Paul Krugman's liberal conscience has been eaten by giant vampire squid
That's the kindest explanation I can think of.
Bloggeth the formerly-liberal perfesser a few days ago:
What this suggests is that the really important thing, for reformers, is to get the principle of universality established. Once that happens, there’s no going back.
Yeah, well, I guess it helps if you define universe.
So, we're not going to help out illegal aliens when they get sick, that's in all the bills. And Massachusetts, when the money began running out, decided not to help out legal immigrants either. Guess that whole Give me your tired, your poor, your huddled masses yearning to breathe free thing is just some sappy poem engraved on some tarnished plaque on some statue standing on some godforsaken island somewhere.
God alone knows why some people want to make the baby Jesus cry, and he/she/it/they ain't tellin.
But aside from that, people like their new health insurance law, right?
Like good used car salesperson everywhere, Krugman pooh-poohs the doomsayers and points out the bright sunshine:
Liberals have held up Massachusetts as a cautionary tale: pass a reform that isn’t really good, and the public will turn sour on the whole thing.
But what the poll actually finds is that public support for the plan is holding up pretty well, given the political environment. And what’s really telling is this finding:
The poll found that 79 percent of those surveyed wanted the law to continue, though a majority said there should be some changes, with cost reductions cited as the single most important change that needs to be made.
Only 11 percent of state residents favored repealing the law, similar to last year’s finding.
What Krugman doesn't mention is that in that same poll  there's this question:
Given what you know about it, in general, do you support or oppose the Massachusetts Universal Health Insurance Law?
And what smart used car buyers everywhere know is check out the customer reviews:
How about that, support is at an all-time low and opposition is at an all-time high. Not to mention that the uninsured aren't super-keen on this law. Gee, I wonder why.
Support is also higher among those whose income more than 300% of FPL, though not by as great a difference as between the insured and uninsured, indicating that maybe those subsidies aren't generous enough.
But wait! In his column on Monday Krugman not only repeats the 79% support it claim, he adds this:
Like the bill that will probably emerge from Congress, the Massachusetts reform mainly relies on a combination of regulation and subsidies to chivy a mostly private system into providing near-universal coverage. It is, to be frank, a bit of a Rube Goldberg device — a complicated way of achieving something that could have been done much more simply with a Medicare-type program. Yet it has gone a long way toward achieving the goal of health insurance for all, although it’s not quite there: according to state estimates, only 2.6 percent of residents remain uninsured.
This expansion of coverage has tremendous significance in human terms. The Kaiser Commission on Medicaid and the Uninsured recently did a focus-group study of Massachusetts residents and reported that “Health reform enabled many of these individuals to take care of their medical needs, to start seeing a doctor, and in some cases to regain their health and control over their lives.” Even those who probably would have been insured without reform felt “peace of mind knowing they could obtain health coverage if they lost access to their employer-sponsored coverage.”
Yeah it's kludgy, but people were helped! Lives were saved! Yay!
Credit where credit is due, the focus group report does go into some detail on both the good and the bad -- people with cancer, heart disease, diabetes get care without which they quite possibly could have died, but most of these people were low-to-moderate-income and in many cases they have been left with significant medical debt.
Now I can tell you from personal experience that even with job prospects doomed by a credit rating that lies on the floor of the Marianas Trench, constant harassment from collection agencies, and every last penny of my savings gone into the maws of the medical industrial complex, alive and in debt beats dead any day of the week.
Krugman, however, doesn't mention that last part, about the debt, when he talks about the tremendous significance in human terms. Others do, though, noting that medical debt and bankruptcy in Massachusetts has not abated.
Okay, we've covered the people who weren't born here [we're not going to] and the lower-income working folks [only if we can put them into debt peonage], what about the really poor?
They used to get care absolutely free, but now often have to pay copays. This would be bad enough, but the whole design behind this 'reform' effort was to shift taxpayer dollars away from directly caring for poor people and funnel them through insurance companies first:
Preservation of the Safety Net
The existing Uncompensated Care Pool, which reimburses providers for uncompensated care, will be converted into a new Health Safety Net Trust Fund that will combine these funds with other Medicaid funds, including Medicaid Disproportionate Share Hospital funds. A new fee schedule will be developed to standardize provider reimbursement. As more uninsured gain coverage and uncompensated care drops, funds will be shifted into the health insurance subsidy program.
Yeah, we're gonna preserve the safety net by killing it.
So, I see 5 or 6 universes here: foreigners [no care], poor people and non-creative-class folks [good care, but in a your money or your life kinda way], old people [less care], rich people, and the rest of us.
This isn't an inefficient Rube Goldberg apparatus for helping people that we can fix later as we go along, it's a fairly efficient machine for transferring yet more wealth from the have-nots to the have-a-lots that will accidentally help some people along the way.
Any liberal worth their salt would have called bullshit on this long ago, and would still be calling bullshit on it even today.