In a column entitled "Health Reform Realities," New York Times (Jan. 18, 2016, on page A21) [READ HERE], the Nobel Prize recipient Prof. Paul Krugman criticizes presidential candidate Bernie Sanders' proposal for "Medicare for All." The peculiarity of Krugman's criticism, however, is that he starts out by mis-characterizing Sanders' proposal, as if Sanders were proposing to start the whole political process of health-care reform "from scratch" (his word) by first dismantling what we now have under Obamacare, to "re-litigate" (his word) for the case for a brand-new health-care system. Prof. Krugman does not actually say so in so many words (as he certainly must know that it would be pretty silly!) but there seems little doubt, to this reader, anyway, that he tries to create such impression, or an impression that any attempt to change the current Obamacare for a single-payer system would result in a loss of what we now have under Obamacare or somehow contribute to a premature demise of Obamacare.
The political significance of Sanders' proposal is to declare that Obamacare, whether it was a political victory for the Obama presidency or not, is still a woefully inadequate and deficient health-care system for our country, and that our ultimate goal must be to establish a bona fide single-payer system, as all other advanced nations have done. Needless to say, this only means that we must continue our endeavor to get there by all means, including through incremental changes, but not that we must first dismantle everything that we now have under the current law. In this sense, Krugman's advice that we must not spend any political capital on any further reform of the health-care system is also misplaced, as Sanders' health-care proposal is, in reality, generating a huge new political capital for candidate Sanders, rather than consuming what little (if any) political capital he already has.
Krugman also says that single-payer would require a lot of additional tax revenues, as if that would be a valid reason why we shouldn't even try to move to a single-payer system. This is an intellectually dishonest claim playing on the semantics of "tax" versus "health-care premium," but does he not know that money is fungible? He talks as if money is fungible to some extent, but not 100%. Could that be what he truly believes? As he admits, Obamacare is not a very cost-effective system and one of the major reasons why we must move to a single-payer system is the financial need to control the national health-care cost, which will go out of control under Obamacare regime, not the other way around.
Krugman's another reason for advising us that we should forget about moving to a single-payer system is that the private insurance companies and other financial-interest groups who derive huge profits from the current system have so much political power that they will simply not allow the kind of change in the national health-care system proposed by Sanders to happen. One has to wonder, however, since when we have treated a political agenda unworthy of pursuing for the simple reason that it would meet formidable political enemies? Because that may just be the reason why a political agenda is sometimes the start of a political movement. And we just may be witnessing such historical movement in this election campaign by Senator Sanders.
On the whole, while reading through Prof. Krugman's column, this reader found himself struggling to suppress the ridiculous (?) thought that somehow the lack of integrity or mendacity which some people ascribe to Bill and Hilary Clinton may finally be catching up with everyone in the Clinton support group. For this article does not seem to measure up and fit with the stature and the prestige of the writer and appears to be more like a trash produced by the zealous, run-of-the-mill partisan campaigners, and to this reader who has been a long-time admirer and follower of his writings, it is a profound disappointment, to say the least.