Krugman: Annoyed at people who say that the plan isn’t really covering the uninsured

[johan helge]

Krugman (http://krugman.blogs.nytimes.com/2009/12/23/simulating-single-payer/):

When I first began writing a lot about health care, I often found myself taking the pro-single-payer position against people who argued that it was better to work through private insurance companies. I took to arguing that Massachusetts-type plans were, in fact, just imperfect, somewhat inefficient ways of simulating the results of a single-payer system. And if I thought there was any chance of creating Medicare for All any time in the next decade, I’d be pushing for single payer now.

But what actually seems possible — not in the distant future, but tomorrow morning — is the passage of a Massachusetts-type plan for the United States. And now my argument cuts the other way: what we’re getting will, in its overall results, work a lot like a single-payer system. It will be an imperfect, inefficient simulation; but those on the left who decry it as terrible, evil, nothing but a giveaway to the insurance companies are missing the very real good it will do.

(...)

Let me say that I get especially, um, annoyed at people who say that the plan isn’t really covering the uninsured, it’s just forcing them to buy insurance. That’s missing not just the community rating aspect <that premiums can’t be based on medical history (which means that coverage becomes available to people with preexisting conditions)>, but even more important, it’s missing the subsidies. And we’re talking about big stuff: between Medicaid expansion and further support for families above the poverty line, we’re looking at around $200 billion a year a decade from now. Yes, a fraction of that will go to insurance industry profits. But the great bulk will go to making health care affordable.

So how anyone can call a plan to spend $200 billion a year on Americans in need a defeat for progressives is a mystery.

I wish there were a public option in there; I wish there were broader access to the exchanges; I wish the subsidies were even bigger. There’s lots of work to be done, work that may eventually culminate in a true, not simulated, single payer system. But even in this form, we’re looking at something that will make America a more just, more secure nation.

[daa]

1. Its not the fact that they are covered or not

its the idea that they can't afford health CARE after being forced to buy private insurance from that same ones that have been ripping us off.

And where is the cost control?

And charging older people 3 times as much is no big deal to idiots with tenure.

[still_one]

Please provide a link so I can see the specifics of the bill? I have been looking on the internet

and except for the house version, I cannot find the Senate version, and of course the final reconciled bill isn't even there yet

[grantcart]

9. There is my summary plus a link to the managers ammendment report

http://journals.democraticunderground.com/grantcart/256

[still_one]

3. .....

[still_one]

5. Self-DeletE (Duplicate post)

[KrR]

4. Low income people are going to be subsidized

Everyone getting insurance is a cost control itself. Also Insurance companies will have to spend 85%+ of their premiums on healthcare. Also those currently without insurace will be able to buy on the exchange which has real competition along with a Not-for-profit plan. Staes may also be able to offer a Public option here as well.

[RBInMaine]

6. Cost control, in part, comes through exchange competition. Yes, it needs more, but it's a START.

[SpartanDem]

7. where is the cost control?

here:

http://krugman.blogs.nytimes.com/2009/12/21/coverage-and-costs/


http://voices.washingtonpost.com/ezra-klein/2009/12/five_cost_controls_in_the_sena.html

[daa]

14. And who is eligible for that??

That will only be for those with no insurance. If you have insurance and the rate goes up 20% like it did this year, that will be deemed affordable and you do not get in the exchange, although I fail to see how an additional layer will lower the cost.

[HuckleB]

2. Krugman seems to want an honest discussion, but he's having a hard time getting one from the critics

[Clio the Leo]

10. That's asking for the impossible I'm afraid. NT

[SpartanDem]

11. It is more than hard

it is impossible you post about various experts on how the bill will control cost, but they simply stick their fingers in their ears and go 'la la la'. I could go on and on about the complete lack of understanding that many kill billers seem to have.

[liberalpragmatist]

12. public option, public option, public option

... somehow the public option (remember - a weak, "non-government-run," negotiated-rates nonprofit limited to the insurance exchanges, estimated to have premiums roughly the same or even slightly higher than private insurance) - was going to be some miracle cost-control, cure cancer, and bring peace to the Middle East.

What I also find hard to understand is why the public option purists continually say that without the bill, there's no cost control, yet they oppose all the other cost control measures in the bill. The excise tax, for example, is criticized because it will force people to buy cheaper plans or result in some services being cut. What do people think a strong public option would do?. It would do the exact same thing - it would make it unfavorable for insurance companies to offer expensive plans and they would cut costs or companies would instead purchase cheaper plans. That's the POINT of cost-control.

[HuckleB]

8. The glums of August

http://krugman.blogs.nytimes.com/2009/12/23/the-glums-of-august/

Are the glums of August the same as the glums of December?

[eridani]

13. $200 billion is not being spend on Americans in need--it is being given to insurance parasites

"Coverage" that only pays 60-70% of expenses is utterly worthless. MA is all about royally fucking over the older chronically ill of modest means.