Krugman on The Mandate Muddle

In his column today Paul Krugman on “The Mandate Muddle,” Krugman points out Barack Obama’s wrong-minded position on universal health care and the need to “include a requirement that everyone have health insurance — a so-called mandate.”

Krugman points to an imaginary scenario where Obama is elected president and in preparing to “unveil his plan for universal health care,” his “health policy experts have done the math, and they’ve concluded that the plan really needs” to include a mandate. ” “Without a mandate,” Krugman says, “they find, the plan will fall far short of universal coverage.”

Worse yet, without a mandate health insurance will be much more expensive than it should be for those who do choose to buy it.

The gist of Obama’s reticence on including a mandate appears to be that he knows “if he tries to include a mandate in the plan, he’ll face a barrage of misleading attacks from conservatives who oppose universal health care in any form.” But now, Obama has set himself up in a position where “he’ll have trouble responding” to the conservatives, because he has “made the very same misleading attacks on Hillary Clinton and John Edwards.” 

For the sake of clarity, Krugman explains the divide is deep “between Republicans and Democrats on health care,” and although Obama’s plan is “weaker than the Edwards or Clinton plans,” it is still “very much on the Democratic side of that divide.”

In using right wing talking points, which Obama seems hell bent on doing with his rivals, particularly Hillary Clinton, Krugman notes, Obama has “been giving credence to false talking points that will be used against any Democratic health care plan a couple of years from now.” He’s not helping the cause and he’s making false claims to boot. Claims that the right have touted forever and a day.

One of the biggest false claims is that “people won’t be able to afford the insurance they’re required to have — a claim usually supported with data about how expensive insurance is.” But, Krugman notes, “all the Democratic plans include subsidies to lower-income families to help them pay for insurance, plus a promise to increase the subsidies if they prove insufficient.”

And interestingly, “the Edwards and Clinton plans contain more money for such subsidies than the Obama plan.” So while Obama claims to have the better plan that will help more people get healthcare insurance, sadly low-income families who “find insurance unaffordable” under the plans offered by the Democratic contenders , will “find it even less affordable under the Obama plan.”

Krugman points to the reports on the latest meme in the news on the “limitations of the Massachusetts plan to cover all the state’s uninsured,” and says the Massachusetts plan is “actually doing much better than most reports suggest.” The “difficulty of enforcing mandates” in Massachusetts stems “from the fact that the state hasn’t yet allocated enough money for subsidies.” But, as this press release shows from The Commonwealth of Massachusetts, they are making great headway with their enrollment.

Krugman goes on to point out that “Obama is storing up trouble for health reformers by suggesting that there is something nasty about plans that “force every American to buy health care.”” Krugman is right and he explains why:

Look, the point of a mandate isn’t to dictate how people should live their lives — it’s to prevent some people from gaming the system. Under the Obama plan, healthy people could choose not to buy insurance, then sign up for it if they developed health problems later. This would lead to higher premiums for everyone else. It would reward the irresponsible, while punishing those who did the right thing and bought insurance while they were healthy.

Here’s an analogy. Suppose someone proposed making the Medicare payroll tax optional: you could choose not to pay the tax during your working years if you didn’t think you’d actually need Medicare when you got older — except that you could change your mind and opt back in if you started to develop health problems.

Can we all agree that this would fatally undermine Medicare’s finances? Yet Mr. Obama is proposing basically the same rules for his allegedly universal health care plan.

Krugman ends by saying that his “main concern right now is with Mr. Obama’s rhetoric: by echoing the talking points of those who oppose any form of universal health care, he’s making the task of any future president who tries to deliver universal care considerably more difficult.” And honestly after all the years Democrats have fought to make health care available to all Americans, the last thing we need is one of our presidential candidates undermining the fight.

Sadly, as Krugman points out the “debate over mandates has reinforced the uncomfortable sense among some health reformers that Mr. Obama just isn’t that serious about achieving universal care — that he introduced a plan because he had to, but that every time there’s a hard choice to be made he comes down on the side of doing less.”

Instead of being progressive, Obama’s stuck in regressive mode. He’s not helping the cause for health care for all Americans, he’s hurting it. And, I have to say on a personal level, as one of those American’s who simply can’t afford health care insurance, I’m not impressed. In ’04, I felt as many did that Kerry had the best plan available. I went on the record here saying in September that Clinton’s plan “may be the ticket,” and I stand by that still. Healthcare should not be an option for Americans, it should be a right.

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2 Responses to Krugman on The Mandate Muddle

  1. jacksmith says:

    The #1 cause of injury, disability, and DEATH in America is, Health Care. More people die now from contact with the American Medical Health Care system than from any other cause of death. More than from Cancer, Heart disease, or Stroke. More than any other country in the world. Many times more than any other people in the world. This fact is a catastrophic indictment of the entire US Health Care System.

    Driven by greed. And a rush to profit. Thousands of Americans are killed, and injured daily in America. By compromised health care. Cutting corners. Over, and under treatments. And poisonings with all manor of toxic, poisonous pharmaceuticals. Especially the children. America only makes up 2-4% of the world population. But Americans buy, and consume 50% of all pharmaceuticals world wide.

    But the tide has turned. I can see it. Hear it. And feel it. The message is getting out. And taking hold about the fact that we have a very serious, and major health care crisis going on in America. Hurting everyone. Especially our precious little children. Rich, and poor alike. And most all Americans seem to understand now that “HR 676 Not For Profit Single Payer Universal National Health Care For All (Medicare For All)” is the way to go. Like all the other developed countries have done. I have seen numbers as high as 90% of Americans want government managed health care Now. Medicare for all. Like other developed countries have. And like older Americans have now.


    It’s NOW TIME to bring out the BIG GUNS!! The BIG GUNS!! are you. The American people. And anyone else that wants to help. From now until HR 676 is passed into law. I want every person to reach out and touch their fellow Americans every day if you can. I want you to take a phone book. And call at least one of your fellow Americans every day. And ask them to pickup the sword of HR 676 Single Payer Not For Profit Universal Health Care For All (Medicare For All).

    Call more than one each day if you can. And ask them to do the same as you are doing if they can. And also to put maximum pressure on their politicians to get HR 676 done. And to make sure their politicians support HR 676. Accept no substitute. HR 676 is a no-brainer. It’s the best way to go on health care. It’s the only moral, and ethical way to go. That is why every other developed country has done it. Most did it years ago.

    I know that many of you have been doing a fabulous job of spreading the word by talking it up with family, friends, and co-workers. And putting pressure on the politicians to get HR 676 done ASAP. The phone calls to your fellow Americans will increase the pressure. And grow the movement at an astonishing, and exponential rate. And I know many of you have been wanting to do something more to help. The phone calls to your fellow Americans is something you can do every day to help.

    Trust me. It will be something to see. But you have to keep the focus, and pressure on getting HR 676 passed pronto. They will try to distract you. With all manor of other crises, and catastrophes. And other plans. Don’t be distracted. HR 676 Single Payer Not For Profit Universal Health Care is the #1 concern of the American people. Thousands of Americans are dieing daily now. And you or your loved ones could be next.

    There is no good reason HR 676 cannot be passed into law well before the coming elections. Do not tolerate delays. If it is not passed before the coming elections. All America will know which politicians are on the side of the American people. And which are not when they vote. Well before the elections.

    Everyone can do this. Most of you are well informed about HR 676. This truly is one of those no-brainers. Be considerate of your fellow Americans when you call. But be comfortable about calling. These are your fellow Americans. Some will be receptive. And some will not be. Some maybe rude, and mean. Just thank them, and move on to the next. Most will be with you. And if you get a call from one of your fellow Americans about HR 676. Let them know you are already on board. And thank them for calling. Build them up. And keep them strong. They are fighting for all of us.

    I will try to make a second post with just a few of the reasons everyone with 2 working brain cells agrees HR 676 is the best way to go. But you can also look them up for your-self. And read some of the positive informed post on many of the message boards too.

    Lastly, I am sick and tired of hearing how the candidates, and politicians health care plans are going to protect, and preserve the private for profit health insurance companies that have been killing, and ripping off the American people. And now the politicians want to mandate (require) that every American has to support the private for profit insurance company’s that have been killing, and ripping you off. Or you will be fined, and PENALIZED. Thats right. PENALIZED. Ridiculous! The politicians really think you are all detached idiots. CASH COWS! To lead to the slaughter. Don’t put up with that.

    So get on it America. Get those phones going. Chat it up! Save some lives. You want all of America talking about HR 676 becoming law, Now! Before more die needlessly. Make it happen. And to my fellow cyber warriors. You have been doing great! I see it! Keep it up. 1 of 2 post…

    Below are a few reasons why “HR 676 Single Payer Not For Profit Universal Health Care For All (Medicare For All) is a no-brainer. And some reasons why private for profit health insurance is a stupid idea, and injuring, and killing you and your loved ones.

    Medicare cost 2-3% to administer. Private insurance cost 30% to administer.

    Under HR 676 everyone would be covered from birth to death. No co-pays. No-deductible. No out of pocket cost. Plus Dental. And Vision. For less cost than we pay now under private health insurance.

    With private insurance. You have 47 million Americans with no insurance.

    And 89 million Americans that had no insurance part of the time from 2006-2007.

    And over a 100 million that are under insured.

    18-30 thousand Americans that die each year from lack of health care.

    Health Care bills as the #1 cause of personal bankruptcy. And loss of homes.

    Under HR 676 health care is moral, and ethical.

    Private for profit insurance is immoral. And unethical.

    Profit is the primary motive of the private insurance companies.

    They make profit by charging needy, vulnerable, sick Americans as much as they can charge them.

    Then they make more profit by denying them care when they most need it. And are most vulnerable and unable to fight back. When they are sick. Or trying to recover from major illness.

    Yep! I know you are getting angry. I’m sorry. But I have to continue.

    Under HR 676: we will save 300 billion dollars in administrative cost each year.

    With private insurance: we spent more per capita on health care than any other country in the world. Over twice as much as most other developed country’s. Yet we have 47 million with no health care.

    We rank at the bottom in quality of health care #37.

    Americans have a shorter life expectancy than people from all other developed countries. We rank # 42 in life expectancy. Down from #1.

    For the first time in American history. The life expectancy of American children is less than that of their parents. American children are dieing at a record rate. And are in terrible health generally.

    People from other country’s enjoy a much higher level of general health than the best privately insured Americans.

    Americans are also shrinking. We used to be the tallest people in the world. Now we are down to # 10.

    People from other country’s never have to worry about going bankrupt, or loosing their homes over medical bills if they get sick.

    Maybe you should go take a break for a while before I go on. I know this must be upsetting. But this is just a small part of the sad truth about private health insurance that HR 676 can fix.

    Under HR 676: Health care will be based on need. Not on profit. And high standards, and quality will be enforced, and patients protected by the Government through a dedicated civil service. With the power, and resources to rain in abuses of patient care. Like they do with Medicare now.

    With private insurance: Medical care is base on ability to pay. And profit. Tens of thousands of patient are killed, and millions are injure, crippled, and mutilated each year under private for profit health care, and insurance.

    By insurance companies denying needed care to increase their profits.

    By hospitals cutting corners. And using the cheapest least experienced personnel, equipment, and standards they can get away with.

    By doctors that over treat, and under treat. Who injure, mutilate, and kill patients with unnecessary test, procedures, surgery, and invasive diagnostic test for profit. Who poison, kill, and injure millions of Americans with all manor of unnecessary pharmaceuticals for profit. Men, Women, Children, and babies.

    Americans makeup 2-4 % of the world population. But Americans buy, and consume 50% of all pharmaceuticals world wide. This is a monstrous evil. And immorality.

    And lastly, by politicians that take blood money from all these despicable groups and turn blind eye’s to this slaughter of the American people. And the slaughter of their own loved ones. And them-self.

    Well I could go on. And on. But I think this is enough to get you started making your daily phone calls to your fellow Americans to support HR 676. And to help them understand how important it is that each of them join the fight. And bring the MAXIMUM pressure to bear on all individuals, parties, and especially your politicians, and Representatives. To get HR 676 passed into law immediately.

    This is an emergency. America is in a crisis. More Americans have died from this health care crisis than have died in all the wars in US history. Do your best. Millions of Americans lives are counting on each of you. Including your own life. Remember, you are Americans. You know how to fight for your country when you have too. The whole world is in your blood. I’m with you.

    All the best… 2 of 2

  2. Darrell Prows says:

    Okay, I’m sold on 676, and I’m glad that we have something that we can start taking a look at as soon as we get a Dem in the Whitehouse. Becasue we sure as hell ain’t going to make any real progress before that. Oh, and we need to get rid of a ton of wingers from the Senate, or everything will be like the energy bill today.