Tag Archives: Paul Krugman

Health bill: In defense of Senate “obstructionism”

OK, the Senate passed HR 3590 last week, but Gene Healy at Cato has some great observations:

In [the] Washington Post, E.J. Dionne cursed “the bizarre habits of the Senate,” which show that “we are no longer a normal democracy.” In a “normal democracy,” apparently, you get to ram through a scheme that the public opposes 52 to 38 percent, according to the latest RealClearPolitics polling average. …

If democracy means anything, it has to mean that the people’s representatives comprehend the laws they pass and expect us to follow. Yet when Coburn asked that each senator certify that he or she has read and understands the bill, Sen. Max Baucus, D-Mont., objected: “I cannot certify that members of the Senate will understand what they’re reading” (!)….

Krugman points out that the 60-vote requirement for cloture “appears nowhere in the Constitution.” While he’s got the document out, maybe he can enlighten the Times‘ readers as to where Congress finds the power to force all Americans to buy health insurance.

Read the whole article in the Washington Examiner: In defense of Senate ‘obstructionism’.

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Filed under Policy - National

Responses to Paul Krugman on economics of health insurance

In a recent post on health care, Paul Krugman writes (in his typically obnoxious smug style):

Both George Will and Greg Mankiw basically argue that we don’t need a government role because we can trust the market to work — hey, we do it for groceries, right?

Um, economists have known for 45 years — ever since Kenneth Arrow’s seminal paper — that the standard competitive market model just doesn’t work for health care: adverse selection and moral hazard are so central to the enterprise that nobody, nobody expects free-market principles to be enough. To act all wide-eyed and innocent about these problems at this late date is either remarkably ignorant or simply disingenuous.

Check out Brian Caplan’s response here. After making good points in response (government controls make the problems worse & that there’s advantageous selection), Caplan adds:

Unlike Krugman, I not going to dismiss everyone who doesn’t know these facts as “remarkably ignorant or simply disingenuous.”  What I will say, though, is that if you don’t know them, you have a lot to learn from nobody.

Thank you, Brian for demonstrating the class that Dr. Krugman does not.

Also check out David Henderson’s post: Krugman Misstates Arrow.  Here’s part of it:

if by “standard competitive model” you mean “perfect competition,” doesn’t work well even with gasoline stations and repair shops. When a company can invest in reputation, what Ben Klein called “brand name capital,” the perfectly competitive model goes out the window. But if you read just Krugman’s short post, you might think that Arrow is arguing for a government role in health care, as Krugman is, right? And I would bet that Krugman wants you to think that. Yet, nowhere in Arrow’s article can I find such an argument.

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Filed under insurance, tax code, HSAs

Obama’s health care reform: road to single-payer serfdom?

Will Obama’s proposal for a nation-wide mandate for guaranteed issue insurance decimate insurance companies to the point that government will have to “save the day” with a single-payer monopoly that Obama really wants?  Consider this from the Associated Press:

Barack Obama’s campaign promise should prove irresistible to the millions of uninsured: guaranteed access to affordable health coverage, regardless of illness or condition. …

No participating company could turn someone away because he had cancer, heart disease or diabetes. Nor would someone have to pay a higher monthly premium based on those conditions.

The coverage guarantee is not a new concept. But it has had a troubled history in several states that tried it for people seeking coverage through the insurance market. Some states, such as Kentucky and South Dakota, eventually dropped the guarantee after insurers left. In the few states where guaranteed coverage continues, monthly premiums generally are much higher for younger, healthier people than in nearby states. …

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Filed under Policy - National, regulation, single payer

Health care: Individual or “Collective” Responsibility?

…every wealthy country except the United States already has some form of guaranteed health care. …The politics of guaranteed care are also easy, at least in one sense: if the Democrats do manage to establish a system of universal coverage, the nation will love it. I know that’s not what everyone says; some pundits claim that the United States has a uniquely individualistic culture, and that Americans won’t accept any system that makes health care a collective responsibility.

— Paul Krugman, August 10, 2008

It amused me how glibly Dr. Krugman can predict how the nation will love “universal coverage.”  In a previous post I pointed out how such coverage does not guarantee care.

Krugman has broached the core issue behind health care policy: Whether or not health care is an individual or collective responsibility.

If we are each responsible as individuals, we each take initiative to insure our own health care and that of our families.  Responsible adults who want assist in providing health care to others can donate to health-related charitable organizations that demonstrate their effectiveness.

Under “collective responsibility,” we empower politicians to make these critical choices.  But this disempowers ourselves and neighbors, and there’s no virtue in spending other people’s money. With “collective responsibility,” those who peacefully refuse to conform with what politicians say they are “responsible for” becomes a criminal, and faces punishment by law enforcement authorities. 

The health care debate isn’t about the intricacies of one plan vs. another.  It’s about the ethics: individualism vs. collectivism, or free-market medicine vs. politically-controlled medicine.

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Filed under morality

Canadians Tell Krugman About Socialized Medicine

From a recent debate on universal coverage:

Actually, can I just — I wanted to ask a question. And—

Please—please do—

—and I wanted to ask, actually two questions, to the audience. First, how many Canadians, would Canadians in the room please raise your hands. [ONE PERSON APPLAUDS, LAUGHTER]

We have about seven hands going up—

Okay, not as many as I thought. Okay, of those of you who are not on the panel who are Canadians, how many of you think you have a terrible health care system. [PAUSE] One, two—

We see—almost all of the same hands going up. [LAUGHTER]

Bad move on my part. [APPLAUSE]

The whole debate is on YouTube, but I haven’t looked to see which of the twelve segments it’s in. 

(via FIRM)

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Filed under Policy - National

Krugman: Ignorant, or a Liar?

Paul KrugmanWhat’s easy about guaranteed health care for all? For one thing, we know that it’s economically feasible: every wealthy country except the United States already has some form of guaranteed health care. – Paul Krugman, August 10, 2008

Many pundits see red at the words “single-payer system.” They think it means low-quality socialized medicine; they start telling horror stories — almost all of them false — about the problems of other countries’ health care. — Paul Krugman, May 1, 2006

If citizens of these other wealthy countries have guaranteed care, can Dr. Krugman explain to me to following instances of people in these countries not getting needed medical care?

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Filed under coverage isn't care, single payer

More doctors drop Medicare patients

I like Ted Kennedy’s slogan “Medicare for all.” It reminds voters that America already has a highly successful, popular single-payer program, albeit only for the elderly. — Paul Krugman, June 13 2005

Paul KrugmanHow “highly successful” is Medicare?  Consider the following story from ABC News:

The Houston Chronicle reported last week that more and more Texas doctors are opting out of Medicare due to growing cuts in reimbursement. And the trend is not limited to Texas doctors. Primary care doctors from around the country have told ABC News that they too are either opting out of treating Medicare patients, or are preparing to do so if Congress once again OKs slashing reimbursement rates. …

“With the cost of running a medical practice only going up on a daily basis, and reimbursement taking a dive, how can doctors running a solo practice keep accepting a payer that only continues to cut its reimbursement?” said Dr. Gil Holland, a family physician in Chandler, Ariz. “This is problem is far reaching because as Medicare cuts its fee schedule, other insurance payers tend soon to follow suit. Many of my colleagues in Arizona are dropping Medicare.” …

According to the American Medical Association (AMA), reimbursements that have been reduced every year for nearly a decade have slashed physician payment rates by about 40 percent. Meanwhile, the cost of practice rises annually. The AMA estimates that this year practice costs will increase by 20 percent.

And according to a 2007 AMA survey of 8,955 physicians in the United States, 60 percent of doctors said they plan to limit the number of new Medicare patients and 40 percent of doctors said they plan to limit the number of established Medicare patients that they treat if Medicare payment rates are cut by 10 percent in 2008.

And because the Senate failed to block the latest reduction, this year’s Medicare cut of 10.6 percent has already taken effect — and an overwhelming majority of physicians contacted by ABC News say this will force them to either give up on Medicare patients altogether or limit the number of new Medicare patients they can treat. …

“I anticipate that Medicare patients will see a work slowdown — delayed access to routine and planned care or consultation — access problems with fewer providers, and downright strikes among physicians, especially sub-specialists,” said Dr. Michael Pontious, program director of Oklahoma University’s Enid Family Medicine Residency in Enid, Okla.

(via FIRM)

See also this excellent critique of Krugman’s Medicare endorsement.


Filed under Medicaid/Medicare/SCHIP