Paul Krugman’s two columns this week in the New York Times are a great help in sorting through the health care debate. It’s most effective to read them in full online. Here’s a quick synopsis:
Monday:
Obama’s proposed reform rests on four pillars:
Regulation: an example is requiring insurance companies to cover pre-existing conditions.
Mandates: everyone must have insurance. Creating such a large pool of those covered helps manage costs because healthier individuals will be paying insurance premiums.
Competition: a public option in which government would provide coverage in competition with private insurance companies.
Subsidies: providing help to the poor to pay for health insurance. This idea includes proposals for cutting medical costs-such as establishing a panel that would set Medicare reimbursement rates-to avoid future deficits.
Any attack on one of the pillars increases the future cost of the American health care system. Republicans and Blue Dog’s are fighting for compromises that would remove one or more of the pillars. That will increase future deficits.
Friday:
Our broken health care system remains marginally functional only because of government involvement. Those obtaining insurance privately are at the mercy of private insurance companies that spend enormous sums on efforts to deny payment to those covered. These companies, by the way, refer to payments for health care as “losses.” Those of us with insurance through employers get the protection of government regulation. Government requires employer provided, non-taxed health benefits, to cover pre-existing conditions and not reduce benefits to more highly paid employees.
There is some thoughtful work on this crucial topic in the generally vast wasteland of the media. Thank you Dr. Krugman.
