Krugman sure has a penchant for stating the obvious, albeit in a lucid and direct manner:
The real risk is that health care reform will be undermined by “centrist” Democratic senators who either prevent the passage of a bill or insist on watering down key elements of reform. I use scare quotes around “centrist,” by the way, because if the center means the position held by most Americans, the self-proclaimed centrists are in fact way out in right field.
Before we get into why these "centrists" are a special breed of douchenozzles, let's sift through the beginning of the article:
The polls suggest that hardly anyone does. Voters, it seems, strongly favor a universal guarantee of coverage, and they mostly accept the idea that higher taxes may be needed to achieve that guarantee.
No kidding, as I'm sure fellow Kossacks have seen the recent polls, but it's actually more profound than that; earlier this year, when asked if the government should take a more active role in regulating health care insurance, a majority of respondents have answered yes:
NBC/WSJ:
I’m going to read you two statements about the role of government, and I’d like to know which one comes closer to your point of view.
Statement A: Government should do more to solve problems and help meet the needs of people: 51%
Statement B: Government is doing too many things better left to businesses and individuals: 40%
CBS/NYT:
HEALTH INSURANCE: PRIVATE ENTERPRISE VS. GOVERNMENT?
1979
Private Enterprise: 48%
Government - All Problems: 28%
Government - Emergencies: 12%
Don't know: 12%
2009
Private Enterprise: 32% (-16%)
Government - All Problems: 49% (+21%)
Government - Emergencies: 10% (-2%)
Don't know: 9% (-3%)
CNN:
Seventy-two percent of those questioned in recent CNN/Opinion Research Corporation survey say they favor increasing the federal government's influence over the country's health care system in an attempt to lower costs and provide health care coverage to more Americans, with 27 percent opposing such a move. Other recent polls show six in 10 think the government should provide health insurance or take responsibility for providing health care to all Americans.
But Krugman also points out, a majority of voters also support the public option:
What’s more, they overwhelmingly favor precisely the feature of Democratic plans that Republicans denounce most fiercely as “socialized medicine” — the creation of a public health insurance option that competes with private insurers.
Nate Silver has a graph that pretty much says it all when it comes to the public option (though Rasmussen remains the outlier):
So really, WTF is up with these "centrist" Democrats? What fucking obstacles are there to including a "robust" health care plan? Republicans? Hardly. No... when Democrats talk about the obstacles to health care reform, they're not talking about whether a majority supports it (well, polls make clear they can't use that as an excuse). They're talking about the power and influence of interest groups to which they're tethered, all of which don't want to see a government program out-compete them.
Remember that.
There are a few other things from his article that I wanted to comment on:
For the record, neither regional health cooperatives nor state-level public plans, both of which have been proposed as alternatives, would have the financial stability and bargaining power needed to bring down health care costs.
This is true, but Krugman doesn't explain why. I frequently hear conservatives ask, "Why not just leave health care reform up to the states? Why does the federal government have to be the agent of reform?" The answer to this question is common sense though: assuming that a proposed means of health care reform delivers on affordability and cost reduction, and assuming that we live in an integrated economy (WOW, what a hard assumption to fathom!), the best way to maximize the benefits from any reform is to implement reform at the national level. Even free market fundamentalists must acknowledge this point; if they really believe in the power of the Invisible Hand to solve all health care cost ills, they know that their plans would maximize benefits if implemented at the national level!
Conservatives will continue to bleat about how the Tenth Amendment is being shat on, but the fact of the matter is that Americans live in a fucking integrated economy. One state implementing a public plan, as well as the other reforms discussed by the House, is not going to drive down health costs like the use of the federal government will as an agent of health care reform. In fact, it's generally irresponsible to talk about leaving significant fiscal reforms up to the states during a fucking recession. If it's true that health care costs contribute to the majority of bankruptcies in the states, then it seems reasonable to implement health care reform at the national level to maximally safeguard future protection against bankruptcies, which in turn will benefit our economy!
I know conservatives like to pretend that the commerce clause doesn't exist, or at least pretend that somehow health insurance doesn't fall under "commerce... among the several states" and that extending coverage does not count as "regulat[ing] it," but we don't live in a fairy tale world where fetishizing the Tenth Amendment will get us out of a recession. Jesus...
Honestly, I don’t know what these Democrats are trying to achieve. Yes, some of the balking senators receive large campaign contributions from the medical-industrial complex — but who in politics doesn’t? If I had to guess, I’d say that what’s really going on is that relatively conservative Democrats still cling to the old dream of becoming kingmakers, of recreating the bipartisan center that used to run America.
But this fantasy can’t be allowed to stand in the way of giving America the health care reform it needs. This time, the alleged center must not hold.
Meh. I don't think they're thinking that far into the future when it comes to the role of the Democratic Party. I tend to believe this has more to do with interest groups. Yes, Krugman said that the medical-industrial complex is pervasive in Washington, but right now, private insurers and their ilk hold the power, so it's not inconceivable to fathom Democrats turning to private insurer interest groups over those groups concerned with extending coverage.