"The American people are pretty sharp!"

TUESDAY, OCTOBER 22, 2019

No distraction left behind:
In this morning's column, Paul Krugman offers some basic words of caution about the politics of Medicare-for-all in an election year.

That said, we'll admit that we were provisionally puzzled, as we often are, by something in Krugman's second paragraph. The column started like this:
KRUGMAN (10/22/19): On Sunday, Elizabeth Warren said that she would soon release a plan explaining how she intends to pay for “Medicare for all.” Like many policy wonks, I’ll be waiting with bated breath; this could be a make or break moment for her campaign, and possibly for the 2020 election.

There are three things you need to know about Medicare for all, which in the current debate has come to mean a pure single-payer health insurance system, in which the government provides all coverage, with no role for private insurers.
As we've noted in the past, we've long been puzzled by the description of Medicare as a "single-payer" system. We've been puzzled because there are two major "payers" in the current Medicare system—the federal government on the one hand, and the individual health care recipient on the other.

Why call the system "singe-payer" when there are two major payers? Such matters are rarely allowed to intrude on our hapless American discourse.

That said, "Medicare for all," as formulated by Bernie Sanders, really would be "single-payer." Essentially, the federal government would pay the whole tab. Earlier this year, PolitiFact spelled it out:
GREENBERG (2/19/19): For individuals, there would be no costs—no deductibles, no copays or coinsurance. The two exceptions would be for some prescription drugs—though that would be limited to $200 a year—and possibly for long-term care.

[...]

Medicare for All is much more generous than the current Medicare program. Right now, the Medicare program is for Americans 65 and over; they receive care, but they’re also responsible for part of the costs. Unlike traditional Medicare, Sanders’ Medicare for All would cover medical bills completely, with no burden on the patient. There would be no Medigap insurance or Medicare Advantage.
Presumably, this explains why Krugman refers to "Medicare for all" as "pure single-payer." That said, how many voters understand such matters?

Not too many, we'll guess. As a nation, we spend all our time discussing whatever Donald J. Trump most recently said, preferably in the last fifteen minutes.

Today, the thing Trump said in the last fifteen minutes involved the fraught term "lynching." In response, everyone has swung into action, from Whoopi and Newt on down.

In theory, Medicare-for-all would be a dream in certain major respects. As with the financing of public schools, so too here—there would be no charge to the individual who received some medical treatment.

That doesn't mean that MFA isn't tricky as a political proposition. Krugman explains some of the problems—and eventually, he also says this:
KRUGMAN: An independent estimate from the Urban Institute (which is, for what it’s worth, left-leaning) suggests that a highly comprehensive Medicare-for-all plan, similar to what Sanders is proposing, would substantially increase overall health spending, although a more modest plan wouldn’t.
Why did we stumble over that? Here's why:

On the one hand, it makes perfect sense to read that Medicare-for-all would "increase overall health spending." If everyone is covered, and no one has to pay anything out of pocket, it stands to reason that many more people would receive many more medical services.

On the other hand, there's this:

At present, we already spend two to three times as much on health care, per person, as any comparable nation. In the abstract, it's hard to believe that a competent overhaul of the health care system might not be able to reduce overall spending.

That said, the question of America's massive health care spending is virtually non-existent within the American press. Donald J. Trump said "lynching" today! The children are struggling with that!

"The American people are pretty sharp!" Plainly, it's the oldest song in the nation's political song book.

Except we actually aren't pretty sharp, or so the anthropologists tell us, at least not when it comes to conceptual matters like this.

Our most brilliant elites are in charge of this game. As Donald J. Trump seems to know full well, few distractions will be left behind!

22 comments:

  1. Oh dear. It's so cute when a neoliberal hack expresses 'concerns' about election-year bullshit of his globalist comrades.

    "In the abstract, it's hard to believe that a competent overhaul of the health care system might not be able to reduce overall spending."

    Well, dear Bob, Obamacare didn't reduce the spending, so what gives?

    In fact, in the abstract, it's hard to believe that any overhaul of the health insurance practices would reduce overall spending.

    Medical mafia is the issue, to a much greater extent than the way their ludicrous bills are paid...

    ReplyDelete
    Replies
    1. mao mao * 你的阴茎很小

      Delete
    2. Mao, granted Obamacare was not a cure all by any means - that's why Sanders and other dems are now pushing universal Medicare. Will what they advocate ever be enacted (assuming one of them gets elected)? Seems doubtful. Will it work? That's questionable. The current system is entrenched, and there are too many vested interests. Is the current system irreparable, because, as you say, a lot of the reasons the U.S. pays so much more than everyone else is the exorbitant fees doctors get, and the inflated cost of medical equipment and drugs. I watched the 2016 GOP debates, and recall Trump promising that he'd come up a plan to fix all this, that it would be easy, everyone would be covered, and it would cost way less. Needless today, no one can outdo Trump in the bullshit department. He hasn't done much of anything, and has no plan. And you seem to throw this "globalist" accusation around like they used to do (well they still do) about Commies. If Trump is so great, why doesn't he do anything about this?

      Delete
    3. Is there any possible blog comment in this universe that you dembots wouldn't retort with Orange Man Bad?

      As for Mr Trump, since the congress has been taken over by zombies from the beginning of this year, he's hardly in any position to be fixing things. His job, for the foreseeable future, is to be investigated behind closed doors, denounced by zombie media based on orchestrated leaks, impeached by the house, and then acquitted by the senate. Get on with the program.

      And as for 'globalist' being, in your mind, an accusation rather than characterization, that's your problem, not mine.

      Delete
    4. mao mao * 你的阴茎很小

      Delete
    5. Mao,
      If you want to hear "Orange Man Best President Ever", you'll need to read a blog where the Establishment posts.

      Delete
  2. It should be noted that the increase in spending that Krugman warns about would occur at the federal government. The actual spending represents a shift in who pays what. Under the pure single-payer approach modeled by the Urban Institute:

    “Health spending by employers would be eliminated, and household and state health spending would decline considerably while federal spending would increase significantly.”

    The total cost to the economy would actually be lower using this system than were nothing done.

    ReplyDelete
  3. I have always said that Trump was Zaphod Beeblebrox. As Douglas Adams said "The purpose of the President is not to wield power, it is to draw attention away from it."
    Zaphod is very good at his job.

    Had to ROFLMAO (wink) though since I, myself, used the fraught term 'lynching' in my last post perhaps an hour ago.

    There are no coincidences, right V?

    ReplyDelete
    Replies
    1. It's curious, I reckon, that it's both zombie lynching and star chamber prosecution.

      Not an entirely new phenomenon, of course; seems like a resurrection of HUAC, more or less.

      Delete
    2. mao mao * 你的阴茎很小

      Delete
    3. Wow. A Right-winger is accusing someone else of lynching. I (don't at all) wonder what that means.

      All of them, Katie.

      Delete
  4. In Somerby's world, we can only talk about one thing at a time. Where is that written?

    ReplyDelete
    Replies
    1. You might consider cancelling your subscription and asking for a refund.

      Delete
    2. TDH should go to a subscription base.
      People can pay to see all Right-wing memes amassed in one place

      Delete
  5. It's very simple, talk about Trump, Trump wins.

    Talk about reforming government and government policies to benefit the people, Trump loses.

    ReplyDelete
  6. 'hat said, the question of America's massive health care spending is virtually non-existent within the American press.'

    In fact, it has been covered multiple times. But TDH prefers not to mention it, since he doesn't like the press pointing out the venalities of his idols Trump and Moore.

    ReplyDelete
  7. “There are three things you need to know about Medicare for all, which in the current debate has come to mean a pure single-payer health insurance system, in which the government provides all coverage, with no role for private insurers.”

    Bullshit, as as far a Sander’s plan is envisioned. Here’s the only thing I could find against private insurance:

    SEC. 107. Prohibition against duplicating coverage.
    (a) In general.—Beginning on the effective date described in section 106(a), it shall be unlawful for—
    (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or
    (2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.
    (b) Construction.—Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, including additional benefits that an employer may provide to employees or their dependents, or to former employees or their dependents.

    LINK

    See that section 107.(b), Krugman? Hm, no, plainly not. Well who knows, maybe Sanders has recently excised that bit. But I don’t think so.

    Leroy

    ReplyDelete
  8. I dunno. If this dump ain't free, I'm gone. I wouldn't pay two shits much less two cents to read it.

    Well, maybe I would if I could shit in Bob's mouth.

    ReplyDelete
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