Article Of The Week

Columnist and Nobel prize-winning economist Paul Krugman may be the foremost advocate in the U.S.A. of single-payer health care and thus is a staunch supporter of the public insurance piece of the Obama health care plan. He writes in "Not Enough Audacity" in The New York Times on July 26

And that’s why the public plan is an important part of reform: it would help keep costs down through a combination of low overhead and bargaining power. That’s not an abstract hypothesis, it’s a conclusion based on solid experience. Currently, Medicare has much lower administrative costs than private insurance companies, while federal health care programs other than Medicare (which isn’t allowed to bargain over drug prices) pay much less for prescription drugs than non-federal buyers. There’s every reason to believe that a public option could achieve similar savings.

But that's not his point. He is concerned that the post-partisan Barack Obama is unaware "reform isn’t worth having if you can only get it on terms so compromised that it’s doomed to fail." Krugman notes that it now appears that the President, obsessed with bipartisanship and the art of the possible, is amenable to a health care bill watered down in the mistaken belief "that half a loaf is always better than none."

Krugman uses the analogy of the stimulus bill passed earlier after inclusion of compromises which won the support of three-3- Republican senators. Bipartisanship, limited as it was, was gained at the cost of enactment of a measure which would have been larger and more likely to forestall a serious recession. Still, it has beenmet with continued antagonism from the GOP, which now would probably prevent passage of a needed, second stimulus bill.

The pursuit of hazy, feel-good partisanship may be sensible, even necessary under other circumstances. Senator Obama himself noted (video below) that passage of a single-payer health care plan required a Democratic President, House of Representatives, and Senate. Now there are a Democratic President, a Democratic House of Representatives, and 59 1/2 Democratic Senators, and Senator Dianne Feinstein (D.-Cal.)on June 21 says of that Democratic President "Well to be candid with you, I don’t know that he has the votes right now. I think there’s a lot of concern in the Democratic caucus.” And sort-of Democrat Joe Lieberman of Connecticut warns "Let’s get something done instead of having a debate.”

It may be unfair to dump on Joe Lieberman- no, it never is- for an instinct common among the political and, especially, journalistic class. There is an impulse to "get something done," to pass some sort of bill, so that it is a notch in the belt of the congressman or the president. It becomes, as the mainstream media would have it, a "win" rather than a "loss." But as Paul Krugman understands well, "yes, the perfect is the enemy of the good; but so is the not-good-enough-to-work. Health reform has to be done right."