[CONTENT NOTE: profanity.]
Via Loyal Subject™ SJ cometh a link to a Paul Krugman post at truthout entitled “US Health Reform Keeps Insurance Companies in the Mix, No Matter the Cost.” Not for the first time, he lays out a false dichotomy between single-payer and the ACA:
Obamacare is not complicated because government social insurance programs have to be complicated: Neither Social Security nor Medicare is complex in structure…it’s complicated because political constraints made a straightforward single-payer system unachievable.
So… the implementation problems aren’t revealing problems with the idea of social insurance; they’re revealing the price we pay for insisting on keeping insurance companies in the mix, when they serve little useful purpose.
Does this mean that liberals should have insisted on single-payer or nothing? No. Single-payer wasn’t going to happen — partly because of the insurance lobby’s power, partly because voters wouldn’t have gone for a system that took away their existing coverage and replaced it with the unknown. Yes, Obamacare is a somewhat awkward kludge, but if that’s what it took to cover the uninsured, so be it.
I am not impressed with Krugman on this subject. At all. I was going to write about it a month ago when he ran this op-ed in the Times, once again beating the stuffing out of his ridiculous strawman of “Obamacare-vs.-single-payer, i.e. nothing.” As if the public option (Medicare buy-in) wasn’t something many people were pushing for, and in my opinion would have been included in the ACA had Obama backed it instead of secretly selling it out early on.
It was popular with the public. It provided a real alternative to for-profit insurance companies, which nearly everyone hates except Republicans, Joe Lieberman and his healthcare lobbyist wife. It would have put real pressure on these companies to reform their unconscionable practices. The entire system’s infrastructure already exists.
The public option was the compromise, between single-payer and locking in the for-profit health system we have for at least a generation. I’m sorry, but a modest Medicaid expansion and a mandate for everyone else to enrich private insurance companies should have been flat-out unacceptable. In the wake of the bank bailouts, it would have been a piece of cake for Democrats to frame any bill without a public option as the corporate handout that it is. Nancy Pelosi delivered a House bill with a public option, yet strangely, it was DOA in the Democratic-controlled Senate. Harry Reid could have stripped Lieberman of his precious chairmanship to pressure him to back off the public option, but he didn’t do that. Reid could have killed the filibuster (which he recently did) and thus would have had the votes to pass the House bill by a simple majority. But he didn’t do that either. Why? Because Joe Lieberman and a handful of conservadems were doing President Obama’s bidding by blocking the public option in the Senate. And at the same time, Krugman was carrying water for these DINOs by writing columns entitled “Pass The Bill” and shit like this:
Bear in mind also the lessons of history: social insurance programs tend to start out highly imperfect and incomplete, but get better and more comprehensive as the years go by.
Gee, that’s a really great point, Paul. But aside from the modest Medicaid expansion, the ACA is not a social insurance program. It’s a corporate giveaway. Paul Krugman knows this, he was instrumental in pushing for its passage, and now he has the nerve to pretend it was always back and white, either/or, single-payer vs. Obamacare, this or nothing.
I have come to detest professional liberals. They do far more harm than good by selectively spinning history into lies, and worst of all, putting a lefty-flavored sauce on right-wing policies. And while I generally like Krugman’s writing on Keynesian economics, he is just way out of his depth here.
So just shut up about the ACA and single-payer Paul Krugman, because either you’re willfully bullshitting your readers or you don’t know what the fuck you’re talking about.