Krugman Slams Obama On Health Care Reform: Not Enough Audacity

New York Times:

When it comes to domestic policy, there are two Barack Obamas.

On one side there's Barack the Policy Wonk, whose command of the issues and ability to explain those issues in plain English is a joy to behold.

Read the whole story: New York Times

Comments

[CanadianBeef]

Krugman is right. Obama has compromised health care reform to the edge of a cliff. He promised not to affect the (corrupt, inefficient, expensive) existing health system. He could only do that by, on one side, forcing employers and individuals into private insurance. And on the other, by giving heavy subsidies to a plan that's restricted to people who can't afford insurance anyway. There is no threat of actual reform, and the cost of an ineffcient private system paired with a subsidized public scheme will be ruinous.
When you start from a losing position, you finish that way.

[Doofus]

Not enough audacity? Well, the remaining Repos (mostly?) are the
ones who prefer to see the Demos fail, and they happen to control
('influence'?) much of the economic capacity in the good ol' USA.
What are we going to do about that, people? Let's put on a show!
At least a few bake-sales or car-washes. Let's get US moving!

[SiberianRat]

I agree with Krugman (as usual) and I even forwarded this to the WH in hopes that someone will read it (I imagine there are people on his team who would read it anyway). I really like Obama, but I agree that he's been to soft on some of this stuff and that the situations are so dire that they need a stronger stance, even if the GOP is gonna wig at every turn. We need to GET RID of Harry Reid and start sending a deluge of messages and phone calls to other wimpy Dems who are giving into special interest groups rather than the interests of the American people.

[Crissy Patters]

I see one Obama with an exorbinate amount of problems on his plate that some believe he should be able to solve in less then a year.
On the stimulus, only 10% as been distributed, until at least 90% is distributed and spent I don't know if we can say what he asked for wasn't enough. I do know that emotionally and mentally our country is 1000x more positive and hopeful than it was back in February.

As far as the health care, the president ran on a public option, me and thousands of others were on making calls today to garnish support for the president health care reform, which includes a public option. The bill may not include the words public option, but I am assured the bill the president signs will have a (public option) even if it goes by a different name.

[jmpurser]

Can you tell us what a "Public Option" actually is? I mean now that you spent all that time calling for it?

Personally I want single payer myself because it's well defined and has a long history of being a great tool for fixing all the problems that are causing our current crisis. But I can define single payer and point to other countries using it and getting the results we want.

[Doofus]

There was a time not so long ago that some thought GWB
would just postpone the election, call it a national emergency
or whatever. Instead, after 8 idiotic years, we got a new guy, a really
new guy, for President. THAT seemed like a miracle, and miraculous
results were expected.

Unfortunately, the reality is that we were left in a pretty deep hole, deeper
than was appreciated even, the way out is difficult & uncertain.
It's going to take a lot of time, effort, patience & luck.

Hopefully, we can pull this off. What have we got to lose?

[jmpurser]

What we have to lose is 4 more years. Unless Obama starts working smarter to make things better I'm afraid we're going to keep sliding backwards his entire administration.

[Doofus]

It's not all on Obama. It's on Reid & Pelosi and a lot of other
Democrats in Congress, not to mention a lot of recalcitrant
Republicans who really are not helping US even a tiny bit.

[Okieborn]

I usually agree with Krugman !!
Sir you are way off on this one !!!

[jmpurser]

I don't think so. Krugman articulated exactly the impression I've been forming of President Obama. What did you disagree with?

[Christian]

I'm with you! It seems he has taken pragmatism to a destructive level on some issues. name me one where you knew where he stood and would stand over time? He has not stayed with all his campaign promises, hedging on most of them in some form or another. So far I have not been happy with his performance as a fighter for issues.

[freshnotbitter]

I was just watchin Ari Belcher on CNN and he had the usual, two talking heads debating health care with himself "moderating".

Comments:

Ari opened with "let's drop the usual partisan debate because the viewer at home wants to know what this talk in Washington means for him".

Wrong. I could not care less what it means for me. The only thing I care about is which model for medical care satisfies the three parameters of universality, affordability and quality.

The conservative debater commented that people don't want government running their health care and we know that private enterprise delivers better results.

Nobody bothered to ask her: "Are you saying the public does not want Medicare, Medicaid, Va, and Schip?"
Or "Madam, are you saying that the private companies would do a better job of caring for those now cared for by Medicare, VA, Schip, and Medicaid? If so, why aren't they doing it?"

Belcher "called her out" with "but there are 45 million uninsured right now so how can you say that the private insurers are doing a better job?"

I am getting tired of the litany about 45 million uninsured while the vast majority are happy with their employer based private insurance.

45 million uninsured plus 50 million on Medicare and millions on medicaid and schip means that private insurance insures about half the population.

Why are the figures always skewed to favor private insurance companies in these debates?

[jmpurser]

The figures aren't skewed the debate is. Reality always has a liberal bias so "the media" feels it has to provide "balance" by over representing and under challenging the conservatives.

[freshnotbitter]

Yes, or they are worried about that surreptitious phone call from the CEO of Aetna to the CEO of Time Warner that gets their show moved or cancelled without them ever knowing it. Why take the risk?

[Jlong]

I think it is admirable that he seeks compromise on issues. However, the Republicans aren't really interested in compromise. They are taking advantage of the President's willingness to reach across the aisle with no genuine intent on voting for any real reform. On healthcare, I say, push the plan you want, get the rebellious Dems in line and don't even plan on getting any Republican votes. They wouldn't be there anyway.

[jmpurser]

I too think genuine compromise is a good thing. But a genuine compromise is between two people with the same goals and differing but equally valid methods of achieving those goals.

That is not the situation we have here. The GOP is either utterly insane or has radically different goals than the vast majority of America.

In other words it makes no sense to "compromise" between giving someone the tonsillectomy they need and letting Jack the Ripper cut them open. There is no "middle path" that satisfies all parties.

[Melissa]

We cannot afford single payer insurance. It's as simple as that.

[Whinger]

That's an audacious thing to say Paul, thank goodness there's only one of you!

[Gatormouth]

So we have a Janus kind of situation here? Obama on the one hand describes very well what our situation is and possibilities are, and on the other hand seems a Centrist concerned with compromise. Well, he did say in campaigning something about having these conflicts and that the public from time to time would have to "make" him do the right thing. But make him with what? Debate alone is not going to be enough against bought politicians. Our once energetic unions are now prostate. They forgot solidarity in the PATCO debacle. Labor rights and privileges were never given to them from the government in the first place, though. They were forced from reluctant government and corporations. Non violent protest is not the only thing that works, but it seems the best. Our politicians have to be made to fear for their political life, and the corporations have to fear for their profit. Gandhi, MLK, and Eugene Debs have all shown that this works. This and a resurrection of the union movement may be the best way to put us back on FDR's golden path of the New Deal.

[econ1]

The reason private companies fear a public option is not that it will be more efficient or that it will have lower costs, it is because it will have access to the public purse. No company can compete with a another that can tax and print money.

So with a public option, you eventually get no option....only a public one. And, then, yes, the price of drugs will come down because the government will simply say 'I will pay half". Of course you won't have many people investing lives or money in creating new drugs. But health care will eventually get cheaper.

[vanmungo]

Econ--I'm sorry--you seem to have your own private version of the public option that you're basing your assumptions on. The Waxman/Ran­gel/Schume­r version--the only one really specified so far--is not really public (it will be barred from accepting public funds after an initial infusion) and not really an option for most people (it will charge the same kinds of premiums and impose the same kinds of deductibles as private HMOs). It will probably be saddled with the oldest, sickest, and thus most expensive cohort while the HMOs aggressively market the youngest, healthiest, and thus most profitable cohort.

This public option is a farce--an enfeebled, hamstrung nonstarter designed to foster a semblance of reform while accomplishing its real purpose--posing no real threat to the continued dominance of the HMOs.

Public options have been tried and repeatedly failed at the state level. There is only one reform with a proven track record of reducing costs and guaranteeing high-quality coverage: nonprofit, single-payer Medicare for all, as practiced in Canada and Europe for the past fifty years.

In the 2008 election cycle, the health sector donated $90 million to the Democrats in Congress and $76 million to Republicans. Congress is a wholly owned subsidiary of the health industry. The wo parties agree on one essential matter: doing everything possible to torpedoing real reform--single payer--because it would put their paymasters out of business, and the gravy train would be over for all these knaves.

[longtalldrink]

I'm so glad there are posts like yours on these sites, they are so informative. I wish the MSM would be so informative.

[jmpurser]

Thank you. Excellent post clearly dissecting one of the common fantasies about the "public option".

I do believe that if more people understood what the policy makers were really saying about the "public option" then Single Payer would experience a surge in popularity. Your post certainly is a step forward in that regard.

[freshnotbitter]

Vanmungo and econ1:

The public plan can be complementary instead of competitive. Under that scenario the private system would remain in place and take its slice of the pie while the public option takes the remaining slice.

Vanmungo would say that such an arrangement would doom the public plan to failure because it picks up the sickest and financially less able that the private plans don't want. Yes, but that is why I used the term complementary. Isn't that what medicare, VA, schip, and medicaid are? Complementary systems? And yet the privates are happy to make them comply with the competitive model, i.e., no bulk buying, no electronic universal records system, no prevention programs, etc. Why? Because of the unholy alliance between all in the medical field that happily gobble up 2 trillion a year, twice as much as most countries, because the system is fragmented and nobody can do anything.

Compementary public option that combines all the various options to operate at an economic level. Universality, affordability, quality.
This was interesting:
http://www.nybooks.com/articles/22798

[NoOneSpecial]

Typical right-wing drivel

-- The reason private companies fear a public option is not that it will be more efficient or that it will have lower costs --

because lord knows Medicare has only 2% overhead. Although it does lack bargaining power thanks to greedy Republicans...

-- yes, the price of drugs will come down because the government will simply say 'I will pay half". Of course you won't have many people investing lives or money in creating new drugs. --

The vast majority of "creating new drugs" happens in medical research universities that have government grants and funding to conduct the R&D. Drug companies do some R&D on their own, but only a very small percentage.

(And often its dubious discoveries ... for instance like they find that two generics combined into one pill with a better absorption carrier works "better" than one or the other individually. So OOOO, they've got a new wonder drug they can charge outrageous prices for.)

So build on the research of our government-funded discoveries, often being granted patents to the technology without any reciprocal benefit for the taxpayers that funded it.

The vast majority of funds drug companies use is for advertising and marketing to push sales of their enormously high-priced patented "miracles".

[marignymitch]

Those still expecting to find spines among Democrats are in for a disappointment.

[jmpurser]

Why do you attribute the Democratic parties failure to act in our interest to weakness instead of having a radically different agenda than that of most of the people they represent.

Take a look at the long term evidence. I think you'll see it's a mistake to consider them to be "our" friend just because they're the enemy of our enemy.

I always did that that quip was horribly off track.

[StephenJK]

Democrats only appear to be the enemy of our enemies. They're all in cahoots with the filthy pool of money they swim in.

[edwarvir]

If Krugman and his buddies would have watch Bush
half as much as they are trying to screen President O
then maybe just maybe we wouldn't be in the fix we
are in. Krugman needs to leave him the h@ll alone and
let him do his jjob.

[getsit]

Krugman did watch Bush and wrote, and wrote about the administrations activities. Remember his acticles on Medicare, Social Security, etc. etc. Unless you are 1 year old how could you not know this?

[jmpurser]

And the rabid right made the same attacks on Krugman that the Obamaphiles make today. Fascinating in a "can't stop looking at the car wreck" kind of way.

[OverIt]

Two Barack Obamas!!!! Is the other one SINGLE???

[DrPneumann]

The healthcare industry is spending upwards of $1.4 million each day on average to lobby members of Congress on health care legislation, a report issued by Common Cause this week reveals.

Industry spending has nearly doubled since 2000. Healthcare interests contributed $94 million to Congress members during the 2008 election cycle alone — up from $40 million in 2000.

Common Cause’s report has received almost no treatment in the press — with a single article in Bloomberg News and one in the National Journal.

The industry is attempting to alter the course of Democrats’ plans to provide universal health coverage for most Americans.

“The top recipients of health industry campaign contributions from 2000 to 2008 are new Democrat Sen. Arlen Specter (D-PA) and Sen. Blanche Lincoln (D-AK) at $7.3 million and $6.3 million respectively,” National Journal reports. “All of the campaign finance data used in the report came from the Center for Responsive Politics.

“The report concludes that members of Congress face a disheartening conflict of interest: side with their large campaign donors or back reform measures that have support from the public, like the public plan option which would create a publicly-funded health insurance entity to compete with private insurers,”

http://rawstory.com/08/news/2009/06/26/healthcare-spending-14-million-a-day-on-lobbyists/

[MuchMadness]

Senator Harkin of Iowa has pretty much said that where this will eventually lead is to a single payer system twenty or thirty years from now, but there is not enough political will to get a single payer system now. What may happen is that once a public option is available, fewer employers will feel that they have to offer health insurance to employees. When that starts to happen, the pool of people in the public option plan will become healthier and it will be able to compete more effectively against private insurance plans. Then the private plans will either gradually fade away or morph into luxury plans that cater only to the rich while most people get their health insurance coverage through the government. In effect, it will just be a roundabout way of moving toward a Canadian style system.

[NoOneSpecial]

I agree with this assessment. Things are not going to change overnight.

And the perfect is the enemy of the good.

2/3rds of people who currently hold private insurance are unhappy with their insurer(s) and/or don't trust them to deliver services when needed.

That's a BIG incentive for people to migrate to a true public option, if offered and implemented correctly.

[vanmungo]

This is preposterous. The public option being proposed will not even be able to accept public funds after the initial infusion of cash, and it will have to charge premiums and impose deductibles to stay afloat. There is no way this will contain costs or expand coverage. It's a nonstarter--and intended as such, so it will not compete effectively with the HMOs.

Jacob Hacker of Berkeley, the academic doyen of public-option theory, has stated that the public option would EXPAND the market for HMOs.

See http://www.pnhp.org/news/2009/april/hacker_says_that_pub.php