FROM THE TPP TO THE ACA: Krugman praises the ACA!

WEDNESDAY, JULY 15, 2015

Part 3—The things which don't get said:
The Affordable Care Act is the fruit of Democratic Party effort which dates, in its current iteration, to 1991.

In that year, a string of presidential candidates spoke of the need for “universal coverage.” Twenty-four years later, how is the ACA doing in that and other regards?

Last month, the ACA survived a major challenge in the Supreme Court. At the New York Times, Paul Krugman used the occasion to ask and answer that question.

“The Affordable Care Act is now in its second year of full operation; how’s it doing?” That was the question with which Krugman started his June 25 column.

“The answer is, better than even many supporters realize,” he then said.

Krugman argued strongly that the health law has been a major success. He started with the number of people who have gained insurance—and with those who haven’t:
KRUGMAN (6/25/15): Start with the act's most basic purpose, to cover the previously uninsured. Opponents of the law insisted that it would actually reduce coverage; in reality, around 15 million Americans have gained insurance.

But isn't that a very partial success, with millions still uncovered? Well, many of those still uninsured are in that position because their state governments have refused to let the federal government enroll them in Medicaid.

Beyond that, you need to realize that the law was never intended or expected to cover everyone.
Undocumented immigrants aren't eligible, and any system that doesn't enroll people automatically will see some of the population fall through the cracks. Massachusetts has had guaranteed health coverage for almost a decade, but 5 percent of its nonelderly adult population remains uninsured.

Suppose we use 5 percent uninsured as a benchmark. How much progress have we made toward getting there? In states that have implemented the act in full and expanded Medicaid, data from the Urban Institute show the uninsured falling from more than 16 percent to just 7.5 percent—that is, in year two we're already around 80 percent of the way there. Most of the way with the A.C.A.!
We’ll assume all those statement are accurate. In our view, Krugman is plainly describing a significant degree of success.

It could also be said that he’s describing low or lowered expectations from us in the liberal world. Here’s why we say that:

On the one hand, “universal coverage” is now said to mean 95 percent coverage. There’s no attempt to characterize the missing five percent.

Beyond that, when Krugman says we’re 80 percent of the way to that goal, he’s basically discussing the blue states. The red states have basically been dismissed from Krugman’s discussion of coverage rates. They are lagging, Krugman says, because their governors and legislatures rejected Medicaid expansion.

Without any question, that does help explain why the red states are lagging in the expansion of coverage. Beyond that, it helps explain why 21 percent of low-income adults nationwide still lack coverage, according to Gallup—a number that is horrifically bad by the norms of the developed world.

Krugman is right about the dynamics which have slowed the growth of coverage. He doesn’t explain why it’s politically possible for red-state governors and legislature to make a decision like that.

Those decisions raise a basic question you’ll never see us liberals ask. What the heck is wrong with us—what’s wrong with our political skills—when these decisions are still being made seventy years after President Truman first sought national health care—after the rest of the developed world instituted such programs?

What the heck is wrong with us? That’s a question you never see asked in the modern liberal world, where we fuel ourselves with constant talk about our own moral and intellectual greatness. As we litter the countryside with our pleasing R-, B-, N-, X-, H- and M-bombs, it simply never enters our heads that there could be something we are doing that’s slowing the nation’s progress.

Do you read the new Salon or watch our clowning cable programs? If so, you know the game we enjoy:

First, we tell the others that they’re racists, xenophobes, bigots. We then marvel at the way they refuse to do whatever we tell them next.

It’s true that the red states have rejected Medicaid expansion. We leave the second question unexplored:

Why haven’t we brilliant liberals been able to convince our fellow citizens of the folly of this refusal, seven decades after Truman? To the extent that we do ask that question, we answer it with our alphabet soup, raining our R’s, our X’s and B’s all over the countryside.

Rachel clowns, then plays with her toys. Happy, we go to bed.

As Krugman continued, he continued to praise the ACA. We don’t disagree with anything he said, but we did think he went a tiny bit partisan at one or two points.

He praised the quality of the coverage people have received—or at least, he didn’t condemn it. He said the rise in premiums has been just two percent this year, and that the rise will only be slightly higher than that next year.

He said there has been “a sharp slowdown in the growth of overall health spending, which is probably due in part to the cost-control measures” in the ACA. He said the ACA hasn’t been killing jobs.

In our view, there’s already a major point that Krugman is semi-avoiding. But as he ended his column, we thought we saw his thumb on the scale a tiny tad in a slightly tribal sense:
KRUGMAN: Finally, what about claims that health reform would cause the budget deficit to explode? In reality, the deficit has continued to decline, and the Congressional Budget Office recently reaffirmed its conclusion that repealing Obamacare would increase, not reduce, the deficit.

Put all these things together, and what you have is a portrait of policy triumph
—a law that, despite everything its opponents have done to undermine it, is achieving its goals, costing less than expected, and making the lives of millions of Americans better and more secure.
Would repealing Obamacare increase the deficit? We assume it would, but Krugman didn’t note that this would be caused, in part, by the repeal of the taxes in the law.

In the red states, folk do notice an omission like that. They think they’re being played.

By light-years, Krugman has been the press corps’ MVP over the past fifteen years. For that reason, we hate it when we think we see him going a tiny bit partisan.

We thought we saw that drift in this particular column. We thought that even before we saw Chris Hayes seeming to boast about the fact that our uninsured rate is now just 11.4 percent nationwide—an utterly hideous number by international norms.

In our view, we in the liberal world tend to be extremely easy on ourselves. We love to blame the others, enjoying the use of our alphabet bombs.

As droogs have done through the annals of time, we thrill to our own tribe’s moral greatness and intellectual brilliance. We recoil in horror from the fallen state, the sheer loathsomeness, of those in the other tribe.

In the case of American health care, we seldom ask if we have possibly failed in some possible way in the seventy years since Truman. Tomorrow, we’ll start to answer that question, starting with something Krugman said and moving to something he didn’t.

Tomorrow: Zeke Emanuel’s reply

59 comments:

  1. Not to mention one has trouble imagining even the most notorious Wall Street scumbag or other Republican coming close to reaching the "fallen state" of discussing how a human being will be crushed efficiently in order to harvest his or her organs, between bites of salad. Or defending such a person or practice.

    ReplyDelete
    Replies
    1. Are you seriously objecting to organ donation? Or does it mostly bother you that doctors cut people? That is what they do. Take your single-issue hysteria about abortion someplace else.

      Delete
    2. Are you seriously not objecting to a human individual being killed at his or her mother's directive, and her then presuming to donate his or her organs (that the killer meticulously preserved during the killing process with the objective they would remain intact for use)?

      Some "single issues" are understood by civilized people to be more important than all others combined.

      Delete
    3. Troll someplace else.

      Delete
    4. Anon 11:17, you're being too vague. I doubt many in the other tribe will know you're referring to the Planned Parenthood money for organs video.

      Delete
    5. "If you are going to kill all these people, at least take the brains out so that the material may be utilized."  
      Nazi doctor Julius Hallervorden, Nuremberg trials, 1945.

      Damn Jews and their organ donation hysteria.

      Delete
    6. Please also note that the video in question was massively edited to present a physician's comments out of context and to heighten outrage. It was another conservative sting operation in which someone misrepresented themselves to an unsuspecting interviewee in order to ask them leading questions while video recording them. The result is pure propaganda.

      Delete
    7. These are sick people. Please don't encourage their trolling here. We have enough problems with ugly trolls without bringing in a whole new batch.

      Delete
    8. Yes!!!! Ugly trolls who actually comment on the great Bob Somerby are problem enough. But they, like the assassin Dylann Roof are part of God's plan to test our ability to resist hating them. These sick people are merely others.

      They are all going to hell anyway.

      Delete
    9. @Anon 12:07, so pretty much the same as the Romney 47% audio.

      Delete
    10. Yes. The duplicitous videographer even forced Romney to do the damage in a single, unedited take without having to give Romney any direction or ask any questions about his understanding of the character's motivation. He did, however, have to falsely pose as a server.

      Delete
    11. No, @ 12:30. Romney actually said what he said. The video wasn't selectively edited to portray him saying anything different. No one lied to him to get him to say what he did. No one asked him leading questions: "How bad are the poor?"

      Delete
    12. "Please also note that the video in question was massively edited to present a physician's comments out of context and to heighten outrage"

      A lie. Only someone whose conscience will not allow him to accept what he plainly sees and hears, so must throw some justification out there. Here is the full three hours of the video showing Planned Parenthood doctor discussing the most efficient killing of humans to maximize utilization of and profit from their organs. If you defend this, think about who and what you are, or blind yourself with focus on the means by which the truth was obtained and exposed.

      https://www.youtube.com/watch?v=H4UjIM9B9KQ

      Delete
    13. Just like delusional Nancy Pelosi actually said:

      " So we have to pass the bill so you can find out what is in it away from the fog of controversy."

      https://www.youtube.com/watch?v=hV-05TLiiLU

      Delete
    14. Romney could have said "All poor people are lazy and of low character" and it wouldn't begin to approach what the left is defending now unless he added, "...and should be killed by their mother and their organs harvested for profit."

      There is no other equivalent of the evil contained in that video in mainstream American politics now, although there have been identical rationalizations in other places at various times in history, so by all means defend criticism as "hysteria" over business as usual.

      Delete
    15. Moderator please remove these comments. In our fantasy New Bill of Rights we hope to replace the backward, religion-permitting and offensive joke-permitting First Amendment with one that reads "No woman shall ever be exposed to expressed thoughts that may make her aware the ethics of the act of terminating the life of a human being with no legal rights are debated, most especially expressed thoughts that may cause her to reconsider this ultimate act of empowerment before engaging in it for the greater good."

      Delete
    16. "Just like the nasty mrc-drone cicero trolled ...."

      FTFA - $$$$$$

      Delete
    17. cicero's blowup dollJuly 15, 2015 at 8:55 PM

      cicero and David inCal's idol, Roger Ailes;

      Ailes told [Philipstown, NY supervisor Richard] Shea that as president he would send Navy SEAL trainees to the border as part of a certification program: “I would make it a requirement that you would have to personally kill an illegal immigrant coming into the country. They would have to bring home a dead body.” [The Loudest Voice in the Room,pg 392]

      Delete
    18. 1:46,
      "...terminating the life of a human being with no legal rights..."

      I thought this was about a fetus, and not a human being.

      Delete
  2. Given that about 3.5% of the population travels overseas each year, Americans may be unaware that the developed world has it better than we do here. Every time I visit Europe I wonder why we cannot have good trains and rapid transit like the have in nearly every city there. You need the comparison with someplace that does things better to recognize that there could be improvement here. But Americans do not travel much outside the US (except for business and some 1% leisure travelers and immigrants going to visit relatives elsewhere).

    http://www.huffingtonpost.com/william-d-chalmers/the-great-american-passpo_b_1920287.html

    ReplyDelete
    Replies
    1. Huge taxes on gasoline might lead to that.

      Delete
    2. In California, the refineries are manipulating the gas prices again by withholding supply. Prices jumped nearly a dollar in the past few weeks. The rest of the country doesn't care because prices are still low for them. I wish the government would set the price so that we are not robbed every summer just when people want to put their kids in the car and take a vacation.

      Delete
    3. Maybe people don't respond to the kinds of questions Somerby asks because we are used to thinking the cost and quality of goods and services are beyond our control. When governments sets prices you can complain to the government (picket, march). When market forces supposedly determine these things, where do you direct your complaints? Everyone passes the buck and the consumer is left having to just suck it up and live with conditions as they are.

      Some of us dream about going to live in Canada or Europe. That seems like a more viable way to accomplish change than anything political we might do.

      Delete
    4. Even if you are dead broke and in debt there is nothing to stop you from realizing your dream of Canada or even Europe!!!

      Even couples in public housing, where the husband was about to lose his job, caught cheating on his wife, diagnosed as an addict, and the wife was reentering the labor market after child rearing and household duties have been able, through hard work (an a little American luck) to make dreams come true.

      Tour this couple's new dream home for inspiration.

      http://www.oprah.com/oprahshow/Tour-Bill-and-Hillary-Clintons-Chappaqua-New-York-Home-Video

      Warning to casual commenters on this blog: This couple did not, REPEAT, DID NOT, go to Canada or Europe. Rumors about the role of spellcasters in their success are just that, rumors. No baby organs were harvested to finance this video.

      That said, your results may differ.

      Delete
    5. See, this is why we can't have nice things. Instead of a substantive discussion about why Americans don't complain about their health care choices, we get this kind of stupid troll garbage.

      Delete
    6. Instead we are having a discussion demonstrating that, even when given the chance by one of America's most thoughtful critics of lazy liberal culture, Americans would rather comment on travel, leisure, high prices of gas, and even home buying tips rather than health care.

      So in that sense we are getting a practical view of the problem rather than some theoretical discussion that might please the professors in the audience, but really does little to display how irreversible the melting trend has become.

      Delete
    7. Excessively literal to the end. You interpret my earlier comment about how travel has prevented people from knowing what health care is like in developed countries as a comment on "travel, leisure". It was a comment on why Americans don't know that our health care system is looting us. Lack of comparison with better systems.

      You then use my comment as an excuse to bash Somerby again. I hate you trolls.

      Delete
    8. Hillary and Bill have nice things. Plus they travel. A lot. In other people's very nice planes. They are so impressed with health care around the world they have created a giant discount drug company you can donate to if you want to pay to hear them speak.

      Delete
    9. This is a progressive blog. You are wasting your breath and contributing to the noise death of the universe with your blathering. No one wants you here.

      Delete
    10. "In California, the refineries are manipulating the gas prices again by withholding supply. Prices jumped nearly a dollar in the past few weeks."

      They should be thankful they don't live in Europe where the government does the gouging.

      Delete
    11. Moderator please remove these comments. In our fantasy New Bill of Rights we hope to replace the backward, religion-permitting and offensive joke-permitting First Amendment with one that reads "No woman shall ever be exposed to expressed thoughts that may make her aware the ethics of the act of terminating the life of a human being with no legal rights are debated, most especially expressed thoughts that may cause her to reconsider this ultimate act of empowerment before engaging in it for the greater good."

      Delete
  3. Bob. I'll stay on topic! Who named Krugman the liberal MVP?

    Did the players themselves make the selection? Was it the coaches? Did fans get to vote online? If it is the latter I doubt the results are valid. The Liberal League may have let fans vote more than once. If not, votes from red states really shouldn't matter since that is how Obama forced Hillary to quit right before she got the nomination she had clearly won.


    BTW, how come we are getting leftover Krugman from last month, MVP notwithstanding? I thought we were going to see Zeke Emanuel in today's line-up. Injured reserve for Zeke? Rainout? What gives?

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    Replies
    1. I dream of Canada. Even Europe. But with gas prices as high as they are here in California, and nobody else in the rest of the whole darned country giving a rat's ascot I doubt I'll make it past Yorba Linda, that godforsaken burg with the cruddy ditch.

      So you're stuck with me till I can't tell the forest from the tress or the pizza from the sushi.

      Delete
  4. "Here Are 5 Big Things Paul Krugman Says He Got Wrong Over The Years"

    https://screen.yahoo.com/5-big-things-paul-krugman-050000273.html

    ReplyDelete
    Replies
    1. "Here are 5 Commenters With Zero Credibility
      1. cicero; 2. cicero; 3. cicero; 4. cicero; and 5. cicero."

      FTFY - $$$$$

      Delete
    2. @ 1:43

      Spoken like one of the "nerd virgins" working for David Brock's "Correct the Record."

      Delete
    3. cicero, don't you think abstinence is the best practice for anyone who is unmarried, whether they are a nerd or not?Shouldn't it be the primary focus of health education in our schools?

      In other words, shouldn't virginity be something to applaud rather than scoff at?

      Delete
    4. @ 2:04 PM - in the case of cicero's parents and in hindsight, abstinence would have been the way to go.

      Delete
    5. @ 2:04

      The U.S. public school curriculum is already heavy on gender identity and carnal knowledge. That is why Millennials know all about how to get free contraception but are clueless about what the Fourth of July represents.

      Delete
  5. "Despite the multiple 'near-death' experiences, the health reform law is 'historic,' and 'I'm proud to have done my small part,' Emanuel writes. Nonetheless, he acknowledges the ACA 'isn't perfect; no legislation in a democracy will ever be. But it was heartening to learn that sometimes, sound policy can trump politics when politicians show leadership.'" (Emanuel, Wall Street Journal, 3/7/14).

    ReplyDelete
  6. I didn't read this post, but whatever it's about, I blame Rachel, Maureen and Matthews.

    ReplyDelete
    Replies
    1. I blame their lazy, dumb, immoral liberal enablers myself. But I was sleeping in the woods when this all got started and only woke up when the R-, B-, N-, X-, H- and M-bombs began littering the countryside.

      Delete
  7. "In the red states, folk do notice an omission like that. They think they’re being played."

    In the blue states, lazy dumb Alphabet bomb droppers get fooled when "We were broke" is not coupled in the lead paragraph or two with "and in debt."

    Bob Somerby knows these things. He lived his life in blue states. He rode the comedy circuit through red states a decade and a half ago. You have to be sharp as a tack to observe people are either really really smart when it comes to reading between the lines in a Krugman column or so dumb you have to shake them screaming from their nightmares.

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  8. The big Dumb going down here, I say more in anger than in sorrow, is this mind bogglingly stupid post by Bob Somerby.
    First, is he highlighting the fact that Obamacare would not cover everyone because I think that kind of came up at the time. It is always rather obvious that it's goals were a step back from the Clinton's ideas.
    Yet the topper for the books, truly A DAILY HOWLER, is that liberals are to blame for the uninsured of the Red States because they just didn't do a good job convincing the Tea Party that single payer would be a good idea! The name named in this liberal failure Rachel Maddow! Talk about sticking to a script!! Is Bob simply too STUPIDLY married to his script to have noticed what has been going in this Country for the last six or seven years?? When the right has mounted a well funded, relentless, four sheets to the wind, UNPRECEDENTED attack on all things Obamacare, the HALF MEASURE towards universal coverage??
    What an inane, ridiculous, truly DUMB performance from Bob Somerby.

    ReplyDelete
  9. "Would repealing Obamacare increase the deficit? We assume it would, but Krugman didn’t note that this would be caused, in part, by the repeal of the taxes in the law.

    In the red states, folk do notice an omission like that. They think they’re being played."

    No, I don't think that's right. In the red states their eyes glaze over when you start talking about how repealing taxes (good!) increases deficits (bad!). What they think in the red states is:

    -Obama is bad
    -ergo Obama-care is bad
    -ergo it must be repealed

    And that's it. Anything further than that is giving them too much credit for rational thinking (another dangerous tendency of liberals/progressives).

    You continually bemoan the tribalism infecting our national politics, and rightly so...but it bears repeating that in this case, "both sides do it" is actually a valid argument. It makes no sense for liberals to unilaterally disarm, suppressing their natural tribal instincts in the name of bipartisanship, when the only "bipartisanship" the other tribe will accept is total capitulation to their views. I'm tired of it. The conservatives are not just the other tribe, they are WRONG about everything but think they are RIGHT, and I am no longer willing to try to find middle ground with them. To heck with them. They are wrong and that's the end of it.

    ReplyDelete
  10. "It’s true that the red states have rejected Medicaid expansion. We leave the second question unexplored:

    Why haven’t we brilliant liberals been able to convince our fellow citizens of the folly of this refusal, seven decades after Truman? To the extent that we do ask that question, we answer it with our alphabet soup, raining our R’s, our X’s and B’s all over the countryside."

    Because that's the only rational explanation we have for why they continue to refuse to work with us! What possible explanation could there be for refusing the Medicaid expansion other than racism, bigotry, and extremism? I have waited in vain for some kind of actual evidence of any other reasoning. Why, why, why do they persist? Do they even know? Ultimately, they refuse it because they choose to do so...and they choose to do so on irrational, tribal, and ultimately inhumane grounds. Why should I compromise with that?

    "What the heck is wrong with us—what’s wrong with our political skills—when these decisions are still being made seventy years after President Truman first sought national health care—after the rest of the developed world instituted such programs?"

    There is nothing wrong with our political skills. The problem is that the other tribe flatly rejects our overtures, then blames us for not wanting to compromise! Liberals are not perfect, but you cannot say that we are not willing to compromise...within reason. If the demanded "compromise" is total capitulation or nonsensical concessions that would cause actual harm to the people we're trying to help, that's not our fault. That's on the ones proposing such ridiculous things and presenting them as "compromises". Well, "compromise" has a second meaning beyond ceding part of a position in the name of securing agreement; it also means irrevocably damaging a thing by eliminating vital structures within it, leading to its inevitable failure. There is no earthly reason to accept that kind of "compromise."

    ReplyDelete
    Replies
    1. You like to quote Shakespeare, "the fault lies not in our stars, but in ourselves." But I say in this case "ourselves" doesn't apply to liberals only, but to the American people as a whole. The reason there is such resistance to Obamacare is not due to a failure of liberal politics; it is because those who oppose it and resist it are fundamentally irrational, unpersuadable through rational means. Something is rotten in the state of America.

      Delete
    2. Thank you for stating in eloquently, if overly kindly. But the short version is Bob is writing like an idiot with his head up his ass.

      Delete
    3. There is no law requiring you to here. You've stated your opinion, now go away.

      Delete
    4. There is no law requiring him to here.

      There is a magnet that attracts those of your mentality. And a mindset that requires you to reveal it.

      I'd tell you to go away. I know you can't.

      Delete
    5. At the risk of exposing myself to scorn as a "Bobfan" my take is that the blogger's point is that the liberal media have failed to explain that in other developed countries everyone is covered by insurance or the equivalent (even for nursing homes I believe); if you lose your job you are not exposed to losing health care; average life spans are longer than in the US; and they pay less than half per capita than in the US. All this should be a major topic of discussion, but it is virtually ignored. Very few Americans are aware of these factors. This should be a major focus of the talking heads at MNBC and in the media in general - yet it gets ignored, probably, one reason, because it's too complicated

      Delete
  11. What is wrong with liberals on health care?

    Liberals have learned to throw up our hands and say national health care is a pipe dream.

    Liberals have learned it's more fun to call people over-medicated than hold agribusiness and insurance companies accountable.

    Liberals have learned to caricature learning about natural medicine and biology is something stupid Eastern Europeans do, so uncouth!

    ReplyDelete
    Replies
    1. Plus they sleep a lot. They are lazy.

      Delete
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    ReplyDelete
  13. i want to give thanks to my dr and i will always give thanks to DR OGUDUDU who brought back my love that has left me for 6years within 48hours, i have said about this last week but i promised to always tell people about this every week end so that those that did not read about it last week will read about it this week, i have been looking for how to get this boy back to my life because i love this boy with the whole of my heart, i could not replace him with any body,one day i was watching my television when i saw a lady giving thanks to DR OGUDUDU and telling the world how he helped her i was so shocked i could not believe it because i never taught that there are powers that can bring back lost love, then that was how i decided to contact him too because i do really need my love back,when i contacted him i told him everything and he told me not to worry that my love will surely be back to my arms within 48hours at first i could not believe because i was thinking how could somebody that has gone for 6years come back within 48 hours,so then i decided to watch and see,unbelievable within the next 48hours i got a call from unknown number so i decided to pick the call the next thing i could hear was my loves voice he was pleading and begging me on the phone that i should forgive him that i should forget all that have happened that he did not know what came over him,he promised not to leave for any reason, that he was really sorry for what he did,i was so surprised because i never believed that this could happen,so that was how i accepted his apology and the next morning he came to my house and still pleading for me to forgive, him i told him that everything is okay that i have forgiven him, that was how we started again and now we are married, i promised to say this testimony in radio station, commenting this testimony is still okay but before this month runs out i promise to say this in radio station and i will,sir thank you very much.World please am begging you people to try and thank this man for me,or if you need his help here is his email address drogududuspellhome@gmail.com. or call +2348144368825 THANK YOU DR

    ReplyDelete
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