Krugman: Hillary's health care plan better than Obama's

From http://www.nytimes.com/2008/02/04/opinion/04krugman.html?hp:

"If Mrs. Clinton gets the Democratic nomination, there is some chance — nobody knows how big — that we’ll get universal health care in the next administration. If Mr. Obama gets the nomination, it just won’t happen."

If his base were saying they didn't want to pay taxes for universal health care, that would be one thing. But what I'm hearing them say is that they want universal single payer. Of course, universal single payer, as implemented in Europe results in higher taxes, but gives everybody coverage, its a trade off. In these countries, to my knowledge you can't opt out of the coverage (mandate) and you can't opt out of the tax. ("garnishment" as I have heard it called today) So Hillary's plan is, once the media spin gets removed, closest to what they say they want. How they intend to get closer to universal single payer without requiring people pay for it or recieve the coverage truly baffles me...which is why these things will get them right in the butt down the road.

http://www.pnhp.org/news/2008/january/doctors_give_massach.php

Posted on January 14, 2008
Doctors Give Massachusetts Health Reform a Failing Grade - Poor Early Outcomes Raise Red Flags, Only Private Insurers Profit

For Immediate Release

Contacts:
Dr. Rachel Nardin, 617.667.4382
Dr. David Himmelstein, 617.665.1032
Todd Main, 312.782.6006

Over 250 Massachusetts doctors have signed an open letter to the country warning that the health reform model enacted by Massachusetts is failing and that a single payer program is the only alternative.

“It is urgent that the rest of the country know that Massachusetts is a living laboratory for the health care reforms being pushed in California and by the Obama/Clinton/Edwards campaigns. Right now the Gov. Romney/Massachusetts’ plan gets a failing grade on the ground,” said Dr.Rachel Nardin, Assistant Professor of neurology at Harvard Medical School.
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While patients, the state and safety net providers struggle, private insurers have prospered under the new law, and the costs of bureaucracy have risen. Blue Cross, the state’s largest insurer, is reaping a surplus of more than $1 million each day, and awarded its chairman a $16.4 million retirement bonus even as he continues to draw a $3 million salary. All of the major insurers in our state continue to charge overhead costs five times higher than Medicare and eleven-fold higher than Canada’s single payer system. Moreover, the new state agency that brokers private coverage adds its own surcharge of 4.5% to each policy it sells.

A single payer program could save Massachusetts more than $9 billion annually on health care bureaucracy, making universal coverage affordable. But because the 2006 law deepened our dependence on private insurance, it can only add coverage by adding costs. Though politically feasible, this approach is already proving fiscally unsustainable. The next economic downturn will push up the number of uninsured just as the tax revenues needed to fund subsidies fall.

The lesson from Massachusetts is that we still need real health care reform: single payer, non-profit national health insurance.

From http://krugman.blogs.nytimes.com/2008/02/02/misinformed-on-massachusetts/:

"While we’re talking about health care reform: I’ve been getting a fair bit of mail from people who have heard that things are going very badly in Massachusetts. And there have, indeed, been some very downbeat reports in the media lately.

The problem is that they’re all wrong. People are confusing an increase in costs that was largely (not completely) anticipated — after all, the plan is supposed to cover more people, and subsidize their coverage — with a cost overrun.

The fact is that the plan does seem to be making a serious dent in the number of uninsured. One thing that has come to light is that there may have been more uninsured people in Massachusetts to start with than previously estimated, so there’s a steeper hill to climb. But claims that it’s all a disaster are based on nothing but bad journalism."

In addition to premiums rising, the costs to the state of MA are rising because of the underestimation of uninsureds.

Krugman gets it wrong in that he is looking at the cost to the state to cover more people while I am looking at the increasing costs per insured.

Take a look at his link...all he does is cite the budget shortfall.

But as far as I remember, Krugman has said that the Clinton plan can develop into a single payer system over time. So costs in Massachusetts today because of insurance companies is not an argument against universal health care or the Clinton plan - since the Clinton plan is the only way of getting rid of the insurance companies over time.

even further.

That looks self evident to me.

It's a trick, get it passed in the senate, saying "It's private company based," and then the private companies can't compete with the government subsisidzed side of things, pow, single-payer.

I dunno. It seems like all the good stuff is impossible to get passed.

However, in reality, monopolies outcompete all others, a government monopoly could be run as efficient as any big corporation (one reason I find capitalism funny is how it trends towards monopolization and corporatization).

So I think it would readily get passed because no one on the "market side" would consider the government the biggest competitor.

Mandating health insurance is necessary to get universal health care. But once you got universal health care, this can develop towards a single payer system over time. Read e.g. Krugman's blog here:

http://krugman.blogs.nytimes.com/2007/10/07/why-not-single-payer/?scp=1-b&sq=krugman+insurance+companies+single+&st=nyt.

Why it must be true!

:eyes:

Krugman supported Edwards.

Also it's unfortunate and ultimately damaging to Obama that so many of his supporters arguments in his defense consist solely of attacking the messenger rather than the message.

In other words, he can't back down from his flawed plan now if he wanted to.

in the 2006 election. Remember Hillary and Obama? Don't act like this is a new issue. We debated it already.

I think the average Democratic voter is thinking of a true universal health care plan, which would eventually require regulation( of doctors, insurance, hospitals) to hold costs down. The plans they are presenting would be something the insurance cos would be able to live with, which means continued excessive charging, bonuses for executives, etc. When you take big money from these industries there are IOUs to be paid back. Why aren't we talking of comparative systems to European models? Maybe because, as usual, the corporations need to be satisfied. Anyway, I hope I'm wrong, but we do need much more 'truth' in this worthy discussion.

Dennis Kucinich said, it would be cheaper too.

Right now you don't get much for your money when you do visit a doctor. They are so busy working to get enough to run their office and big houses. They are stressed from the insurance companies. Drug companies pay their vacations, etc.

BTW, how many political campaigns has he won?

Here are some things to consider:



And it turns out that:



Arizona governor Janet Napolitano agrees:



Not directly related, but also interesting - Professor Brad DeLong on Obama's economic stimulus plan (and Krugman's criticism of it):

I've always admired Krugman, and to some extent, I still do. But there's no denying that he really has a stick up his butt when it comes to Obama.

neither of which contribute anything to the actual delivery of effective and efficient healthcare . . . all they do is siphon off a huge percentage of every healthcare dollar for their own profit -- and to help fund political campaigns of those who will ultimately guide healthcare decision-making . . . a disgusting system if ever there was one . . .

He's hardly an honest broker here...

His partisanship has erased any belief in his integrity from his op-eds, IMO.

I'm for Clinton, but one-note Krugman has lost it, IMO

debunked and smacked down.

It's sad to think that I back her policies more than another finalist for the nomination, but I do. The question of electability looms large, but his policies are the same mollifying, bullshit cozying-up-to-the-despicable that characterized Bill Clinton's, and we're being swept up with a faddish frenzy based on nothing.

She is now to the left of him, and it's tiresome that his acolytes won't at least admit that; it's almost like a Dean redux: he was basically the most conservative candidate in the '03-'04 contest, yet constantly hyped as the most liberal.

Bad mood here. Must stop.

Single payer now!