Paul Krugman is For Single-Payer Healthcare
Fri Dec 07, 2007 at 09:11:54 PM PDT
I've seen a couple of diaries recently, including this one today, taking Krugman to task for his support of mandates in the Democratic healthcare plans (in clear opposition, therefore, to Obama's plan). He's been called a hack, a neo-liberal who's looking out for the interests of for-profit health insurance over the interests of consumers, and has been smeared in any number of ways.
It's been asked why he supports mandates instead of single-payer healthcaere.
Well, here's the thing: he doesn't. But don't take my word for it. Try looking at everything Krugman has been saying on health insurance the past few months instead of just focusing on one column.
Two months ago, Krugman actually responds to the question of why the current Democratic plans are not proposing a single payer system. Krugman's take?
A number of people, including Atrios (who happens to be a trained economist) and Matthew Yglesias have been wondering why, exactly, the Democratic plans for health care involve such complicated schemes. The generic Demoplan, which basically follows the template laid down by John Edwards, involves four moving pieces: community rating, requiring that insurance companies offer insurance to everyone at the same rate regardless of medical history; a mandate, requiring that everyone have insurance; subsidies to help lower-income people pay for insurance; and public-private competition, in which people have the option of buying into a plan run by the government.
The alternative would be single-payer, aka Medicare for all: a payroll tax on everyone, and a government insurance program for everyone. Wouldn’t that be simpler, easier to administer, and more efficient?
Yes, it would. I myself described the Schwarzenegger plan in California, which contains all these elements except the public-private competition, as a "Rube Goldberg device — a complicated, indirect way of achieving what a single-payer system would accomplish simply and directly. "
He goes on to affirm that:
In an ideal world, I’d be a single-payer guy. But I see the chance of getting universal care, imperfect but fixable, just a couple of years from now. And I want to grab that chance.
It is in this context we need to understand his discussion of mandates. Krugman is not advocating these cobbled together mixes of government assistance, private insurance and government mandates as a substitute for a single-payer system. He's advocating it as something that can be achieved politically in 2009.
So agree or disagree with Krugman on whether single-payer can be achieved in 2009. Agree or disagree with him on whether mandates are politically manageable. But please, don't distort him into someone who is opposed to a single-payer system. Single-payer is what he wants, and he's stated as much in many of his columns over the past couple of years.
My personal opinion on mandates: if we're going to fix two of the current problems with healthcare-- the fact that insurance companies are allowed to reject applicants based on their health, and the fact that so-called "pre-existing conditions" aren't covered for the first year of insurance if you were previously uninsured for 60 days before receiving your new insurance-- we have to mandate coverage. Otherwise, a significant number of people would simply not buy health insurance until they became sick, which would substantially drive up the price of insurance for everyone else.
The preferred solution is universal, single-payer healthcare. Anything else is just a band-aid. But Krugman acknowledges that; he's of the opinion that a band-aid is better than nothing, and that all we can manage now is a band-aid.
So argue with what he actually says. I'm confident arguments can be marshalled against him. Just don't attribute to him views he doesn't actually hold.
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