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View Diary: Krugman: Dwindling Deficit Disorder (135 comments)

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  •  Krugman also says that when we do (1+ / 0-)
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    address the unsustainable growth of Medicare (in 10 years?), we are going to have to have, in his words, "death panels" (denying "extreme care" -- i.e., end of life care) and "sales taxes" (a VAT or something similar).

    That's not where I want to be in 10 years.  

    •  Note the date of Krugman's post (2+ / 0-)
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      Laconic Lib, elwior

      and it might help to read beyond the headline. (Not saying you didn't...)

      First, the post is dated Nov 14, 2010 when conditions were not quite what they are now. Something about an election I seem to recall that had some effect on the political atmosphere in Washington... Perhaps Krugman will revisit the issue in due time and revise and extend his remarks. At any rate, a blog post in 2010 is hardly definitive of a permanent position on dynamic issues. Things have a tendency to change over time.

      Second,  he states clearly that he was being deliberately provocative on This Week, using terms that would get a rise out of the panel (and perhaps the audience.) "Death panels" and "sales taxes" are terms that get noticed. "Adjusting medical costs downwards" and "enhancing revenues" do not.

      Third, public policy makers (and not solely through Medicare and Medicaid) are already confronting questions of outrageous medical costs  -- including the costs of extreme end of life care. Krugman doesn't refer to "denying" end of life care, he wrote about the policy question of "how much we're willing to spend" for "extreme care." That question is still open. No one I know of has a universally agreed upon answer, but more and more people are recognizing that "extreme care" is the most expensive -- and often completely futile -- option.

      Fourth, when he wrote, soon after the 2010 elections that handed House and effective Senate control to the Rs, Krugman and some others saw a VAT as the most politically feasible means of raising additional revenue. It was never proposed as the only means nor the best means. It is a means.

      Of course unlimited spending for medical care and continued reductions in government revenues are always an option...

      Blogging as Ché Pasa since 2007.

      by felix19 on Mon Mar 11, 2013 at 08:30:12 AM PDT

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      •  Sorry, he restated it in January 2013. (1+ / 0-)
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        At a speech at he gave for 6th and I..  

        Promo for the speech here.

        There are several videos of the speech on Youtube, like here and here.

        •  Sorry, nothing at that link (2+ / 0-)
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          Words In Action, elwior

          backs up your claim.

          It is an old strategy of tyrants to delude their victims into fighting their battles for them. FDR

          by Betty Pinson on Mon Mar 11, 2013 at 11:18:15 AM PDT

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          •  "The snarky version is death panels and (1+ / 0-)
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            sales taxes."  

            Did you watch the video?  

            It's a restatement of what he said in the 2010 op ed I linked to.  Here'sthe video the op ed refers to.

            He's said it a few times.  His way to handle the unsustainable growth in Medicare is the oversight review board to make decisions about what they will and won't pay for "in extreme care" as he says, along with a broad based middle class tax like a VAT.

            •  I've been reading Krugman for years (2+ / 0-)
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              Words In Action, elwior

              So, no, I'm not a sucker for these kinds of diversions.

              It is an old strategy of tyrants to delude their victims into fighting their battles for them. FDR

              by Betty Pinson on Mon Mar 11, 2013 at 11:37:28 AM PDT

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              •  Krugman's own words (1+ / 0-)
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                posted in the NYT under his name are "diversions"?  

                A video of him saying the same thing on ABC This Week is "diversions"?

                •  Yes, here they are: (5+ / 0-)
                  So, what I said is that the eventual resolution of the deficit problem both will and should rely on “death panels and sales taxes”. What I meant is that

                  (a) health care costs will have to be controlled, which will surely require having Medicare and Medicaid decide what they’re willing to pay for — not really death panels, of course, but consideration of medical effectiveness and, at some point, how much we’re willing to spend for extreme care

                  I'm sorry, but I'm a long-time health care activist, so I actually know what he's talking about.  He's referring to "medical effectiveness" or, in the parlance "evidence-based medicine".  That's the practice of providing treatment to patients based on the results of sound, scientific evidence, as opposed to the current practice by some physicians of prescribing expensive tests and treatments during end of life care that are known to not be effective or necessary.

                  Now, members of the Tea Party call these "death panels", but I'm sure you don't want to be lumped in with that group.

                  There are a large number of scholarly articles on the topic, I can provide you some links if you really want to learn more about it.

                  It is an old strategy of tyrants to delude their victims into fighting their battles for them. FDR

                  by Betty Pinson on Mon Mar 11, 2013 at 12:00:13 PM PDT

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                  •  He called it "death panels" as well. (1+ / 0-)
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                    Several times.

                    Yes, he means that, as he says in that op ed, we are going to have to make decision about what "extreme care" (end of life care) we are going to pay for.  In that January 2013 video, he says the "snarky term" is death panels, but he doesn't flinch from the notion that some oversight board is going to have to make a decision that we are not going to pay $100,000 for a treatment that has a 30% chance of increasing the life of an 80 year old for 6 months.  I understand exactly what he was talking about.  I wonder how comfortable people are with that notion.

                    He says that we will ALSO need a broad-based middle class tax increase, like a sales tax or a VAT.  (If you look at the numbers, that kind of tax raises a LOT of money.) I suspect that far fewer people are comfortable with the notion of a national sales tax or VAT.

    •  Then produce your plan (1+ / 0-)
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      for how to control health care costs.

      Discussions of Medicare costs without concurrent discussions of health care costs are specious.

      if necessary for years; if necessary, alone

      by SouthernLiberalinMD on Mon Mar 11, 2013 at 11:26:36 AM PDT

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      •  If I knew, I'd be on TV or advising the President (1+ / 0-)
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        The reason I posted is that people here rely on everything Krugman says, and they seem to forget that, along with Krugman's view that we ought to wait 10 years to address the Medicare/Medicaid issue, Krugman says that the way he thinks we are going to handle it in 10 years is by deciding what "extreme care" we will not pay for, and a broad-based sales tax or VAT.  

        If people adopt Krugman's view on "wait 10 years," are they ALSO adopted Krugman's view "and then do death panels and sales taxes"?  

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