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"Message discipline"

C'mon, Paul. You must know your latest column isn't all true, and what's true is nothing like the whole truth. Do you really believe we can fix it later?

What would work?

Wrong question. The right question is what does work. To answer that question, we might look at systems that pay at most half what we pay per capita, and all of which have better health outcomes: Canada (single payer). France (like single payer). The UK (socialized medicine). Taiwan (single payer). And so forth. Why aren't we doing that? More importantly, why weren't you building the case for it?

By all means, let’s ban discrimination on the basis of medical history — but we also have to keep healthy people in the risk pool, which means requiring that people purchase insurance.

Wrong. It doesn't "require" that. And if the experience of countries above is any guide, keeping healthy people in the risk pool might require abolishing insurance companies entirely ("Everybody in, nobody out"). The real question is Anthony Weiner's: What value do the insurance companies add to the transaction? None of the defenders of our murderous system of health "care" for profit have ever been able to answer that question. Not even you, Professor Krugman. So why are we bailing them out by guaranteeing them a market? Why isn't that part of the conversation? More importantly, Professor Krugman, why didn't you make it part of the conversation?

This, in turn, requires substantial aid to lower-income Americans so that they can afford coverage.

Wrong. See above; the reason is the same. Moreover, forms of "aid" "required" are very, very different. There's the "aid" supported by "progressives," where you've got to be poor enough to get covered, and lose enough assets, like your house. That would be Medicaid, which will also be under constant assault as a politically toxic welfare program; the "excise tax" is foretaste of the coming race to the bottom. Now, the "aid" "required" could have been Medicare, a true single payer program people support, progressively expanded to the entire population over time. Which do you support, Professor Krugman, and why? And if the good choice is not "politically feasible," why didn't you try to make it so?

And if you put all of that together, you end up with something very much like the health reform bills that have already passed both the House and the Senate.

"Something very much like."* Indeed. I can think more precise and evocative descriptions, but let that pass.

What about claims that these bills would force Americans into the clutches of greedy insurance companies?

Wrong. That's not a "claim." That's a fact. The mandate "forces," by definition, and the insurance companies are greedy, as shown by the "sky-high rate increases" that you mention a mere twelve paragraphs back. Worse than being wrong: Sloppy writing. I mean, if you're going to distort the position of your opponent, you should at least make sure the distortion isn't trivially easy to point out!

Well, the main answer is stronger regulation...

Wrong. The main answer is to eliminate the need to regulate insurance companies by eliminating them entirely. Why? Because otherwise they'll just game the system again, for example by using "wellness incentives" as a backdoor to reinstating pre-existing conditions. And guaranteeing the insurance companies a market, which is what the mandate does, just makes it easier for them to buy more congresscritters, regulators, and shills.

But it would also be a very good idea, politically as well as substantively, for the Senate to use reconciliation to put the public option back into its bill.

Wrong. If [a|the][strong|robust|triggered]? public [health insurance]? [option|plan] has ever been anything else than a marketing slogan, it is one now. Why? Because nobody knows what's in the bill Obama's cooking up!**

Who kidnapped Paul Krugman? Partial truths, false statements, bad writing... It's almost like he's turning into an access blogger!

NOTE * Very like, forsooth:

Ham. Do you see yonder cloud that ’s almost in shape of a camel?
Pol. By the mass, and ’t is like a camel, indeed.
Ham. Methinks it is like a weasel.
Pol. It is backed like a weasel.
Ham. Or like a whale?
Pol. Very like a whale.

When "message discipline" forces a formerly progressive firebrand like Krugman to channel Polonius, we know we're in a very bad way. What does the White House have on these guys?

NOTE ** Who knows? Maybe the words "public option" will be used. I'm sure "progressives" would trade, oh, women's rights for a few moments of semantic triumphalism. In a heartbeat! Because that's really, really gonna help when the next billing cycle comes round...

UPDATE Keeping the useless as tits-on-a-bull so-called "public option" firmly in place as the farthest left policy option in legitimate discourse (the Overton Window) is message discipline, so far as I'm concerned.

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chicago dyke's picture
Submitted by chicago dyke on

(paraphrasing) "they make up about 1/6 of our economy. getting rid of them would crash the economy and throw millions out of work." Sen. Landrieu

and another argument i've read has to do with investments and retirement funds. apparently (and i wouldn't know cause i aint got any) lots of big pension funds and other investment schemes revolve around people putting money into insurance company stocks. insurance companies tank, and grandma public school teacher will have to eat dog food when she retires.

progressives need to develop arguments and plans that address these concerns, regardless of how legit they may or may not be. lots of Serious people believe them, so that's the problem/challenge.

Submitted by lambert on

My thoughts:

1. If true, 1/6 of the economy's devoted to murdering people with spreadsheets. That should change on moral grounds alone, but I can't believe it's "good for the economy" either. Parasites never are.

2. With single payer, they could get real jobs either taking care of people or in new coding opportunities that appear.

3. The productivity increase from allowing people to shift to jobs they want, or start new business, more than outweigh the job losses.

4. I don't recall this argument being made for the steel industry, or the IT industry, which were actually productive. So why are we making it for an industry that adds no value whatever?

NOTE Financial implications make the censoring motive crystal clear, given that Golden Sacks runs the government.

MoveThatBus's picture
Submitted by MoveThatBus on

All health insurance providers should be given a timeline in which they must return to Not-For-Profit status and perform the service intended. The idea of investing in health insurance is repulsive as it encourages denial of services and making a buck for the investors. Not all large health insurance companies are publically traded, but that doesn't stop them from acting like they are: sharing their profits with management and employees rather than lowering premiums, increasing payments to the providers, or improving coverage for their members.

The instant an industry becomes open to investors, the entire focus of the industry changes and the only people being considered are the shareholders.

Submitted by lambert on

It's certainly conducive to better health for some, including and especially artificial persons.

Submitted by Anne on

the insurance companies at the upper levels, those who sit on the boards of directors of these companies, those who own stock in these companies are all experiencing the rosy glow that comes from watching the profits stack up.

I have a friend whose sister works for BC/BS here in MD; lest anyone think that working in middle management and lower levels exempts these people from having to jump through the bureaucratic medical hoops the rest of us do, think again.

In addition to paying more if she isn't willing to be weighed and her body fat calculated, she has suffered for years from endometriosis and has been begging for a hysterectomy, which her doctor had been trying to get approved forever. Instead, she has had to proceed through numerous steps that have involved invasive testing, multiple drug regimens and other procedures before they finally allowed her to have the operation.

This is wrong on so many levels it's unconscionable.

chicago dyke's picture
Submitted by chicago dyke on

it's not enough to say "new jobs will appear," even tho you are likely correct. we've got to have a clear plan that says, "the paper pusher who used to work for Aetna will receive a subsidy for X months, job training, and mortgage payment protection, once USP is passed." something like that has to be included. what are your ideas for protecting people with stock portfolios heavily invested in insurance companies? let's just assume for argument's sake that they are a significant number of people, Little People, even.

Submitted by lambert on

... would be easy enough to demolish. The California Nurses Association claims 2.6 million created. Tendentious, I'm sure, but unions do tend to like job creating programs...

Less so is the stock portfolio argument (though, again, I don't see this argument being made anywhere else, so why are the serious people privileging the health insurance companies?)

Since all the countries I've listed have done just fine -- Canada, for example, seems to have survived just fine -- I can't imagine the issues aren't soluble. Got time for a post?

With the caveat, of course, that our financial overlords haven't pissed this money away, too, so if anybody comes looking for it, it won't be there.

Submitted by hipparchia on

there are provisions in hr676 for up to years' worth of unemployment/training funding for the low-level paper pushers that would be displaced.

iirc [can't find the link i had] ira and 401k accounts aren't heavily invested in health insurance, but pension funds might be in trouble if the health insurance industry contracted or disappeared and the govt might have trouble bailing them out, which probably at least partly explains their willingness [and probably the necessity] to bail out wall street.

Submitted by jawbone on

but they do not make up the entire health industry's portion of the economy. That encompasses businesses and people who do indeed add value: hospitals, medical workers, support staffs (albeit some of the accounting, billing, bill collecting employees will no longer be needed), EMTs and other rescue personnel, etc.

The Big Health Insurance Parasites just suck up much needed money from the nation's economy and force doctors and hospitals to spend high amounts to handle the bureaucracies and gotchas of the parasites. Egregiously, they demand the time of highly trained medical experts to just fight for treatment of their patients.

dr sardonicus's picture
Submitted by dr sardonicus on

Some thought also needs to be given to the possibility that a serious reduction in health care costs could trigger a general deflation, with ramifications to the general economy well beyond the health care system.

gqmartinez's picture
Submitted by gqmartinez on

It was stupid then and is stupid now. Further, it was grossly wrong then. I'd be surprised if any normal person* took that person seriously. Its not an argument worth giving more play than it would otherwise get. Part of the conservative strategy is to make outrageous claims and then rely on the refutations to give the stupid argument more airtime. (Does anyone remember how quickly the latest anti-Clinton book fell off the map when the Clinton camp didn't waste time on it?)

* by "normal" I mean people *not* in the Vilage or trying to be in Versailles.

dr sardonicus's picture
Submitted by dr sardonicus on

I do think, though, that one must be careful when presuming that shrinking activity in one economic sector will be made up for by activity in others.