Krugman Is Overly Optimistic About Obamacare: The Difference Between Better and Good

Paul Krugman seems very optimistic about Obamacare. I hope he’s right but I think he’s far too sanguine about the pitfalls. In fact, I don’t think he’s right about the potential problems:

What can still go wrong? Well, Obamacare is a complicated program, basically because simpler options, like Medicare for all, weren’t considered politically feasible. So there will probably be a lot of administrative confusion as the law goes into effect, again especially in states where Republicans have been doing their best to sabotage the process.

Also, some people are too poor to afford coverage even with the subsidies. These Americans were supposed to be covered by a federally financed expansion of Medicaid, but in states where Republicans have blocked Medicaid expansion, such unfortunates will be left out in the cold.

Still, here’s what it seems is about to happen: millions of Americans will suddenly gain health coverage, and millions more will feel much more secure knowing that such coverage is available if they lose their jobs or suffer other misfortunes. Only a relative handful of people will be hurt at all. And as contrasts emerge between the experience of states like California that are making the most of the new policy and that of states like Texas whose politicians are doing their best to undermine it, the sheer meanspiritedness of the Obamacare opponents will become ever more obvious.

If Massachusetts is any guide, it’s not just the poor that will be hit–it’s the next two fifths as well. The data from Massachusetts are clear: having health insurance is better than not having it. But better than is not the same thing as good. In Massachusetts in 2008, forty percent of those who made between $39,000 – $63,000 reported skipping needed medical treatment due to costs.

Again, that’s better than the fate of the uninsured. But the issue isn’t the premiums, it’s the deductibles and copayments. Paying low monthly rates and still getting hammered on the copays can actually leave lower-middle class households worse off–they don’t qualify for Medicaid, but they can’t afford deductibles.

Like I mentioned, I hope Krugman is right, but he really doesn’t seem to understand how healthcare costs hit moderate income families. This is an improvement, but that might not be good enough for millions of people–that’s not bureaucratic problem but a policy one.

At least, he’s now calling it a conservative plan…

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7 Responses to Krugman Is Overly Optimistic About Obamacare: The Difference Between Better and Good

  1. What in hell is wrong with you people?
    Canada has all the health infrastructure in place for you to copy freely.
    It works. NO, it is NOT like the present U.S. system where you can have better care if you have more money. It’s about fairness and human decency. We HAVE to take care of each other, it is just the right thing to do.
    Will you have to wait for a minor surgery? Maybe, if someone needs the operating time more than you do. But you WILL be taken care of, just not to the schedule you might want.
    It’s -still- better and more humane than your current or proposed systems.

    • Janice,

      I’ve actually made that point multiple times.

    • Because we are a nation of gamblers – we’d rather win or lose than have the mediocrity of everyone just having it “ok”.

      Or a least that’s what they tell us.

      • Incidentally that was sarcasm and to note maybe “ok” should have been replaced with “good”.

        Sincerely though – we all think we’re going to join the 1% and would rather skimp on something like taxes or healthcare toward that end than ensure all of us have an equal and positive footing.

    • gilgit says:

      You may not have intended to convey this, but you imply that if you have lots of money and don’t want to wait, there is nothing you can do about it in Canada. That isn’t correct. I mention it because conservatives claim it to be the case and it just isn’t so.

      I remember when Obamacare was going through congress, stupid Republicans brought forward some dopey Canadian who came to America for an operation, paying for it out of pocket, and claiming she couldn’t get care in Canada. And one of the web sites I used to check was about health care in Canada and the blogger wrote how stupid this was. That you can always pay for the care yourself at any time.

      Over the years I’ve heard various conservatives says, “Socialized Medicine prevents me from doing something different if I want to.” So I’ve kept an eye out for articles on this topic and there are no countries on earth where, if you have the money and don’t want to wait, there is nothing you can do. You can always go to the front of the line if you pay full price yourself.

  2. hipparchia says:

    This is an improvement, but that might not be good enough for millions of people–

    y’all are both overly optimistic. count me in those millions you talk about, or the handful that paul krugman mentions… http://correntewire.com/baseline_geezers_in_the_health_insurance_exchanges

  3. Pingback: Healthcare: It’s the Deductibles, Stupid | Mike the Mad Biologist

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