I wandered over to the New York Times to check out its latest online editorials and opinion columns and was met with Krugman's latest piece on the entire healthcare reform debate.
I'm actually pretty surprised not to have seen a front page post or diary on this particular column. I did a search over the past three days on "Krugman" and got back some stuff, but nothing really germane to the column most recently posted. So I press forward. :)
More over the fold.
I have to admit - Krugman has been such a vocal contributor to the HCR discussion and, often, a stinging critic of the Administration and Congress as it's ground on and on over the past year. I always open his columns with some measure of trepidation because so often they've been replete with dire news and provided very little to look forward to. I'm not saying he wasn't right - only that it was difficult at times to hear his take on HCR and find nothing but bad news. The fact that it was true only made it worse somehow.
But I value and respect Krugman's input, so even though I always suspected I wasn't going to like what I was going to hear (read), I still read him whenever I'm able to ensure I have as complete a picture of the HCR effort as possible in front of me.
So imagine my surprise today when I opened his column and saw this sentence as his opening:
Health reform is back from the dead.
My eyebrows raised a little. I felt a little clammy, though, suspecting that as I read onward my bubble would be burst by some solid piece of evidence. I came to this:
(On healthcare reform myth #1, that HCR represents a government takeover of 1/6th of the economy)
Well, if having the government regulate and subsidize health insurance is a "takeover," that takeover happened long ago. Medicare, Medicaid, and other government programs already pay for almost half of American health care, while private insurance pays for barely more than a third (the rest is mostly out-of-pocket expenses). And the great bulk of that private insurance is provided via employee plans, which are both subsidized with tax exemptions and tightly regulated.
Krugman goes on to explain and reiterate that the goal of the current HCR effort is to address that part of the market that is NOT already regulated so that people who currently want and can't gethealth insurance will be able to do so. He ends this section with: "What's wrong with that?"
So the clammieness is departing my palms, but I can still feel my stomach a little clenched as I prepared to read further into his column, figuring that the other shoe (the bad one) would soon drop.
(On healthcare reform myth #2, that the proposed HCR does nothing to control costs)
To support this claim, critics point to reports by the Medicare actuary, who predicts that total national health spending would be slightly higher in 2019 with reform than without it.
Even if this prediction were correct, it points to a pretty good bargain. The actuary’s assessment of the Senate bill, for example, finds that it would raise total health care spending by less than 1 percent, while extending coverage to 34 million Americans who would otherwise be uninsured. That’s a large expansion in coverage at an essentially trivial cost.
And it gets better as we go further into the future: the Congressional Budget Office has just concluded, in a new report, that the arithmetic of reform will look better in its second decade than it did in its first.
Krugman then adds that his assessment is that the CBOs projections are pessimistic.
By now my stomach has settled down, but I realize that my fists are still kind of clenched, which is something I do kind of unconsciously when I'm nervous or have some level of anxiety. Then I come to his closing:
For a real piece of passable legislation, however, it looks very good. It wouldn’t transform our health care system; in fact, Americans whose jobs come with health coverage would see little effect. But it would make a huge difference to the less fortunate among us, even as it would do more to control costs than anything we’ve done before.
This is a reasonable, responsible plan. Don’t let anyone tell you otherwise.
Now I'm fully relaxed. In the process of reading a Krugman column, it's like I've gottena full body hot stone massage. A pleasant surprise and totally unexpected.
I am not the expert on HCR that Slink or Eve or some others around here are. I do try to read everything they and other contribute, as well as read in both traditional and non-traditional outlets about reform. But let's face it - the details are sometimes confusing to those who are not industry insiders (shrug). I turn to Krugman for kind of an unvarnished, liberal's view of the overall legislation and especially its cost/benefit analysis frequently. And I am well pleased with what he wrote this time around.
As he says - he would have MUCH preferred Medicare for All, but recognizes that this has wound up largely unpassable. So he's focusing on a passable version of the legislation.
This actually made me feel a lot better. But I'm sure our resident experts will give me other things to think about in the comments if this gets any visibility. ;)
Update [2010-3-12 14:49:2 by RenaRF]: First, I would like to say THANK YOU to everyone commenting whether pro or con. It's a good discussion with a lot of information as well as an honest expression of concern. Kudos to us all for (so far!) keeping it focused and respectful.
I have to go AFK for a bit but I'll look forward to reading the comments when I'm back!