Never could quite understand Howard Dean. I don’t think he is 100% all there.
He's an eccentric rich guy who got untethered. He's left medicine and Vermont and (I think) his family behind. He doesn't have much of a real job now. He doesn't have he ties and restrictions that most people have.
Like a lot of rich people (or people who grew up around rich people) he's got a strong sense of entitlement, and also a lot of resentment. I don't think he's really got people to bounce ideas off, so he tosses whatever happens to cross his mind out on the airwaves.