An Incoherent Truth

http://www.nytimes.com/2009/07/27/opinion/27krugman.html?emc=eta1


http://www.nytimes.com/interactive/2009/07/27/health/policy/20090728-health-table-graphic.html?emc=eta3

Watching television can sometimes be a privilege, as it was yesterday morning when Paul Krugman and George Will were part of a panel discussing the issues that face us in the U.S. During the part of their discussion that related to "health care", George Stephanopoulos took a vote on whether the panel thought a bill would be "passed" prior to the end of the year on health care. The vote was unanimous that a bill would be passed. That is the most important thing. Whatever the compromises and the arguments and the "costs", something will be done.

Having said that, I have attached today's post from Krugman on the conservative Democrats that are not making sense because they are looking for concessions that will basically doom the project. In that post, Krugman lists the four main pillars of health care reform: regulation, mandates, subsidies and competition. He defines regulation as the nationwide imposition of rules that would prevent insurance companies from denying coverage based upon medical history, or dropping your coverage when you get sick. This would stop insurers from "gaming the system" by covering only healthy people. While there are 3 health care bills working there way thru Congress (see my second attachment - "Impact of Health Care Measures"), it is the basic right not to be denied coverage, and/or not to be "dropped" from coverage that will survive in whatever form the final bill takes.

As the NY Times states in a separate editorial today, "It is true that the long-term goal of health reform is to get rid of the fee-for-service system in which patients often get very expensive care but not necessarily the best care. Virtually all experts blame the system for runaway health care costs because it pays doctors and hospitals for each service they perform, thus providing financial incentive to order excessive tests or treatments, some of which harm the patients."

That editorial goes on to say, "The AARP, the main body for older Americans, has praised the emerging bills and thrown its weight behind the cause. All this suggests to us that the great majority of Americans - those with insurance and those without - would benefit from health care reform."

Back to Krugman on TV yesterday, he completely dismissed the Congressional Budget Office (CBO) - the non-partisan budget arm of the House and Senate - testimony before Congress on the potential substantially increased costs of various aspects of health care reform. He said those estimates were ill-timed and inaccurate. Because of Krugman's personality (he has a consistent air of humility and deference to others) and his knowledge of the issues, nobody argued with him. George Will (a Pulitzer Prize winner and a powerful force) simply accepted that and moved on (as did everybody else on the panel). A little humility mixed with knowledge of the issues can go a long way. In Krugman's case, he sprinkles in a sense of humor which everyone appreciates.

So, we will get health care reform and some of the key much needed changes will be made. And, as we've said here in prior posts, and others are discovering, don't even assume that the needed improvements in health care coverage can be combined with lowering overall health care costs - you cover more people, it's going to cost you more.