[Peace-discuss] FW: Paul Krugman's Shocking, Revisionist, and Obscurantist Views on Single Payer

[David Johnson]

I always suspected that Paul Krugman was a neo-liberal and his recent attack
against single payer proves it. I found this excellent article from 2013
that shows he always was against single payer.

 

 

Paul Krugman <http://www.nakedcapitalism.com/2013/10/46940.html> ’s
Shocking, Revisionist, and Obscurantist Views on Single Payer

Posted on October 28, 2013
<http://www.nakedcapitalism.com/2013/10/46940.html>  by Lambert Strether
<http://www.nakedcapitalism.com/author/lambert-strether>  

By Lambert Strether of Corrente <http://www.correntewire.com/> .

I hate to chew the ankles of blue America’s favorite quasi
<http://www.nobelprize.org/nobel_prizes/economic-sciences/> -Nobelist,
because during the dark early days of Bush the Younger, his was a lonely and
desperately needed voice of sanity. Also too, cats. But I read this column
(“Why Is ObamaCare Complicated
<http://krugman.blogs.nytimes.com/2013/10/26/why-is-obamacare-complicated/>
?”) in Conscience of a Liberal, and I was shocked. This is too much.
Krugman’s piece contains historical errors, analytical errors, and errors of
conscience. Let’s take each in turn:

Krugman’s historical errors:

[P]olitical constraints made [note lack of agency] a straightforward
single-payer system unachievable.

But what was the origin of these mysterious “constraints”? Krugman doesn’t
say, so let us supply the lacuna. I suggest the real constraints came from
three sources, as indicated by their behavior from 2009, when battle for
health reform was joined: (1) The Democratic nomenklatura, which censored
single payer stories and banned single payer advocates
<http://correntewire.com/profiles_courage_open_left_makes_its_single_payer_c
ensorship_policy_explicit>  from its sites
<http://www.ianwelsh.net/a-brief-note-on-why-the-progressive-blog-movement-f
ailed/> , and refused even to cover single payer advances
<http://www.correntewire.com/selective_posting_surprise_list_progressives_re
fuse_cover_weiner_videos_single_payer>  in Congress
<http://www.correntewire.com/film_11_progressive_a_list_front_pagers_continu
e_single_payer_coverage_fail> , while simultaneously running a
<http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%E2%80%9Cpublic-opt
ion%E2%80%9D-was-sold/> “bait and switch” operation with the so-called
“public option,” thereby sucking all the oxygen away from single payer;1 (2)
Democratic office holders like Max Baucus, the putative author of ObamaCare
— Liz Fowler, a Wellpoint VP, was the actual author
<http://www.correntewire.com/obamacare_clusterfuck_corruption_in_the_white_h
ouse_as_we_meet_our_old_friend_liz_fowler>  — who refused to include single
payer advocates in hearings
<http://www.correntewire.com/baucus_meeting_single_payer_advocates_i_might_n
ot_press_charges_now_stfu>  and had protesters arrested and charged
<http://www.correntewire.com/sen_baucus_single_payer_advocates_we_want_polic
e_single_payer_advocates_removed_senate_hearing> ; (3) and Obama himself,
who set the tone for the entire Democratic food chain by openly mocking
single payer advocates (
<http://www.correntewire.com/obama_got_little_single_payer_advocates_here>
“got the little single payer advocates up here”), and whose White House
operation blocked email from single payer advocates
<http://correntewire.com/white_house_blocks_email_single_payer_advocates_mad
_hell_doctors> , and went so far as to suppress a single payer advocate
<http://www.correntewire.com/how_will_white_house_make_amends_censoring_sing
le_payer_advocates_its_iowa_health_care_forum_transcript> ’s question from
the White House live blog of a “Forum on Health Care.” (Granted, the forums
were all kayfabe, but even so.) As Jane Hamsher
<http://fdlaction.firedoglake.com/2009/12/04/blue-america-for-single-payer/>
wrote, summing of the debacle: “The problems in the current health care
debate became apparent early on, when single payer advocates were excluded
[note, again, lack of agency] from participation.”

In short, if single payer was
<http://pnhp.org/blog/2009/08/08/reply-to-critics-of-%E2%80%9Cbait-and-switc
h-how-the-%E2%80%98public-option%E2%80%99-was-sold%E2%80%9D/> “politically
infeasible” — the catchphrase of that time — that’s because Democrats set
out to make it so, and succeeded.

But Krugman goes on:


 Single-payer wasn’t going to happen [and why? See above]— partly because
of the insurance lobby’s power2, partly because voters wouldn’t have gone
for a system that took away their existing coverage and replaced it with the
unknown.

“Wasn’t going to happen?” Krugman’s remarkably passive and compliant
attitude reminds me of the Obama Fans who kept bleating “He’s only been in
office one two three four five six X months! Give him a chance!” (That, or,
“The President is not a dictator!”) Think back. Does you remember the state
of play in January, 2009? The Democrats had just won the House, the Senate,
and the Presidency. They had just beaten the McCain/Palin ticket like a
gong. Thanks to a brilliant, tactically ruthless campaign — and the
lingering good will on the Democratic balance sheet for economic issues
<http://krugman.blogs.nytimes.com/2008/11/04/time-and-chance/> , perhaps
remnants from FDR’s time — Obama’s Democrats had a mandate for “hope and
change.” Moreover, the Republicans under Bush had been completely
discredited, both in the eyes of a majority of the public and, even more
importantly, in the political class of opinion shapers. Obama’s personal
charisma was at its height. So too, like all Presidents in their 100 Days,
was his power. If Obama had wanted to make single payer the hallmark of his
100 Days, instead of HeritageCare -> RomneyCare -> ObamaCare, he could have
done so. And he could have gotten it passed, via reconciliation or ending
the filibuster
<http://www.nakedcapitalism.com/2012/07/the-obama-enablers-big-lie-we-never-
had-the-votes.html>  in the Senate if need be. Moreover, Krugman’s absurd
claim to the contrary, single payer is both well known, in the form of
Medicare, and polls well.
<http://www.medicareforall.org/pages/Chart_of_Americans_Support>  (That’s
why the TPers don’t want government interfering with their Medicare! They
reconcile the cognitive dissonance of a government program actually working
to their satisfaction by denying it’s a government program at all.) The 100
Days were there for the taking. Replace “[P]olitical constraints made a
single-payer system unachievable” with “Obama and the Democrats decided
against a single payer system” and you’ll have something closer to the
truth, if that matters these days.3 So much for Krugman’s historical errors.

We turn next to Krugman’s analytical errors:

It’s been clear all along that the Affordable Care Act sets up a sort of
Rube Goldberg [hat tip, lambert
<http://www.correntewire.com/search/site/%22Rube%20Goldberg%22?f%5B0%5D=is_u
id%3A23&f%5B1%5D=ds_created%3A%5B2009-01-01T00%3A00%3A00Z%20TO%202010-01-01T
00%3A00%3A00Z%5D> ] device, a complicated system that in the end is supposed
to [supposed by whom?] more or less simulate the results of single-payer,
but keeping private insurance companies in the mix and holding down the
headline amount of government outlays through means-testing. 

Even accepting the weasel words, what on earth can “more or less simulate”
possibly mean? One can simulate a dynamic process or system, but not a
static result. (Strat-O-Matic baseball does not “simulate” a score; it
simulates a game!) Forgiving Krugman’s sloppy language, let’s assume Krugman
means to say that ObamaCare, as a system, is meant to “simulate” single
payer, as a system. If that’s so, it does a remarkably poor job. If I were
going to sketch a single payer system on a blackboard, my first step would
not be to chalk in multiple payers (“keeping private insurance companies in
the mix”). Moreover, single payer has at least the connotation of
universality — Medicare is single payer for all over-65s; the VA is single
payer for all veterans — and so a single payer simulation that isn’t
universal (“means testing”) wouldn’t be my first step either. It’s as if
Krugman’s trying to argue that reptiles “simulate” mammals, or fish simulate
bicycles.

Considering what “the results” might mean leads us to Krugman’s errors of
conscience. He writes:

Yes, Obamacare is a somewhat awkward kludge, but if that’s what it took
[note well the past tense] to cover the uninsured, so be it. .. [T]he odds
remain high that this will work, and make America a much better place.5

(I get a kick out of  <http://en.wikipedia.org/wiki/Amen#Etymology> “so be
it”; it’s a classic example of vacuous, banal pragmatism from Obama’s Amen
corner of Democratic hacks.) Forget the weasel word
<http://www.correntewire.com/obamacare_clusterfuck_dueling_flow_charts>
“somewhat”; let’s just unpack the deception in “cover the uninsured,” shall
we? Never mind that the “infuriating” #FAIL of the ObamaCare rollout has
made it impossible to get a good overall sense, despite anecdotes, of
whether the coverage on offer from ObamaCare offers value for money
<http://www.nakedcapitalism.com/2013/10/obamacare-narrow-networks-how-they-a
ffect-doctor-specialties.html> ;4 and never mind that, although Obama claims
health care is a right
<http://www.correntewire.com/obamacare_clusterfuck_obama_says_health_care_is
_a_right> , access to that right is delivered capriciously and whimsically
<http://www.bing.com/search?q=%22relentless+creation%22+site%3Awww.nakedcapi
talism.com&qs=n&form=QBLH&pq=%22relentless+creation%22+site%3Awww.nakedcapit
alism.com&sc=0-0&sp=-1&sk=&cvid=3323ccc42e4541cfbb698924f37d15f3> , varying
by jurisdiction, age, income (especially at the edge cases of 138% and 400%
<http://www.correntewire.com/obamacare_clusterfuck_kaiser_explains_to_poor_p
eople_in_non_medicaid_expansion_states_how_to_game>  of poverty level), and
whether HHS’s marketers think you will make ObamaCare actuarially more
sound, or not; and never mind that ObamaCare, given that there are proven
<http://www.youtube.com/watch?v=zwDvF0NtgdU>  health care delivery systems
available, is an experiment performed on the American people without their
informed consent
<http://www.nakedcapitalism.com/2013/09/obamacare-staggers-toward-the-octobe
r-1-finish-line-4.html> ; no, never mind all that: Krugman surely must know
that ObamaCare, when fully implemented, will still leave ~25 million without
coverage
<http://www.washingtonpost.com/blogs/wonkblog/wp/2012/06/24/11-facts-about-t
he-affordable-care-act/> . How, in good conscience, can anybody say “So be
it” to that? And how, in good conscience, could anybody write “cover the
uninsured” instead of “cover a large fraction of the uninsured,” when the
former is a lie, and the latter is the truth? The mind reels.

But even worse, the whole tenor of Krugman’s piece reads like he’s trying to
gently anesthetize single payer, ease it into a coffin, and then nail the
coffin lid shut (“what it took“), and all the while with single payer very
much alive. Why? Because Krugman can’t even be bothered to mention ongoing
single payer efforts
<http://www.huffingtonpost.com/linda-bergthold/single-payer---alive-and_b_39
38385.html> , at the state level
<http://www.singlepayeraction.org/resources/> ! Unfortunately — I mean for
the citizens of these states, not for the insurance companies — under 42 USC
§ 18052 of the ACA <http://www.law.cornell.edu/uscode/text/42/18052> ,
states can only apply for “waivers” to set up their own systems by 2017, so
four years from now (and
<http://www.nakedcapitalism.com/2013/09/45883.html> X thousands of excess
deaths) is the earliest an American Saskatchewan could start setting up
single payer. How, in good conscience, and assuming that universal coverage
truly matters to him, can Krugman ignore these state efforts? Surely this is
rank obscurantism? And why, assuming good conscience, doesn’t Krugman
advocate for changing 2017 to, say, 2014, using the admitted complexity and
Rube Goldberg-esque nature of ObamaCare as a reason?

Could do better!

NOTES

1 Hilariously, Obama cut a secret deal with Big Pharma in summer 2009 that
there would be no public option in the final health care reform bill
<http://www.huffingtonpost.com/miles-mogulescu/ny-times-reporter-confirm_b_5
00999.html> . I don’t know which scenario is more appalling: Whether the
savvy and pragmatic career “progressives” who shilled for the public
option’s ever shifting bullet points and shrinking coverage throughout 2009
did so in full knowledge of Obama’s secret deal, or whether they, too, were
betrayed by him. Nobody’s talking.

2 “Power” as expressed in the $20 million from the health care industry
<https://www.commondreams.org/headline/2010/01/12-9>  that went to the Obama
campaign, which outstripped even Obama’s Croesus-like haul of $16 million
from the securities and investment industry
<http://www.opensecrets.org/pres08/indus.php?cycle=2008&cid=N00009638> . Is
it so unreasonable to assume that Obama serviced the health insurance
companies just as assiduously as he serviced the banksters? I won’t use the
word “corruption,” but feel free to think it!

3 Why were Obama’s 100 Days such a bust? It would be irresponsible not to
speculate; so see note 2. 

4 I’d expect Consumer Reports to cover this issue, since it’s in their
remit; so far, such a topic is absent from their coverage
<http://www.consumerreports.org/cro/health/insurance/health-care-countdown/i
ndex.htm> .

5 As a troll prophylactic, let me say that I don’t advocate defunding or
repealing ObamaCare; despite the debacle of its launch and the perversion of
its design, it must end up helping some people who desperately need help
<http://www.nejm.org/doi/full/10.1056/NEJMp1312793?query=featured_home> , if
only because of its sheer scale. However, I regard ObamaCare, and especially
its rollout, as a teaching opportunity; a chance to show people that better
opportunities exist that could give Americans a health care system that’s up
to first-world standards: Single payer. The pom pom waving by members of the
Democratic nomenklatura, including Krugman, is meant to suppress that
teaching opportunity, exactly as in 2009. 

 

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