Obamacare, The Unknown Ideal

[n2doc]

Paul Krugman-

No, I haven’t lost my mind — or suddenly become an Ayn Rand disciple. It’s not my ideal; in a better world I’d call for single-payer, and a significant role for the government in directly providing care.

But Ross Douthat, in the course of realistically warning his fellow conservatives that Obamacare doesn’t seem to be collapsing, goes on to tell them that they’re going to have to come up with a serious alternative.

But Obamacare IS the conservative alternative, and not just because it was originally devised at the Heritage Foundation. It’s what a health-care system that does what even conservatives say they want, like making sure that people with preexisting conditions can get coverage, has to look like if it isn’t single-payer.

I don’t really think one more repetition of the logic will convince many people, but here we go again. Suppose you want preexisting conditions covered. Then you have to impose community rating — insurers must offer the same policies to people regardless of medical history. But just doing that causes a death spiral, because people wait until they’re sick to buy insurance. So you also have to have a mandate, requiring healthy people to join the risk pool. And to make buying insurance possible for people with lower incomes, you have to have subsidies.

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http://krugman.blogs.nytimes.com/2014/03/31/obamacare-the-unknown-ideal/?_php=true&_type=blogs&smid=re-share&_r=0

[VanillaRhapsody]

1. Then run for office and do it yourself Paul Krugman....see how well YOU do!

Good Luck with that....

[ProSense]

2. He's right

And what you’ve just defined are the essentials of ObamaRomneyCare. It’s a three-legged stool that needs all three legs. If you want to cover preexisting conditions, you must have the mandate; if you want the mandate, you must have subsidies. If you think there’s some magic market-based solution that obviates the stuff conservatives don’t like while preserving the stuff they like, you’re deluding yourself.

Republicans like to push stuff, but their proposals don't hold up because the ultimate goal is not protecting people, it's about a "market-based solution" based on gimmickry.

Previously, Krugman explained the disconnect, citing what Jonathan Chait calls the "Heritage uncertainty principle":

And here’s the thing: Republicans don’t want to help the unfortunate. They’ll propound health-care ideas that will, they claim, help those with preexisting conditions and so on — but those aren’t really proposals, they’re diversionary tactics designed to stall real health reform. Chait finds Newt Gingrich more or less explicitly admitting this.

http://krugman.blogs.nytimes.com/2013/12/13/a-health-care-mystery-explained/?_r=0

Republican proposals are hypothetical and theoretical BS, which differ greatly from the current law in approach (the details matter), and doesn't offer everything Obamacare does. That's because Republicans have no intention of doing anything positive. They get credit for pushing things that they don't actually support and would never enact. They still do. Look at how the media hyped aspects of Ryan's budget while ignoring all the damaging crap in it and without exploring the details. Easy to stay "strength Medicare" when he means destroying it.

It's like Romney's veto of the most significant parts of the MA health care law.

It's like the AEI asshole pushing that Republicans should stand up for the safety net when his actual message is the poor should support destroying it.

Naked Blackmail

It turns out that in the final stages of the debt negotiations, Republicans suddenly added a new demand — a trigger that would end up eliminating the individual mandate in health care reform.

This is telling, in a couple of ways.

First, the health care mandate has nothing to do with debt and deficits. So this is naked blackmail: the GOP is trying to use the threat of financial catastrophe to impose its policy vision, even in areas that have nothing to do with the issue at hand, a vision that it lacks the votes to enact through normal legislation.

Second, this is a demand Obama can’t accept, unless he plans on changing his party registration. Health reform doesn’t work without a mandate (remember the primary? Maybe better not to). And if health reform is undermined, Obama will have achieved nothing. So by adding this demand, Republicans were in effect saying no deal — unless, I guess, they believed that Obama is a total pushover.

Awesome.

http://krugman.blogs.nytimes.com/2011/07/23/naked-blackmail/

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