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Let’s quote from the good Professor — and, in between each paragraph, take apart Professor Paul Krugman’s argument from his Monday New York Times column:
Health reform is the signature achievement of the Obama presidency. It was the biggest expansion of the social safety net since Medicare was established in the 1960s. It more or less achieves a goal — access to health insurance for all Americans — that progressives have been trying to reach for three generations. And it is already producing dramatic results, with the percentage of uninsured Americans falling to record lows.
It’s not “more or less.” It certainly isn’t “more” — people can still face medical bankruptcies and denial of critical services under Obamacare. In fact, we know how much “less” it is — it’s about 29 million uninsured Americans less than the goal. Obama does get great credit for getting us a life-saving, misery reducing, “half a loaf” — but part of that credit comes from the fact that it could open the door to our getting a FULL loaf. If Bernie can create a “political revolution” this year, then there’s no law of physics or political science that says that we can’t complete the job much earlier than most people had thought. Fortune favors the bold!
But single-payer wasn’t a politically feasible goal in America, for three big reasons that aren’t going away.
YES BUT: “America” in 2017 will clearly be politically different from “America” in 2009 if, in the meantime, Bernie has won. Let’s consider each on its merits:
First, like it or not, incumbent players have a lot of power. Private insurers played a major part in killing health reform in the early 1990s, so this time around reformers went for a system that preserved their role and gave them plenty of new business.
If Bernie wins in November, those “incumbent players” will have been shown to have much less power than they imagined they do. At a minimum, to maintain their “profit center,” they might be willing to toss a few more slices from their loaf into our basket. Each concession that they make saves lives and protects families.
Second, single-payer would require a lot of additional tax revenue — and we would be talking about taxes on the middle class, not just the wealthy. It’s true that higher taxes would be offset by a sharp reduction or even elimination of private insurance premiums, but it would be difficult to make that case to the broad public, especially given the chorus of misinformation you know would dominate the airwaves.
Come help us fight that misinformation, Professor! There’s no law saying that Americans must be easily fooled. If Obamacare left families totally vulnerable and NO Obamacare leaves then less vulnerable but still costs them $12,000 per year in premiums, co-pays, deductibles, and other fees (not to mention untreated medical conditions), then then can probably understand that an IMPROVED Obamacare system, which only costs them $5,000 in taxes with zero premiums and co-pays, is better for them. In fact, they can probably even calculate that it is $7,000 better for them! You don’t have to be a Princeton economist to do basic math!
Finally, and I suspect most important, switching to single-payer would impose a lot of disruption on tens of millions of families who currently have good coverage through their employers. You might say that they would end up just as well off, and it might well be true for most people — although not those with especially good policies. But getting voters to believe that would be a very steep climb.
So did Obamacare — but it was still worth it to end the costs and suffering of widespread, and emergency-room-smothering, under-insurance. Yes, workers will need to bargain to get back some or all of the extra money that their employers would no longer need to spend due to “Medicare for All.” They said the same thing about Obamacare, and it was true then too — but what this does is strengthen the Labor movement if employers try to hold on to all of the cost savings from a new system. You like employees collectively bargaining for more benefits, right?
Prof. Krugman, you’re a good man — and you have often been a brave advocate for sanity, for people’s rights, and for the common good. But please consider the possibility that maybe people ARE more angry and ARE more desperate than you can see from Princeton — and that they are ready for what is still, by the standards of the rest of the developed world, a relatively modest reform.
As a brilliant economist, you know that both the micro- and macro-economics of Medicare for All IS better that Obamacare’s. And as an honest man you will concede, even if Hillary won’t, that if Bernie tries and fails to get greater reform, Obamacare will remain there — with a vote to repeal it coming along every month or so. This is about politics and psychology and sociology — which are not your areas of expertise. You don’t have to agree — but don’t plant yourself so firmly in the path of progress to help out your peers.
You’ve been willing to admit being wrong before, as when you were a strong and slashing advocate of NAFTA over the objections of people like Bernie Sanders. You know that you’re not omniscient — so have the humility to doubt that what you see as politically impossible really ISN’T.
After all, you never expected Bernie to get even THIS far, did you?
Krugman fails to mention another factor that I think could set the cause of single-payer healthcare back decades, perhaps longer…
The botched rollout of Obamacare.
The counter-argument goes something like “You think the government can administer healthcare for everyone? Remember the disastrous rollout of Obamacare”?
I gave up on Paul Krugman when he declared that debt is good and more debt is even better. Or by cutting government spending we would harm growth and damage the economy. Think about this in personal terms. Let’s say you maxed out your credit card and needed more credit in order to pay your bills. But your income did not justify a credit limit increase. Your current limit is $15,000. You’re making minimum payments on your $15,000 balance. You call up your banker and ask for a $10,000 credit limit increase. What do you think he would tell you? But the government continues to raise it’s credit limit. Today we have accumulated nearly $19 trillion in Federal debt. No wonder they can’t raise the interest rates to normal levels! We are on a road to disaster! Krugman is like a heroin dealer telling his addict that he just needs to increase his dose little by little to feel good (until his liver turns to stone).
Krugman is a lackey for Wall Street. He has to know that the medical industry in America is a de-facto monopoly. Why do you think we pay 2-4 times more for American made pharmaceuticals than the Europeans do? Why do you think I could fly to India and get a quadruple bypass in a first class hospital performed by top American educated heart surgeons for $20,000 (w/ aftercare) while the same procedure would cost me $200,000 in the American healthcare system? Why? Because the politicians, the insurance companies, the pharma companies and the AMA are all in cahoots. That’s why. And the US consumer is being held hostage.
For years I opposed a single payor system. But I would overwhelmingly prefer it over what we have today with the :”Affordable Care Act” with premiums and deductibles still rising 10% a year while consumers are forced to accept insurance policies with fewer benefits and are told they can’t continue to see their favorite doctors. If I were in charge every hospital and every doctor’s office would be required to post a price list for all patients to see – just like any other legitimate business. That should be your first clue that the system is corrupted. If you are not allowed to examine the price before you receive treatment – and only find out after the fact – something stinks in Denmark. That’s not what America was designed to represent. Americans pay about 20% of our GDP on healthcare. On average, the first world European nations spend about 12% with their single payor systems. I have become a recent proponent of single payor. Costs would come way down while the quality of medical care would not change significantly – and all the data supports my opinion. I’ve done my research. In fact, many of the single payor nations outperform the United States with regard to quality of medicine in many health care modalities. I invite you to do your own research. The American consumer is being ripped off. We subsidize medicine for most of the global population via our inflated costs. Krugman won’t tell you that. But I will.
*We love Art Laffer and few people know that his understanding of the economy and our society far exceeds “trickle down economics”. Art is a real guy on top of being a died in the wool conservative……a real conservative…..not the latest iterations of politics by shock. OK, having said that…..what would Art Laffer do about the Health Care System?
Both sides seem to agree that about 18 million folks have joined ACA (Obamacare) since inception. According to our figures, if the population of the United States is around 310 million folks……ACA accounts for about 5.8% of the population. We have not seen the breakdown of how many folks are actually covered by their employers. We have not seen how many are covered by Medicare. We have not seen how many are covered by State Sponsored Medicaid. We have also not seen how many folks are covered by Military, Retired and Cobra Insurance. We have also not seen how many folks that Public Employees (Teachers, Fire, Police and Bureaucrats). It seems to us that Art Laffer would have to have these numbers in order to determine the appropriate course of future action. Our Republican candidate brothers, on the whole, don’t seem to want to know what those figures are.. Hillary and Bernie better catch on to this desire for numbers as well. So, ACA has about 5.8% of Americans covered by mandatory insurance. It seems the Republicans are stomping on ants while the Donkey is getting away. Krugman is having social moment and should step back and look at the numbers, explain them to the American people and then collaborate with Art Laffer on how to fix a bogus system, run by Big Pharma and Medical Providers with aged equipment that was obsolete the day the starting using it. The Medical System is broken in this country and perhaps it is: “Bernie Time!” Without correcting the cost that Big Pharma wants us to pay and without correcting and banning Television Ads for Big Pharma – Side Effect Ridden products……. where is Art Laffer?