Can Reform Cure Krugman-itis?
Krugman-itis is terrible. I should know. I used to suffer from it myself. When I was younger, I used to believe that Democrats were always at a disadvantage because they were too honest for their own good.
This state of affairs was depressing, but also intoxicating. I believed with all my heart that my party was more honest, more intelligent and more enlightened. So now I empathize with those, like Paul Krugman, who still suffer from the same afflication. In his latest column, Krugman writes,
At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.
The right-wing propaganda machine is a very unpredictable thing. It failed tragically to persuade gullible voters to vote against Barack Obama last November. It also fell short in the congressional elections of 2006. Fortunately, it has now recovered its magical powers and has been able to swing the electorate away from their natural support for universal healthcare.
I think you see what I’m getting at. The right-wing propaganda machine — or if you prefer, “the vast right-wing conspiracy” — is a convenient foe that can be blamed for any setback. Or conveniently ignored when he doesn’t do his job.
Now, for a minute there, I began to wonder if I was a victim of the right-wing propaganda machine. Now, I don’t believe in death panels and I don’t believe that anyone is going to pull the plug on grandma, but maybe all that time I spent reading the Weekly Standard had subtly begun to warp my mind.
Thankfully, Krugman’s colleague David Brooks was there to shake me to my senses. As he told Jim Lehrer on Friday,
[Obama] just tells a lot of whoppers now. Now, believe me, Rush Limbaugh and Sarah Palin are saying some things that are extremely off the charts untrue about the plan, but I just wrote down some of the things Obama said today which are whoppers.He said everyone can keep their health care plan. Well, the CBO doesn’t say that. Six million people are going to lose their plan. Preventive care saves money. That’s not true. It’s going to cost $90 billion a year. That’s not true. It’s probably going to cost twice as much when it’s fully implemented. Government will be out of health care decisions.
He tells one thing after another, making it seem so easy. Well, believe me: This is not easy. It’s going to take some sacrifices and some really painful cuts for people to get this system under control.
One of the unfortunate symptoms of Krugman-itis is that it may blind you to the dishonesty of your political allies. As long as folks on the other side (especially Rush Limbaugh) are saying things that are completely off the wall, you have license to ignore the disingenuity on your own side of the aisle. In fact, you may even believe that the policies you favor are right simply because such awful people oppose them.
In addition to missing the dishonesty on your side of the aisle, Krugman-itis may also blind you to those things that make your policies unpalatable to real, live voters. As Ross Douthat, another one of Krugman’s colleagues, points out,
For liberals trying to find the money to make health insurance universal, [Medicare's] inefficiencies make Medicare an obvious place to wring out savings. But you can’t blame the elderly if “savings” sound a lot like “cuts.” When the president talks about shearing waste from Medicare, and empowering an independent panel to reduce the program’s long-term costs — well, he isn’t envisioning a world where seniors get worse care, but he’s certainly envisioning a world in which they receive less of it.
But the biggest problem with Obama’s plan may be that there is no plan at all. Robert Reich may be on Paul Krugman’s side, but he knows that the President himself bears just as much responsibility for the current situation as the lying liars on the right. Reich asks,
Why are these [townhall] meetings brimming with so much anger? Because Republican Astroturfers have joined the same old right-wing broadcast demagogues that have been spewing hate and fear for years, to create a tempest.But why are they getting away with it? Why aren’t progressives — indeed, why aren’t ordinary citizens — taking the meetings back?
Mainly because there’s still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee.
But that’s the problem: It’s always easier to stir up fear and anger against something that’s amorphous than to stir up enthusiasm for it.
On the other hand, if Obama’s plan weren’t so amorphous, people might object to its actual contents. Or they might demand an explanation of how he’ll pay for it. If Obama’s plan were the one Reich wanted, the public might even be angrier. (And Reich might come down with a serious case of Krugman-itis, since he would be incapable of understanding how anything other than “fear and hate” could prevent the American public from supporting an idea he knows is so good.)
The funny thing is, I’m not intrinsically hostile to many of the reforms Democrats have proposed. I may be a Republican, but I agree that healthcare costs are out of control and we need some major reforms. I’m willing to consider any idea on the merits, even it involves more government involvement in healthcare.
But when push comes to shove, I’m much more concered with the truth-value of what the President says than I am with the integrity of Limbaugh & Co. I don’t like it when the President publishes an op-ed (in Mr. Krugman’s NY Times) in which he avoids taking a position on any of the specifics, but still promises that “reform will finally bring skyrocketing health care costs under control.” And as David Brooks pointed out, Obama isn’t letting himself be bound just by the facts.
I wish I could take six months off from my job just to study health care, so I could really understand what’s going on instead of having to trust what other people say about the subject. But since that’s not going to happen, I’m not going to support the reforms unless I really have confidence that the President is telling it like it is.
Cross-posted at Conventional Folly
24 Responses to “Can Reform Cure Krugman-itis?”
[...] will have the mental capacity to confront the increasingly complex challenges that confront us. Can reform cure Krugman-itis? – themoderatevoice.com 08/19/2009 Krugman-itis is terrible. I should know. I used to suffer from it [...]
Be nice to Krugman…he isn't really a lacky. Yes, he is very liberal, but he is one of the few liberals that isn't afraid to tear into Dems when he disagrees with them.
It is hard to find people on either side of the isle that are willing to go after their own party for its wrong doings. Yes, Krugman is out there…but I believe what he says is what he means. He does just puke up talk points given to him from the White House.
You wrote:
“I wish I could take six months off from my job just to study health care, so I could really understand what’s going on instead of having to trust what other people say about the subject.”
I found this recent article (6/1/09) in The New Yorker. The author is a doctor who in my opinion takes a very pragmatic approach to studying the health care problem using statistics and then visiting Doctors in the areas. It is kind of long, but I enjoyed reading the article since it is free of the political bickering that is on-going at the moment. To answer your question, I feel after reading it that I understand what is going on in HealthCare.
http://www.newyorker.com/reporting/2009/06/01/0…
“Preventive care saves money. That’s not true. “
Whoa, that's a pretty big claim to make. I don't think anyone should dismiss the idea of “treating the cause” is such an offhand way.
While it may not save money, it saves people from unneeded and unnecessary pain.
At free clinic, scenes from the Third World
That's only because the Bush Administration and it's Republican flunkies screwed the pooch so badly that the media couldn't hide the damage anymore. Who are you going to believe, Fox News or your lying eyes?
David, thank you very much for recommending the article by Atul Gawande. I hope to post about it later.
Don, you may be rationalizing yourself into a trap. Every election Republicans lose can be explained by something they did badly. Same with Democrats. Whichever side you're on, you can always attribute your victories to other side's obvious bungling while blaming your defeats on the other side's propaganda machine. But for the moment, Democrats seem much prone to this logical trap. As far as I can tell, Republicans seem to accept that they got what they deserved in 2006 and 2008, even if they think the Democrats' exploitation of their failures was less than honest.
Most points you make about the political spin could be reversed, of course. Every conservative knows that conservative principles would be adopted across the nation if it weren't for those irrational Soros-funded libs who control the media lying and hiding the truth and faking the election rolls through ACORN.
To move to a more substantive issue about which there may be an actual answer, I too was taken aback by the quoted claim that preventative care will not save money. In the context given, it strikes me as parallel to the following conversation:
Mom and dad to graduating senior in high school, “Son/daughter, it is really important to attend college. Apart from the benefits of education itself, a college degree, generally speaking, will lead to greater wealth and financial stability.”
Child/Brooks: “False! College costs money, in some places $50,000 a year!”
To which the correct response is, wtf?! Of course getting preventative care costs money in any individual year. The idea is that it saves money over the long term. If the latter is false, I'd definitely want to know about it. Moreover, as others have said already, the idea of health care is to make people actually healthy. On some other thread, someone was talking about obese people or smokers saving us money by dying young. True or not, a health care plan can't be based around trying to kill off its own patients. Similarly, a health care program cannot be based around refusing to monitor health through regular check-ups. Hey, maybe if we don't catch that heart disease until way too late, they'll just up and die, instead of making us pay for a bypass or recommending a better diet. Ka-ching! (I do realize that Brooks was just arguing that preventative care has costs, not that there should be no preventative care. I assume he was, anyway.)
Paca this has been discussed in other threads. Preventive care is a great thing, it saves lives, extends lives and improves quality of life. Unfortunately the great majority of the time it doesn't save money. This was confirmed by the CBO a couple of weeks ago. Obama responded by saying he would focus on the few measures that actually do save money, the operative word there being “few”.
Here's a couple of links:
http://www.washingtonpost.com/wp-dyn/content/ar…
http://content.nejm.org/cgi/content/full/358/7/661
Several comments have observed that Brooks' dismissal of preventive care is overly broad. By itself, it is. But Brooks comment was made in the context of the current debate and was intended as a reference to the CBO's dismissal of the financial benefits of preventive care, as provided for in current legislation.
Pacatrue, you are undoubtedly correct that there is very real conservative equivalent to Krugman-itis. Yet as noted in my previous comment, it seems that for the moment, Democrats are much more prone to this sort of thinking. Would you say that's empirically true? Since last fall's election, the GOP has been much more inclined to talk about its own flaws than to blame it defeat on others.
Dental converge is not included not included in the current plan just like it is not include in Medicare or Medicaid. If you are going to find fault in the current system at least find something that the proposals will change.
Medicaid covers dental here in Iowa. The problem is it pays so poorly hardly any dentists accept it.
Thanks for the links, DaGoat, I will look through them this evening I hope.
My offhand take is that, if preventative care, does not save money, then it is not in fact preventing anything. Seems like that should be the focus of many things.
Anyway, I will read up on it in a bit.
At the Forum, his patients included a diabetic amputee who had not been able to buy his medicine for months, a retiree who couldn't afford an X-ray for a lung problem, and a 30ish female diabetic with a kidney ailment so serious that Taw called for an ambulance to take her to a hospital.
I don't believe that any of the underlined are dental problems…
The CBO paper provides some more nuanced statements than many critics of reform have implied. Here is one section of it.
You know that last part about how “many” insurance plans cover preventive services? How many of those exist for medium to small employers? I know that I've never seen them in that environment.
Jim, the part you have bolded doesn't say that they will save money as Obama claims, it is saying they are “worth it” in terms of clinical benefit (ie saved lives, etc). Like I said above, preventive care is great, it does a lot of good things but it doesn't save money. There is no doubt preventive care has clinical benefits, what it usually doesn't have is financial benefits.
I was simply pointing out that the CBO paper is not purely critical of the value of spending on preventive medicine, which is what some posts referring to it would seem to imply.
superdestroyer–
Yes of course, “dental care” for seniors. An extra $6.43 per month for a box of Efferdent.
Krugman is a hack, and a pathetic hack. (It says so much about his few supporters or admirers, too.)
He is so bad I actually prefer to listen on the radio when someone else on the Left instead is commenting: Robert Reich.
* * *
As to preventive health care efforts: Laying aside the reasonable fears of PC idiocy regarding lifestyle and lifestyle choices and Washington as a perverse surrogate parent that perverse childish people would want, the preventive health care is in large part (with current proponents) silly, unrealistic naivete' at best. So often, those who most need it won't get it even if it's given to them for “free” (and it's not the place of government to force them to get it). But it won't save money, and as foreseen by the naive proponents, it will lose money. Anything, be it care, exams, or even screening, given to huge numbers of people often won't be cost-effective and in fact will cost money. (The more clever Dems know this and don't care, as it furthers their goals of spending and interventionism, which is what they really care about.)
“My offhand take is that, if preventative care, does not save money, then it is not in fact preventing anything. “
Actually, saving money and preventing “anything” are two different things completely. Preventive care prevents disease among those who are more susceptible, and in practice it often catches the progress of disease (or the threat of it) early and results in less disease and less treatment, which incidentally is a saving of money.
The problem (which should be obvious, but which is overlooked, or evaded) is that often you don't know who is susceptible (or everyone is, to different degrees, susceptible), so you treat “everyone,” or at least a large number of (susceptible) people. The large number of those people (you don't know who will get a disease or who won't, or often you don't know the probability or if it's greater or lesser than average, so you exercise prevention on as many people as you can) is what makes the cost so much higher than so many people realize.
In the real world, some preventive care will be sought for everyone ideally such as periodic exams; what we see even with blood tests (that can reveal problems before they become severe) is that they're limited often to those who need additional information sought about them after other symptoms or signs are found. And in the real world, since (sorry, kids) we can't have everything, the costs of this prevention are going to have to compete for funds with other worthy objects of spending.
“Medicaid covers dental here in Iowa. The problem is it pays so poorly hardly any dentists accept it.”
The “solution” some want is to force dentists (and doctors) to accept it, by eliminating a “private option.”
I guess people can kill through words.. it can hurt their feeling and its really really painful..Those word can also considered Deadly weapon of a human..
The seriousness some people give to Krugman amazes me, he is just another pundit. His Nobel Prize was for trade theory, if he was commenting on that, maybe he could speak with expertise. Krugman commenting on other areas of the economy is like a marine biologist who specializes in jellyfish commenting on sharks and claiming to be an expert.because he is a marine biologist, or maybe even claiming to be an expert on Polar Bears because he is a scientist. If the topic is Trade thory I'll give Krugman some attention, if not might as well get Limbaugh or Olbermann and call them experts.
[...] Well, they’re not exactly new ideas. They’re new to me. More importantly, they’re ideas that didn’t seem to make the cut for either Democratic or Republican talking points. Which doesn’t mean they’re good ideas, but at least they’re thought provoking. (Hat tip: david1clark) [...]