byomtov: I just love the moving goalposts. Originally the mantra was that people should be able to get treatment for their serious medical problems; now it’s that people shouldn’t even have to pay for that treatment!

What are you talking about? Who said people shouldn’t have to pay? The point is, they should have insurance available.

See what I mean? I thought they should have health care available. Now all of the sudden the issue is that they shouldn’t have to spend their own money on it?

The shape of an insurance program was what the discussion was about. Please pay attention. 

Besides, in case it’s escaped your notice, bankrupting someone is really not an effective way to get them to pay, so I guess I don’t see the virtue of that.

I don’t know what you mean by “get them to pay.” Bankrupting them is the (potential) result of them paying, not the incentive for them to pay.

I wish.

Jane: currently proposed solution is to lead us to the country’s financial ruin

Yes, this is not a controversial position at all, and is in no way the main point of this whole debate.

And yet, it seems the currently proposed solution is to lead us to the country’s financial ruin. This is somehow better?

What are you talking about? Who said people shouldn’t have to pay? The point is, they should have insurance available. The shape of an insurance program was what the discussion was about. Please pay attention.

Besides, in case it’s escaped your notice, bankrupting someone is really not an effective way to get them to pay, so I guess I don’t see the virtue of that.

Krugman is a “hack” for offering political cant and invective instead of sober commentary. His column is no better than if Coulter were to write that a vote for a Democrat is a a vote for a fascist police state. Satisfying to their fringe supporters, but worthless as analysis.

I don’t read Coulter or Krugman. They haven’t had anything worthwhile to day for several years. They are the most partisan commenters in media bar none. I’ve been following this thread for my own amusement and I find it difficult to believe that a post was actually written about a Krugman article. What a waste of time.

My own opinion is that it is disgraceful that in this country a serious medical problem can lead to financial ruin.

I just love the moving goalposts. Originally the mantra was that people should be able to get treatment for their serious medical problems; now it’s that people shouldn’t even have to pay for that treatment!

rpt:
You would prefer, of course, to return with the Palmreader to the worse policies of the 2,000’s?

The keynesian policies that Krugman promotes lead only to increased deficits. Trust me on this one. Japan tried to pump up its economy with keynesian policies during the 90′s and all it did for them was to rack up their government debt to nearly 200% of their GDP. Krugman basically proposes we do the same, which will have the same effect.

What Krugman fails to understand is that the current recession is a necessary self-correction to an unsustainable bubble. He believes the bubble economy represented real productivity. It did not.

Austrian economic theory is the only concept of economics that makes a lick of sense.

As it is, Democrats don’t even seem able to score political points by highlighting their opponents’ obstructionism.

Paul, don’t you wonder why that is?

A few final comments. I’m all for clinics with NP’s, though I’m not sure what that has to do with the high-deductible scheme.

As for the latter, my response boils down, I suppose, to “meh.” Yes, people will probably seek less care when they have to pay for it themselves. Whether that nets out favorably or not I don’t know. The occasional disaster from not attending to something early can erase a lot of savings from not worrying about things that turn out to be trivial. However it nets out, you do have to consider both aspects.

Also, I assume you are not going to prevent people from buying more comprehensive plans, and a lot of them will do that. I don’t think HSA’s are wildly popular. So whatever savings there are will come from a minority of the population.

And of, course, as we agree, much is in the details, and just saying “catastrophic coverage” doesn’t tell us much.

That said, better than nothing. My own opinion is that it is disgraceful that in this country a serious medical problem can lead to financial ruin. I remember many years ago seeing signs in a grocery store asking for contributions to help pay for a child’s liver transplant, (I don’t know if that financing problem has been solved or not) and thinking that parents shouldn’t have to beg like that. Not in the wealthiest and most powerful country that ever existed. Not all the free-market tracts in the world could justify it. And they can’t justify the situation today either.

ShelbyC: Well, basic economics, right? Partisan crap is easier to write, and probabally gets more hits.

In 1999 he wrote about the flaws in the book, Dow 36,000. He did a good job on that. Funny thing, the Dow is now lower than when the book was written.

A. Zarkov: When Krugman first start writing his NYT column, he provided some informative commentary.

Well, basic economics, right? Partisan crap is easier to write, and probabally gets more hits.

A regular Krugman reader would have gotten little warning of the impending burst of the housing bubble, with the consequential take down of the stock market and the economy. Anyone who regularly read the blog Calculated Risk, Petr Schiff, Nouriel Rubini, Steve Keen, or listened to the UCLA economist Christopher Thornberg, knew what was coming. If you read and understood Professor Didier Sornette analysis of super exponential growth, you knew approximately when the housing bubble was going to burst. All this proved valuable for me personally. I made money where most others lost. Krugman gets $20,000 for a one-hour speech. Is he worth that?

According to Wikipedia Krugman is becoming a post Keynesian and is “gravitating towards the Keynes-Fisher-Minsky” view of macro economics. Well he needs to gravitate more because Fisher’s debt deflation theory along with Minsky’s financial instability hypothesis say that too much debt caused the crisis we are in. Yet he keeps pushing more debt to solve a problem caused by debt. How can this be right?

Krugman is probably a very nice guy in real life. Too bad he got immersed in all the partisan stuff.

eyesay – “Republican senators continued to use every method at their disposal to delay the Democrats’ agenda, which is why the Senate didn’t get a health care bill passed all summer long.”

Well, actually, no they didn’t use “every method”. They had a number of prodedural hurdles they could have used that they didn’t bother with. The undeniable fact of the matter is that the Democrats had the power to pass HCR without Republicans and they couldn’t. You can try to spin this some other way, but as Phatty already pointed out, you have to drink a substantial amount of Kool Aid to buy into that nonsense.

jstar: Matt W.-
There’s at least a third proper response, but it’s a bit more meta.
3) Is this problem something that’s properly within the scope of our jurisdiction/responsibility to address?I can think of lots of issues off the top of my head that are legitimate problems (and I think you can, too), but that aren’t any business of our national Legislative Body.

A great deal of our present trouble stems from the fact that they cannot do this. If 21st Century America had a single guiding political philosophy, it would be, “There oughta be a law!”

Fortunately (or unfortunately if you’re Mr. Krugman) the full version is, “But only if I get to write it, otherwise, screw you guys, I’m goin’ home.”

David Welker: is to concede that the GOP campaign is built upon lies.

Er, aren’t they all built upon lies?

OperationCounterstrike: A lot of you don’t seem to realize what it will mean if we allow our current health-care non-system to continue.It means ALL raises we get in our lifetimes will go to pay for health care.Static wages until death, for everyone.

If that were in fact true, it would not be “static wages” at all. It would be increasing wages that you choose to spend on health care. (Under our “current health-care non-system” — unlike with Obamacare — there is no “individual mandate”; if you’d prefer to spend it on something else, go ahead. To be sure, our current system stupidly tax-privileges employer-provided health insurance over other forms of wages, but that’s a relatively simple reform.)

h2u: “Obamacare” is a widely used term, Captain Carrot. Here’s a link to TIME using it — and I hardly think that publication exemplifies right-wing partisanship.

Is there any precedent in American history for a group of advocates simultaneously claiming that their policy proposal is extremely popular and yet complaining that it’s a dirty trick to associate thepopular president with this policy proposal?

It means ALL raises we get in our lifetimes will go to pay for health care. Static wages until death, for everyone.

Lindsey Abelard: Krugman wants the U.S. to pursue the same disastrous fiscal stimulus policies that Japan pursued in the 90’s. Ones that have resulted in Japan having a government deficit of nearly 200% of their GNP. Way to go, Krugman! Remind me why anyone still listens to this hack.

You would prefer, of course, to return with the Palmreader to the worse policies of the 2,000′s?

Indeed. =)

I guess even the GOP thinks words have meaning.

Semantic meaning. Words matter. ;-)

I guess even the GOP thinks words have meaning. That is a relief. I guess Zywicki is alone in his belief that to campaign on starting over is to campaign on paralysis.

Silly mean,

Man, you are genuinely pissed off, aren’t you?

The problem is, that the less sophisticated among us, like myself, naively think words have actual semantic meaning.

Meaning that they “actually,” erm, mean things? I should hope so.

Agreed, but keep in mind the old 80/20 rule: as in many things, the vast majority of medical expenses are incurred by a relatively small number of people. We all wind up paying for this one way or another except for the small proportion of those unhealthy few who happen to be rich and under 65.

And the relatively few (mostly) young folks whose first contact with medical professionals is being pronounced DOA, generally after a car crash or a murderous assault. (Don’t discount them; they’re doing their part to make sure US life expectancy stats look lousy compared to Europe’s.)

To say that most day to day medical expenses are routine and could be treated for far less than we do today is true but also a bit beside the point.

Is it? I think if you were to add up the cost of the hundreds of thousands (guessing here; don’t sue me) of ER visits yearly that might have been handled equally well by cheap clinics … it’s not an impressive number when you set it alongside the care for anyone in an ICU, but it’s not negligible when you multiply by the number of patients.

So we might as well find a way to cover these costs as efficiently as possible.

Said by you about a different set of costs, but isn’t it still true?

Actually, I think that this was the central Republican message in Massachusetts.

Oh, is a promise of paralysis the message that comes out when Republicans like Scott Brown say we should go “back to the drawing board” and “start over?” Silly mean, I thought that saying we should “start over” meant we should “start over.”

Too bad the average voter probably actually takes the GOP at their word, and don’t realize that “starting over” is apparently code-speak for promising paralysis. The problem is, that the less sophisticated among us, like myself, naively think words have actual semantic meaning. We naively think there is a semantic difference between “starting over” and “paralysis.” In fact, for us less sophisticated types, there is a descriptive word for people who say one thing, but intend another. Liars. I agree with Mr. Zywicki that the central policy intention of the GOP is paralysis rather than progress. But, what Zywick doesn’t seem to realize is that conceding that the GOP intention is paralysis when the campaign message is working hard to make cautious progress (i.e. “starting over”) is to concede that the GOP campaign is built upon lies.

The bottom-line is Todd Zywicki is dead wrong. Paralysis was not the central message that the GOP ran on. If it was, they would have gone down in flames in Massachusetts. Instead, they ran on language suggesting that we should proceed, albeit with caution. Now, when the GOP says they want to “start over,” perhaps politically sophisticated people like Zywicki interpret that as promising paralysis. But people who think politicians actually mean what they say think “starting over” means that they concede there is a real problem that needs to be tackled.

I am the one who called Paul Krugman a hack (in the very first comment no less). However, I consider him a hack not for this particular article, but rather because of a pattern I have seen in his writing going on for several years now.

Ok. But ironically enough, several people jumped in after this post (the one quoted above) and reiterated the compliment.

Michelle Dulak Thomson: Any proposal for universal “catastrophic” insurance would have to deal with these illnesses.

But most day-to-day medical expenses are not like that; they’re more like minor complaints that a decent NP could diagnose rapidly and that don’t need anything massively expensive in the way of medication.

Agreed, but keep in mind the old 80/20 rule: as in many things, the vast majority of medical expenses are incurred by a relatively small number of people. We all wind up paying for this one way or another except for the small proportion of those unhealthy few who happen to be rich and under 65. So we might as well find a way to cover these costs as efficiently as possible.

To say that most day to day medical expenses are routine and could be treated for far less than we do today is true but also a bit beside the point. It’s like Lehman Brothers worrying back in 2008 that it is paying too much for office supplies while it’s facing billions of dollars in losses on derivatives contracts. It’s a distraction from the real issue.

eyesay wrote,

we need to provide health coverage for people who can’t afford even non-catastrophe medical care.

And I wrote,

You mean, like Medicaid?

And you:

Medicaid has strict income eligibility requirements. If you have a chronic condition that requires you spend, say, $600 per month on medicine and you don’t have insurance, you have to wait until you are sufficiently impoverished for Medicaid to kick in.

Yeah. IOW, if you really can’t afford non-catastrophic medical care, Medicaid reimburses it. If you can find a way to pay for it, it doesn’t.

I do agree that a fantastically expensive chronic condition is, for practical purposes, a financial catastrophe, and that it’s not made much easier by the bills being spread out month-by-month. Any proposal for universal “catastrophic” insurance would have to deal with these illnesses.

But most day-to-day medical expenses are not like that; they’re more like minor complaints that a decent NP could diagnose rapidly and that don’t need anything massively expensive in the way of medication.