Way Off Base: PAUL KRUGMAN

THE COMPLETE ARTICLE
THE NEW YORK TIMES

OP-ED COLUMNIST

Way Off Base

By PAUL KRUGMAN

Published: April 16, 2007

On key issues, reluctant Democratic politicians are being dragged by their base into taking highly popular positions.

Normally, politicians face a difficult tradeoff between taking positions that satisfy their party’s base and appealing to the broader public. You can see that happening right now to the Republicans: to have a chance of winning the party’s nomination, Republican presidential hopefuls have to take far-right positions on Iraq and social issues that will cost them a lot of votes in the general election.

But a funny thing has happened on the Democratic side: the party’s base seems to be more in touch with the mood of the country than many of the party’s leaders. And the result is peculiar: on key issues, reluctant Democratic politicians are being dragged by their base into taking highly popular positions.

Iraq is the most dramatic example. Strange as it may seem, Democratic strategists were initially reluctant to make Iraq a central issue in the midterm election. Even after their stunning victory, which demonstrated that the G.O.P.’s smear-and-fear tactics have stopped working, they were afraid that any attempt to rein in the Bush administration’s expansion of the war would be successfully portrayed as a betrayal of the troops and/or a treasonous undermining of the commander in chief.

Beltway insiders, who still don’t seem to realize how overwhelmingly the public has turned against President Bush, fed that fear. For example, as Democrats began, nervously, to confront the administration over Iraq war funding, David Broder declared that Mr. Bush was “poised for a political comeback.”

It took an angry base to push the Democrats into taking a tough line in the midterm election. And it took further prodding from that base — which was infuriated when Barack Obama seemed to say that he would support a funding bill without a timeline — to push them into confronting Mr. Bush over war funding. (Mr. Obama says that he didn’t mean to suggest that the president be given “carte blanche.”)

But the public hates this war, no longer has any trust in Mr. Bush’s leadership and doesn’t believe anything the administration says. Iraq was a big factor in the Democrats’ midterm victory. And far from being a risky political move, the confrontation over funding has overwhelming popular support: according to a new CBS News poll, only 29 percent of voters believe Congress should allow war funding without a time limit, while 67 percent either want to cut off funding or impose a time limit.

***

The only risk the party now faces is excessive caution on the part of its politicians. Or, to coin a phrase, the only thing Democrats have to fear is fear itself.

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Will she invade Iran?

Elect Susie Flynn

"My name is Susie Flynn. I am running for President of the United States of America to help the nine million children living without health insurance."

Yeah, but will she invade Iran?

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Child Dies for Lack of Dental Care

Confusion over Iraq soccer explosion - US carried out blast - 18 children dead

The Health Care Racket: PAUL KRUGMAN

THE COMPLETE ARTICLE
The New York Times
OP-ED COLUMNIST

The Health Care Racket

By PAUL KRUGMAN

Published: February 16, 2007

In our health insurance system, resources that could have been used to pay for medical care are instead wasted in a zero-sum struggle over who ends up with the bill.

Is the health insurance business a racket? Yes, literally — or so say two New York hospitals, which have filed a racketeering lawsuit against UnitedHealth Group and several of its affiliates.

I don’t know how the case will turn out. But whatever happens in court, the lawsuit illustrates perfectly the dysfunctional nature of our health insurance system, a system in which resources that could have been used to pay for medical care are instead wasted in a zero-sum struggle over who ends up with the bill.

The two hospitals accuse UnitedHealth of operating a “rogue business plan” designed to avoid paying clients’ medical bills. For example, the suit alleges that patients were falsely told that Flushing Hospital was “not a network provider” so UnitedHealth did not pay the full network rate. UnitedHealth has already settled charges of misleading clients about providers’ status brought by New York’s attorney general: the company paid restitution to plan members, while attributing the problem to computer errors.

The legal outcome will presumably turn on whether there was deception as well as denial — on whether it can be proved that UnitedHealth deliberately misled plan members. But it’s a fact that insurers spend a lot of money looking for ways to reject insurance claims. And health care providers, in turn, spend billions on “denial management,” employing specialist firms — including Ingenix, a subsidiary of, yes, UnitedHealth — to fight the insurers.

So it’s an arms race between insurers, who deploy software and manpower trying to find claims they can reject, and doctors and hospitals, who deploy their own forces in an effort to outsmart or challenge the insurers. And the cost of this arms race ends up being borne by the public, in the form of higher health care prices and higher insurance premiums.

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Gold-Plated Indifference: PAUL KRUGMAN - Bush & Health

THE COMPLETE ARTICLE
The New York Times
OP-ED COLUMNIST

Gold-Plated Indifference

By PAUL KRUGMAN

Published: January 22, 2007

President Bush is someone with no sense of what it’s like to be uninsured.

President Bush's Saturday radio address was devoted to health care, and officials have put out the word that the subject will be a major theme in tomorrow's State of the Union address. Mr. Bush's proposal won't go anywhere. But it's still worth looking at his remarks, because of what they say about him and his advisers.

On the radio, Mr. Bush suggested that we should "treat health insurance more like home ownership." He went on to say that "the current tax code encourages home ownership by allowing you to deduct the interest on your mortgage from your taxes. We can reform the tax code, so that it provides a similar incentive for you to buy health insurance."

Wow. Those are the words of someone with no sense of what it's like to be uninsured.

Going without health insurance isn't like deciding to rent an apartment instead of buying a house. It's a terrifying experience, which most people endure only if they have no alternative. The uninsured don't need an "incentive" to buy insurance; they need something that makes getting insurance possible.

Most people without health insurance have low incomes, and just can't afford the premiums. And making premiums tax-deductible is almost worthless to workers whose income puts them in a low tax bracket.

Of those uninsured who aren't low-income, many can't get coverage because of pre-existing conditions — everything from diabetes to a long-ago case of jock itch. Again, tax deductions won't solve their problem.

The only people the Bush plan might move out of the ranks of the uninsured are the people we're least concerned about — affluent, healthy Americans who choose voluntarily not to be insured. At most, the Bush plan might induce some of those people to buy insurance, while in the process — whaddya know — giving many other high-income individuals yet another tax break.

While proposing this high-end tax break, Mr. Bush is also proposing a tax increase — not on the wealthy, but on workers who, he thinks, have too much health insurance. The tax code, he said, "unwisely encourages workers to choose overly expensive, gold-plated plans. The result is that insurance premiums rise, and many Americans cannot afford the coverage they need."

Again, wow. No economic analysis I'm aware of says that when Peter chooses a good health plan, he raises Paul's premiums. And look at the condescension. Will all those who think they have "gold plated" health coverage please raise their hands?

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