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Opinion

Paul Krugman: Health bill naysayers should take a look in the mirror

11/7/2009 8:55:02 AM

Comments (10)

OK, folks, this is it. It's the defining moment for health care reform.

Past efforts to give Americans what citizens of every other advanced nation already have -- guaranteed access to essential care -- have ended not with a bang but with a whimper, usually dying in committee without ever making it to a vote.

But this time, broadly similar health-care bills have made it through multiple committees in both houses of Congress. And last week Nancy Pelosi, the speaker of the House, unveiled the legislation that she will send to the House floor, where it will almost surely pass. It's not a perfect bill, by a long shot, but it's a much stronger bill than almost anyone expected to emerge even a few weeks ago. And it would lead to near-universal coverage.

As a result, everyone in the political class -- by which I mean politicians, people in the news media, and so on, basically whoever is in a position to influence the final stage of this legislative marathon -- now has to make a choice. The seemingly impossible dream of fundamental health reform is just a few steps away from becoming reality, and each player has to decide whether he or she is going to help it across the finish line or stand in its way.

For conservatives, of course, it's an easy decision: They don't want Americans to have universal coverage, and they don't want President Barack Obama to succeed.

For progressives, it's a slightly more difficult decision: They want universal care, and they want the president to succeed -- but the proposed legislation falls far short of their ideal. There are still some reform advocates who won't accept anything short of a full transition to Medicare for all, as opposed to a hybrid, compromise system that relies heavily on private insurers. And even those who have reconciled themselves to the political realities are disappointed that the bill doesn't include a "strong" public option, with payment rates linked to those set by Medicare.

But the bill does include a "medium-strength" public option, in which the public plan would negotiate payment rates -- defying the predictions of pundits who have repeatedly declared any kind of public-option plan dead. It also includes more generous subsidies than expected, making it easier for lower-income families to afford coverage. And according to Congressional Budget Office estimates, almost everyone -- 96 percent of legal residents too young to receive Medicare -- would get health insurance.

So should progressives get behind this plan? Yes. And they probably will.

The people who really have to make up their minds, then, are those in between, the self-proclaimed centrists.

The odd thing about this group is that while its members are clearly uncomfortable with the idea of passing health care reform, they're having a hard time explaining exactly what their problem is. Or to be more precise and less polite, they have been attacking proposed legislation for doing things it doesn't and for not doing things it does.

Thus, Sen. Joseph Lieberman of Connecticut says, "I want to be able to vote for a health bill, but my top concern is the deficit." That would be a serious objection to the proposals currently on the table if they would, in fact, increase the deficit. But they wouldn't, at least according to the Congressional Budget Office, which estimates that the House bill, in particular, would actually reduce the deficit by $100 billion over the next decade.

Or consider the remarkable exchange that took place this week between Peter Orszag, the White House budget director, and Fred Hiatt, the Washington Post's opinion editor. Hiatt had criticized Congress for not taking what he considers the necessary steps to control health-care costs -- namely, taxing high-cost insurance plans and establishing an independent Medicare commission. Writing on the budget office blog -- yes, there is one, and it's essential reading -- Orszag pointed out, not too gently, that the Senate Finance Committee's bill actually includes both of the allegedly missing measures.

I won't try to psychoanalyze the "naysayers," as Orszag describes them. I'd just urge them to take a good hard look in the mirror. If they really want to align themselves with the hard-line conservatives, if they just want to kill health reform, so be it. But they shouldn't hide behind claims that they really, truly would support health care reform if only it were better designed.

For this is the moment of truth. The political environment is as favorable for reform as it's likely to get. The legislation on the table isn't perfect, but it's as good as anyone could reasonably have expected. History is about to be made -- and everyone has to decide which side they're on.

Paul Krugman, winner of the 2008 Nobel Prize for Economics, is a columnist for the New York Times.

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There are 10 comments - Display All Comments

Hugh_Bric
e
Rocehster, MN

Posted on 11/7/2009 at 9:49:00 PM

>>> Paul Krugman, winner of the 2008 Nobel Prize for Economics, is a columnist for the New York Times.

Krugman stopped being an economist decades ago and has become a full fledged ideologue. Seems winning a Nobel prize these days is the ultimate hard-left pedigree.

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charlie
Rochester, Mn

Posted on 11/8/2009 at 7:38:30 PM

I find the democrats numbers so hard to believe. Lets start with Cash for Clunkers, hand out something free and they miss it by what, 400 million dollars? They promised 50 million H1N1 vaccines, we got 20. Unemployment reaches 10.2%, and they said that they “saved” 600,000 jobs? Now we are going to give away health care and our and “REDUCE” the deficit by 100 billion dollars? No Paul, I got other reasons to not support this than bill.

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dimpleche
eks
Rochester, MN

Posted on 11/8/2009 at 8:42:10 PM

“Thus, Sen. Joseph Lieberman of Connecticut says, “I want to be able to vote for a health bill, but my top concern is the deficit.”

Lieberman had no concerns for the deficit when he was giving a president blank checks for adventures in Iraq. Apparently a trillion dollars wasted in a middle east sand trap trumps health care for americans.

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Othelmo__
Rochester, MN

Posted on 11/8/2009 at 8:58:19 PM

Paul Krugman is the same Keynesian economist who claims Obama’s porkulus “worked,” in spite of 10.2% unemployment, and, therefore, we should have another one. Genius.

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FrankWHaw
thorne
Rochester, MN

Posted on 11/10/2009 at 8:31:17 AM

Yeah—I/we love how you boys attack the issues & not the person. Inspiring; plus what’s Not to hate `bout Krugman?!? [What kind of name you think that really IS anyway, if you get my drift?]

Now fire-up the pick-up again & let’s do some more chainin’-&-draggin’ of that POTUS fella round the internet backroads.

Give us some more great insights re His cowardly & treasonous actions (and don’t fergit yer hoods!).

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Pirate77
Rochester, MN

Posted on 11/10/2009 at 8:36:10 AM

Now there is a tasteless and completely classless attempt as continually labeling critics of Obama (and his associates in the press) as racist.

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beekeeper
Rochester, MN

Posted on 11/10/2009 at 9:19:09 AM

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len9807
mantorville, mn

Posted on 11/10/2009 at 9:23:44 AM

Othelmo__
Rochester, MN
Posted on 11/8/2009 at 8:58:19 PM

Paul Krugman is the same Keynesian economist who claims Obama’s porkulus “worked,” in spite of 10.2% unemployment, and, therefore, we should have another one. Genius.
---
Either economic philosophy can be successful, but neither seem to work well in conjunction. I think the respective parties have completely forgotten what system they are supposed to run with and the hibred versions are like a dog chasing his tail.

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len9807
mantorville, mn

Posted on 11/10/2009 at 9:31:29 AM

I think the republicans in office secretly want insurance reform legislation to pass. Did you read the StarTrib today? Pawlenty kills GAMC, makes himself look like a cost-cutting wunderkind, but really just shifts the cost to local taxpayers. “No new taxes,” but plently of sneaky cost-shifting. If insurance reforms pass, the republicans are released from caring about poor folks going without health care, but get to keep their conservative veneer.
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Pawlenty is getting very political these days. By that I mean, he is railing against things his conservative base dislikes, but conveniently forgot that he voted for the things he now rails against: stimulus, cap and trade, alternative energy etc..etc..

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ElGuapo
GoingGalt, MN

Posted on 11/10/2009 at 10:08:17 AM

Krugman knows this entire healthcare debacle is a job killer. But he is OK with lying to the public in order to “get the job done.”

He knows full well that passing healthcare costs on to the employer will raise employment costs. Resulting in increased costs to the consumer. The employer isn’t going to just eat their increase costs. You will pay.

Or, the employer could “play the game” and decrease payroll until that magic “small employer” threshold is hit. If the number is 25, look for the employer to cut down to 24. 50? Cuts until 49.

Krugman knows that employers cannot be told that they HAVE to do anything. Least of all, stay in business. Employers don’t HAVE to provide health insurance. They don’t HAVE to provide a pension. They don’t HAVE to negotiate with a union. But Krugman will tell you that anyway, so you don’t HAVE to think about it.

Krugman will tell you that insurance companies will HAVE to cover everyone, regardless of preexisting conditions. That they HAVE to sell you a policy. But what doesn’t Krugman tell you? He won’t tell you that insurance companies don’t HAVE to keep selling health insurance.

But let not your heart be burdened by any of this. The “public option” will be there for you. Just like the $37 billion unfunded Medicare option is there currently.

Elections have consequences. This is the current one.

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