Paul Krugman Confronts Obamacare Haters

Paul Krugman admitted there are flaws with Obamacare, which he has long touted as hugely successful in Friday's column. But he hardly wants to scrap the whole thing and argues against its critics on both the right and the left. Those of course include Ted Cruz, who could have had a teachable moment in Iowa recently when he was confronted with a story about a man whose life would have been saved if the Affordable Care Act had come about sooner. But then again, as everyone knows, Cruz does not do the whole learning thing.


But Krugman's real target is the fact that "Bernie Sanders has chosen to make re-litigating reform, and trying for single-payer, a centerpiece of his presidential campaign." This, says Krugman, has led to an attack on Obamacare from the left and he thinks this too is wrong-headed, though considerably less wrong-headed than Cruz-style denialism and inhumanity. But the columnist does give Sanders' critique a fair hearing:

Let’s start with the good critiques, which involve coverage and cost.

The number of uninsured Americans has dropped sharply, especially in states that have tried to make the law work. But millions are still uncovered, and in some cases high deductibles make coverage less useful than it should be.

This isn’t inherent in a non-single-payer system: Other countries with Obamacare-type systems, like the Netherlands and Switzerland, do have near-universal coverage even though they rely on private insurers. But Obamacare as currently constituted doesn’t seem likely to get there, perhaps because it’s somewhat underfunded.

Meanwhile, although cost control is looking better than even reform advocates expected, America’s health care remains much more expensive than anyone else’s.

The question for Krugman and others is how to address those issues in a "politically feasible way". And the way the question is phrased makes plain that Krugman does not think scrapping Obamacare and going to a single-payer system is politically feasible. "A lot of what I hear from the left is not so much a complaint about how the reform falls short as outrage that private insurers get to play any role. The idea seems to be that any role for the profit motive taints the whole effort," he writes, adding that he thinks that is a bad critique. "The point is to help the uninsured, not to punish or demonize insurance companies."

Krugman closes with a complaint about how anyone who defends the current system is being "demonized" by some Sanders supporters. "One unpleasant, ugly side of this debate has been the tendency of some Sanders supporters, and sometimes the campaign itself, to suggest that anyone raising questions about the senator’s proposals must be a corrupt tool of vested interests."

It's the kind of tactic that Krugman fears will do harm in the general election, dividing people who are essentially on the same side, and possibly harm the longterm prospects of preserving what he thinks is the single greatest achievement in social policy in decades.

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