In a piece ironically titled "What's Next For Progressives?" the star New York Times pundit suggests that we stop being so damned unicorny and fight for universal pre-K as a worthy substitute for the impossible dream of maintaining our lives and livelihoods when we get sick or hurt.
Not that he personally has anything against a single payer health insurance system, of course. It's just that such a program would be too hard to sell to anti-government Deplorables. It's just that a public program would put all those private insurance executives and claims adjusters and rent-seeking lobbyists out on the street. Or should I say, out on The Street?
No, it's simply that the desperate people insanely clamoring for a single payer program are unreasonably forcing Democratic politicians to take a litmus test for purity. Making candidates promise Medicare for All would essentially be inviting them to lie, and goodness knows, they don't want to also be faced with a lie detector test should they have the amazing good luck to win any more elections on their feeble incremental platforms.
On behalf of the Clinton-Obama wing of the party, Krugman chides:
So it’s time for a little pushback. A commitment to universal health coverage — bringing in the people currently falling through Obamacare’s cracks — should definitely be a litmus test. But single-payer, while it has many virtues, isn’t the only way to get there; it would be much harder politically than its advocates acknowledge; and there are more important priorities.What could possibly be more important than life and good health, you may ask?
Why, saving the predatory insurance cartel which helped save Obamacare by altruistically pushing back against Republican repeal, of course! Blue Cross/Blue Shield saved the day for Blue Cross/Blue Shield. Let's give three cheers for the oligarchy.
Also more important than the lives and well-being of 330 million American citizens is the convenience of those who currently obtain their insurance through their employers. No matter that a program like HR 676 would require no effort, automatically enrolling everybody, Krugman claims to be worried that transitioning from private to public would cause a massive outbreak of Post Traumatic Stress Disorder among the current beneficiaries of for-profit coverage.
Moving to single-payer would mean taking away this coverage and imposing new taxes; to make it fly politically you’d have to convince most of these people both that they would save more in premiums than they pay in additional taxes, and that their new coverage would be just as good as the old.As economist Robert Frank and others have demonstrated, this premiums vs. taxes argument doesn't hold water. But Krugman not only refuses outright to discuss the specifics, he dismisses them out of hand. He doesn't tell his readers that for one thing, administrative costs for a government run insurance program would only be two percent of the total budget, as opposed to the six percent costs of running a for-profit system. Further reducing costs would be the government's ability to negotiate lower prices for drugs and other services. And most important, a Medicare for All plan would be virtually repeal-proof. If everybody enjoyed the same benefits, the divide and conquer politics of resentment would be a thing of the past.
This might in fact be true, but it would be one heck of a hard sell. Is this really where progressives want to spend their political capital?
So Krugman pulls the old bait and switcheroo. If centrist Democrats (he calls them "progressives" solely for purposes of propaganda) can't deliver on single payer health care, perhaps they'll get some political mileage from pretending to care about Our Children. Krugman has suddenly discovered that "we" neglect the nation's children. But rather than suggesting a living wage and/or guaranteed income for their parents, an increase in food assistance, a federal jobs program and subsidized housing, he tosses out the crumbs of pre-K and paid parental leave.
My published response:
Health care is either a basic human right, or it isn't.
Incremental improvements to, and more public funding of, our for-profit predatory health care delivery system are not going to cut it. A system in which some lucky people are insured and some are not is, in fact, the very antithesis of social and economic justice. It's health care apartheid.
Whatever happened to "justice delayed is justice denied?"
Krugman maintains that it would be "too hard" to educate people that paying premiums, via taxes, to a centralized government-run Medicare for All-type system is fairer and cheaper than paying premiums to private corporations whose CEOs make obscene salaries and whose wealthy investors suck profits from the pain of ordinary people.
Krugman is squandering an enormous opportunity from his popular perch in the op-ed pages to do some of this educating himself. Of course, his claim of "impossibility" is not true at all. According to most polls, between half and two-thirds of the American populace already support a single payer system.
So he should have titled this piece "What's Next For the Plutocrats Running the Place?" As established by Gilens and Page in their Princeton study, it's the rich donor class which despises the idea of true universal health care.
The only "progress" the billionaires care about is the progress of their own wealth and their own dynasties as the chasm between rich and poor grows wider by the day.
The rest of us can't wait. Single Payer or bust.