Krugman: Health Reform Realities

[flpoljunkie]

Health Reform Realities
Paul Krugman Paul Krugman
JAN. 18, 2016

Health reform is the signature achievement of the Obama presidency. It was the biggest expansion of the social safety net since Medicare was established in the 1960s. It more or less achieves a goal — access to health insurance for all Americans — that progressives have been trying to reach for three generations. And it is already producing dramatic results, with the percentage of uninsured Americans falling to record lows.

Obamacare is, however, what engineers would call a kludge: a somewhat awkward, clumsy device with lots of moving parts. This makes it more expensive than it should be, and will probably always cause a significant number of people to fall through the cracks.

The question for progressives — a question that is now central to the Democratic primary — is whether these failings mean that they should re-litigate their own biggest political success in almost half a century, and try for something better.

My answer, as you might guess, is that they shouldn’t, that they should seek incremental change on health care (Bring back the public option!) and focus their main efforts on other issues — that is, that Bernie Sanders is wrong about this and Hillary Clinton is right. But the main point is that we should think clearly about why health reform looks the way it does.

more...

http://www.nytimes.com/2016/01/18/opinion/health-reform-realities.html?ref=opinion&_r=1

[sufrommich]

1. Krugman expresses my thoughts on health care.

Incremental change is realistically what we can hope for and convincing people with great health care (like the majority of union workers) to give that up is next to impossible.

[tazkcmo]

3. And fuck the dying.

Nice to have the luxury to wait.

[Thinkingabout]

2. There are some issues which is included in the ACA which needs to stay in place.

The pre-existing conditions had been used for years to deny claims. There are many more, is there a need to improve ACA, yes, like removing a governors ability to refuse Medicaid expansion and thereby hurting citizens in a state. Recently Kentucky new Republican governor has changed their acceptance and in Louisiana the new Democrat governor is going to accept Medicare expansion. The Republican punishes their citizens, the Democrat governor rewarded their citizens.

[CTyankee]

4. I am of the mind now that agrees with Krugman. The well has been poisoned on health care in

terms of public opinion. Once the ACA is experienced by the public as working we can move to improve it. And the longer repubs talk about "repeal" and doesn't come up with a damn thing to "replace" it, well, folks will catch on and ask "what's the deal, guys?" And they'll get a big fat NOTHING...

[MeNMyVolt]

5. Rec. The Krug nails it again.

[NCTraveler]

6. K&R. Krugman is about to find out about his "social media" friends.

First he educates people on the Paul "audit the fed" Tea Party legislation supported by Sanders, now this. Put on your helmet Krugman.

[oasis]

7. We don't have the luxury of playing "Let's Make a Deal" with a GOP

Congress. Give up what what we have NOW for a chance at Door 1,2 or 3. These are people's live we'd be putting at risk.

[Armstead]

10. So we should do nothing...okay. I get it

[oasis]

12. Roll the dice with the GOP on the chance THEY would help

build a better healthcare system. Good luck with that.

[Armstead]

14. No, fight the GOP on it. And sell the merits to the public.

That, at the very least, moves in the right direction.

Not even trying guarantees failure.

[oasis]

15. As if a mainstream corporate media will give Bernie a microphone.

Not going to happen.

[Armstead]

16. I think if he were the nominee or president they might -- and.....

it's not up top him alone. Part of the purpose of this enterprise is to inject some energy and encourage the Democratic Party to have some backbone and stand up as the representatives of such liberal/progressive goals.

[Doctor_J]

8. professor Krugman, like too many in the personality cult, is now against healthcare for all

just because it would undo Obama's "signature legislation". many would rather keep our worst-in-the-world system than admit it was a huge gift to big insurance and PHARMA. I hope(and am pretty sure) that Krugman is honestly deluded and not on the take from the insurance lobby.

[Jefferson23]

9. There is no re-litigating the merits of universal health care, support for that

is undeniably strong per Obama as well. The reason we do not have universal
health care is due to lobby control and Sanders wants THAT conversation
front and center and urges Americans to become actively involved in the
political process now and after the election...big difference.

[EndElectoral]

11. If Medicare is hailed as our best achievement in 50 years, why shouldn't it be used as our model?

[in_cog_ni_to]

13. Why are Liberals, Democrats and Progressives against ALL their fellow citizens having healthcare?

Robert Reich Facebook post:

22 hrs ·

Today, Bernie Sanders will be unveiling the details of his single-payer healthcare plan. I've seen it, and it's a huge advance over what we have now. The Affordable Care Act is an important first step towards the goal of universal health care -- insuring more than 17 million Americans who had lacked health insurance. But 29 million Americans still lack health insurance, and millions more can’t afford to see a doctor because of high co-payments and deductibles. And the nation continues to spend a higher percent of our total economy on health care than any other advanced nation while getting the worst health outcomes. We must move to a universal single-payer system, as in almost every other advanced nation.

Bernie’s plan isn't nearly as radical as it will be portrayed. It builds on the strengths of Medicare. Like Medicare, it's universal -- separating health insurance from employment, and enabling people to choose a health care provider without worrying about whether that provider is in-network: All they’d need do is go to the doctor and show their insurance card. No more copays, no more deductibles and no more fighting with insurance companies when they fail to pay for charges.

Through a single national insurance system, we’ll no longer be paying for the marketing and advertising of private for-profit health insurers, nor their giant executive salaries, or their complex billing systems. Government will negotiate fair prices with drug companies, hospitals, and medical suppliers.

I’ve looked at the savings and the costs in Bernie’s plan, and it will work. The United States currently spends $3 trillion a year on health care —nearly $10,000 per person. Bernie’s plan will save American families and businesses over $6 trillion over the next decade. The typical middle-class family will save over $5,000 a year; the typical business will save over $10,000 a year. The costs for families and businesses will be far less than these savings.

Take a look at the plan when it's released later today and let me know what you think.

--------------------------
Healthcare is a matter of LIFE AND DEATH. It's hard to believe there's people on this forum advocating against MEDICARE FOR ALL.

[Nanjeanne]

17. Did I miss something?

Did Hillary call for a Public Option in her plan for healthcare? On her site I see she is going to:

Defend Affordable Care Act (last I looked it didn't have a public option in it)
Build on it to expand affordable coverage (no details on how she will achieve this)
Slow growth of overall health care costs including prescriptions drugs (how?)
Make it possible for providers to deliver the very best care to patients (I think we all want that!)

Lower out of pocket costs like copays and deductibles (she tells us how deductibles have risen but she doesn't say what she would do about it)

Reduce cost of prescription drugs. (I know she tweeted she would put a cap on prescriptions drugs but I haven't seen any details about this. Her website says "Hillary believes we need to demand lower drug costs for hardworking families and seniors." OK - I demand lower drug costs. Did it work?)

Transform our health care system to reward value and quality. (I'm not exactly sure what this means but I'm all for quality when it comes to healthcare!)

I haven't found anything in detail on her website and when I google Hillary Clinton Healthcare Plan - I just get articles. Would love to see her complete plan.

So - in terms of what Krugman is saying, based on what I can find - it sounds like with Sanders pushing for Medicare 4 All - bringing back the public option into the ACA would be more likely in a Sanders administration and I see no evidence that Clinton would be pushing for this in anything she has said. I don't really think I've ever heard words like "I will fight to bring back the Public Option to improve the ACA". Sorry Paul - Hillary isn't right about it based on anything she has said.