Everyone’s favorite former economist turned shrill hyperbolist, Paul
Krugman, has earned a return from obscurity with his column yesterday: “One Nation, Uninsured.”
As usual, there is much to criticize such as the scaremongering claim
that we’ll have a society “in which all but the most affluent Americans
face the constant risk of financial ruin and even premature death
because they can’t pay their medical bills.” As if we would become
Canada by refusing Canada’s healthcare system.
I’m not even going to complain about his conclusion
that “good economics is also good politics: reformers will do best with
a straightforward single-payer plan” because, as usual, he stacks the
deck from the start.
Let’s ignore those who believe that private medical accounts –
basically tax shelters for the healthy and wealthy – can solve our
health care problems through the magic of the marketplace. The
intellectually serious debate is between those who believe that the
government should simply provide basic health insurance for everyone
and those proposing a more complex, indirect approach that preserves a
central role for private health insurance companies.
OK, let’s ignore that one million people signed up for health savings accounts in a year, 27% of whom were previously uninsured.
Let’s ignore that 37% of small businesses offering HSAs to their
employees previously offered no insurance. Let’s ignore that even our
friends at the NC Justice Center have suggested high-deductible
insurance combined with HSAs as a way to make the state employee health plan more affordable for the state and its employees.
Paul
Krugman has decided that this is intellectually trivial and that
intellectually serious people prefer to consider “Medicare for All”
versus a proposal to “buy off the insurance lobby” because
intellectually serious people know that markets don’t work and that “special interests will, once again, stand in the way.”
