Paul Krugman says:
O.K., more seriously, it’s actually Mr. Obama who’s being unrealistic here, believing that the insurance and drug industries — which are, in large part, the cause of our health care problems — will be willing to play a constructive role in health reform. The fact is that there’s no way to reduce the gross wastefulness of our health system without also reducing the profits of the industries that generate the waste.
If I understand him, he is saying that insurance companies and pharmacutical companies cannot have any role in health care reform, and it is naivete on the part of Obama to expect them to do anything to help correct the problems in the healthcare system. To me it seems like Krugman is the one being naive, most Americans like their current healthcare, the goal should should be to insure every American and provide the best medical care. Like it or not the insurance companies and the drug companies have the expertise to do that, it is just a matter of creating the incentive.
Krugman seems to feel that the only way to make anyone cooperate is through force, no wonder he supported the Iraq war. The only way health care reform can succeed is if everyone has a stake in it, especially those who work in it every day. To suggest that a new healthcare system can be created without the assistance of insurance companies and drug companies is more naive than talking with them to see what they want. and what they can offer.
The whole editorial can be viewed here
I make sure to read all of Krugman’s columns, and this one from today became a less-rounded piece of the tapestry evolving in my head under the title of “heath care tomorrow”…I have to give him credit for simply calling it what it is. I think of John Bolton railing against the UN, and about how the only purpose of its existence is to fulfill the interests of the United States…it’s a simple mindset, but one that aptly applies to both the health insurance and pharmaceutical industries.
The denial of claims has given birth to a separate industry of paper-pushers that doctors have to hire just to get paid. Not only are US consumers denied a competitive market that would lower drug costs, but the government gives the industry a big lollypop in the form of Medicare expansion, with the government not allowed to bargain for lower prices.
I’m with Krugman on this score. Let them buy their advertisements and kick and scream all they want. The sooner these government-buying stock prices get shafted, the better. The game needs to change, and the seats at this table should be reserved for the people, not the stock prices.
I was probably a little harsh on Mr Krugman. However, I do think it is a mistake to require perfection from the health care system when it might be better to get everyone covered and then tweak the system to make it more efficient.
If people want perfection or nothing at all it seems like a the status quo will win out. Once it becomes accepted that everyone is entitled to health care and everyone is covered the next step of a single payor system might get some thought. As it is right now it is not politcaly feasible to implement single payor system, and it may not be desirable, I am still thinking that part through. Without a doubt a system that covers everyone is desirable and anyone who is talking about a way to get coverage for everyone should be encouraged. Cynism can become self fulfilling and in this case I hope that is avoided; even if it means working with insuarance companies.
The profit motive is a geared towards a number one goal of sabotage. The Republican Party has basically seen that as their #1 responsibility in Washington during their entire time in power. Nothing can completely eliminate that influence from the debate, so providing the saboteurs the least number of allies in the process is important.
Selling it to the public…that job has already been done. The polls indicate that and have for years now already. In this instance I’d offer academic health care system experts the seats that would have been occupied by the chiseling would-be terrorists who have bled this country dry for so many years.
Enough is enough…fuck Pfizer and United Health. It’s about time they started earning their money like everybody else has to. Once Americans gain control over the country’s health system, we can then start the de-corruption of the drug approval process and kill 100 birds with one stone by making publicly funded elections the law of the land.
Step by step the private money must expelled from our political process, and there’s no better place to start than health care.
I’m not feeling Krugman’s focus on Obama, but after reading his book, I understand where his heart is in all of this. He’s taking the gloves off…he says it’s about time liberals got tough and flipped “bi-partisanship” the bird.
I’m sending you this book – – – if you want it, let me know. Conscious of a Liberal – – –
The book sounds good
I like what Megan McArdle said:
When designing a policy program, you cannot just assume away the interest groups–nor, except in Paul Krugman’s imagination, can you simply overcome them through your steely-eyed willingness to engage in “bitter confrontation”. Drug companies make lifesaving drugs that people need, which of course tends to breed resentment when they charge what the market will bear, but also gives them a rather powerful weapon to deploy in the PR war. Similarly, most people are quite content with their current insurance; if you attempt to destroy the insurance companies outright, they will do their best to get all those people worried about what will happen under your new program. These industries are also very important to several highly populous states with powerful senators and congressmen; threaten them and you threaten your coalition.
I mean, these tactics are fine by me; I don’t want national healthcare. But is Paul Krugman interested in making policy, or just making an expressive statement about his youthful ideals?
http://meganmcardle.theatlantic.com/archives/2007/12/barack_obama_naive_healthcare.php
I think Megan Mcardle might be right but for the wrong reason. The big pharmacutical companies have not really produced that many life saving drugs, mostly they have produced multiple ED treatments and painkillers like Vioxx, that not only caused health problems but really doesn’t work as a pain killer.
Someone needs to make big pharma live up to their retoric and I think the best way to do that is to bring them to the bargaining table and tell them to stop spending the majority of their money on marketing and start trying to help people. I don’t know if it will effect their profits or not but it might improve the health of the average consumer and it might also cut down on wasteful health care spending.
The idea od getting rid of insurance companies and drug companies sort of reminds of de-baathifcation in Iraq. One of the biggest mistakes made in Iraq was to get rid of all baathists from the government as some of these people were very good at their job and were probably needed to keep the country running. In some ways pharma and health insurance companies are sort of like the Baathists in Iraq, some of them are very nasty people who need to go, but many of them are simply technocrats who can help make a new system work, the idea is to work with the ones who want to help fix the problem and end the profiteering without rewarding the people who brought us Vioxx and all the other useless drugs that are advertised during almost every TV show.
BTW why is Viagra and all the other ED treatments such an heavy advertisor on the Rush Limbaugh show?
Very good point! I will think about this for a while. I hadn’t considered such an analogy before, but on first glance, the glove seems to fit.
Hey Al:
Thanks
Awhile back I was trying to do a post on who the real villin is in health care, the doctor who recomends unneeded treatment, the patient who demands unecessary tests and treatment the insurance companies who don’t pay for anything. Maybe the drug companies who don’t seem to take the patients health very serious and seem very good at ignoring long-term health consequences. Even medical researchers seem to design their experiments to not show any long term or even short term health problems generated by certain drugs and procedures.
The real culprit in this mess is the revered market(sorry Caveat) where everyone acts in what they believe to be their best interests, and in the end it turns into a zero-sum game where the patient almost always loses.
I liken this to the way our free market transacted mortgages with people and banks with other banks with other banks, other banks, other banks, other banks…Greenspan was already worthy of being called a fraud long before he assured us in 2004 that the housing market wasn’t a bubble forming right before our eyes.
Capitalism minus government equals suffering.
The mortgage industry is pretty messed up. I am buying a condo and it seems like everyday my mortage broker calls with a new loan “that would be perfect for me” and I have to keep telling him I am happy with a boring fixxed rate loan. It is amazing the number of reasons he can give me as to why a variable rate would be better, I think he really believes what he is saying. Of course it doesn’t hurt that the commisions are probably higher for a variable rate loan.
I think it is exactly like the doctor who probably believes he is helping the patient when he prescribes a unneeded medication; the fact that his income is enhanced is just a bonus.