeteners -- some unrelated to health care or related only tangentially -- had to be tossed into the pot to secure enough votes to get the monster passed. There was a bit of discussion of that during Wednesday's oral argument at the Supreme Court as to what could be left standing if the individual mandate were held unconstitutional.

Others than Dean have also opined that a Supreme Court holding that the mandate is unconstitutional would help President Obama's campaign. A point that they miss is that such a decision this June, well before the election, would raise the specter of finding a way to allow the rest to survive without massive tax increases; an impossible task, I think. I don't that would help President Obama at all.

This is also the reason the “opt out” provision or waiver is not really a solution, either. Your state can opt out of the mandate, or a GOP President could waive it, but it can’t opt out of the taxes which are being used to subsidize everyone else.