Health care reform is a big issue for me, so when Paul Krugman criticized Sen. Obama several weeks ago on his health care reform proposals, I took note and even diaried about it. Most know what ensued. Krugman criticized Obama's plan for its lack of mandates. Then Sen. Obama's people responded with an attack on Krugman that many saw as an attack on Krugman's credibility. Then Krugman responded to the attack on his blog. The entire back-and-forth was also debated hotly in the blogosphere with many Obama supporters criticizing Krugman and many bloggers criticizing Obama for attacking an important progressive voice.
Then campaign news turned in other directions, the horse race and Sen. Obama's rising poll numbers took center stage, and that seemed to be that.
But in tomorrow morning's New York Times, Paul Krugman throws down another and perhaps more inflammatory gauntlet. In contrasting Sen. Obama's approach toward negotiating health care reform with Sen. Edwards, Krugman says:
Which brings me to a big worry about Mr. Obama: in an important sense, he has in effect become the anti-change candidate.
In the previous back and forth about Krugman's criticisms of Sen. Obama, a lot of emphasis was placed on Sen. Obama's choice not to include mandates in his health care plan. In this column, however, Krugman seems to be responding to the campaign zeitgeist at the moment where how the leading Democratic presidential candidates would try to achieve their policy objectives once elected is getting more focus. Krugman considers that this difference in philosophies matters:
Broadly speaking, the serious contenders for the Democratic nomination are offering similar policy proposals — the dispute over health care mandates notwithstanding. But there are large differences among the candidates in their beliefs about what it will take to turn a progressive agenda into reality.
At one extreme, Barack Obama insists that the problem with America is that our politics are so "bitter and partisan," and insists that he can get things done by ushering in a "different kind of politics."
At the opposite extreme, John Edwards blames the power of the wealthy and corporate interests for our problems, and says, in effect, that America needs another F.D.R. — a polarizing figure, the object of much hatred from the right, who nonetheless succeeded in making big changes.
Krugman then critiques how effective he believes Sen. Obama's "big table" approach to health care reform might turn out to be:
...it’s actually Mr. Obama who’s being unrealistic here, believing that the insurance and drug industries — which are, in large part, the cause of our health care problems — will be willing to play a constructive role in health reform. The fact is that there’s no way to reduce the gross wastefulness of our health system without also reducing the profits of the industries that generate the waste.
As a result, drug and insurance companies — backed by the conservative movement as a whole — will be implacably opposed to any significant reforms. And what would Mr. Obama do then? "I’ll get on television and say Harry and Louise are lying," he says. I’m sure the lobbyists are terrified.
Finally, Krugman argues the case that how successful the next president will be in obtaining health care reform will be indicative of how successful they will be overall in providing progressive reform:
As health care goes, so goes the rest of the progressive agenda. Anyone who thinks that the next president can achieve real change without bitter confrontation is living in a fantasy world.
It will be interesting to see how Sen. Obama responds to Krugman's critiques. The tension of how to achieve true change without true confrontation remains an unanswered question in Sen. Obama's quest to be seen as the true agent of change in this election.