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Monday, June 04, 2007

Paul Krugman: Obama in Second Place

Paul Krugman says Barack Obama's health care plan is "better than I feared":

Obama in Second Place, by Paul Krugman, Commentary, NY Times: One of the lessons journalists should have learned from the 2000 election campaign is that what a candidate says about policy isn’t just a guide to his or her thinking about a specific issue — it’s the best way to get a true sense of the candidate’s character. ...

That’s why I’m not interested in what sports the candidates play or speculation about their marriages. I want to hear about their health care plans — not just for the substance, but to get a sense of what kind of president each would be. Would they hesitate and triangulate, or would they push hard for real change?

Now, back in February John Edwards ...[came] out with a full-fledged plan to cover all the uninsured. Suddenly,... candidates were under pressure to present their own specific plans. And the question was whether those plans would be as bold and comprehensive as the Edwards proposal.

Four months have passed... Hillary Clinton has released ... proposals to help reduce health care costs. It’s worthy stuff, but it’s hard to avoid the sense that she’s putting off dealing with the hard part...., how she proposes to cover the uninsured...

[L]ast week Barack Obama ... finally delivered a comprehensive health care plan. ... First, the good news. The Obama plan is smart and serious... It also passes one basic test of courage. You can’t be serious about health care without proposing ... to help lower-income families pay for insurance, and that means ...[a] tax increase. Well, Mr. Obama is now on record calling for a partial rollback of the Bush tax cuts.

Also, ... insurance companies won’t be allowed to deny people coverage or charge them higher premiums based on their medical history. Again, points for toughness.

Best of all, the Obama plan contains the same feature that makes the Edwards plan superior to, say, the Schwarzenegger proposal...: it lets people choose between private plans and buying into a Medicare-type plan offered by the government.

Since Medicare has much lower overhead costs..., this competition would force the insurance industry to cut costs — making our health-care system more efficient. And if private insurers couldn’t ... cut costs enough, the system would evolve into Medicare for all, which is actually the best solution.

So there’s a lot to commend the Obama plan. ... Now for the bad news. Although Mr. Obama says he has a plan for universal health care, he actually doesn’t... mandate insurance for adults. So some people would take their chances — and then end up receiving treatment at other people’s expense when ... in emergency rooms. In that regard it’s actually weaker than the Schwarzenegger plan.

I asked David Cutler, a Harvard economist who helped put together the Obama plan, about this omission. His answer was that Mr. Obama is reluctant to impose a mandate that might not be enforceable, and that he hopes ... that a combination of subsidies and outreach can get all but a tiny fraction of the population insured without a mandate. Call it the timidity of hope.

On the whole, the Obama plan is better than I feared but not as comprehensive as I would have liked. It doesn’t quell my worries that Mr. Obama’s dislike of “bitter and partisan” politics makes him too cautious. But at least he’s come out with a plan.

Senator Clinton, we’re waiting to hear from you.

Previous (5/28) column: Paul Krugman: Trust and Betrayal
Next (6/8) column: Paul Krugman: Lies, Sighs and Politics

    Posted by on Monday, June 4, 2007 at 12:15 AM in Economics, Health Care, Politics | Permalink  TrackBack (0)  Comments (49)


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