Paul Krugman notes that the GOP has collectively been working for around three decades to bring on the catastrophic nexus, “preparing the ground” for the moment at which they can cut wildly popular programs like Medicare and Social Security in the name of “fiscal responsibility.” Unfortunately, with that day all but at hand, the GOP finds itself unwilling to pull the trigger and say these long-held beliefs publicly:
At this point, then, Republicans insist that the deficit must be eliminated, but they’re not willing either to raise taxes or to support cuts in any major government programs. And they’re not willing to participate in serious bipartisan discussions, either, because that might force them to explain their plan — and there isn’t any plan, except to regain power.
Absolutely right. And but Krugman goes on to note in today’s column that the state of the California health insurance system generally and the recent Anthem move to raise rates by ~30% specifically put to lie everything the GOP is saying about national health insurance reforms:
some claim that health costs would fall dramatically if only insurance companies were allowed to sell policies across state lines. But California is already a huge market, with much more insurance competition than in other states; unfortunately, insurers compete mainly by trying to excel in the art of denying coverage to those who need it most. And competition hasn’t averted a death spiral. So why would creating a national market make things better?
More broadly, conservatives would have you believe that health insurance suffers from too much government interference. In fact, the real point of the push to allow interstate sales is that it would set off a race to the bottom, effectively eliminating state regulation. But California’s individual insurance market is already notable for its lack of regulation, certainly as compared with states like New York — yet the market is collapsing anyway.
Finally, there have been calls for minimalist health reform that would ban discrimination on the basis of pre-existing conditions and stop there. It’s a popular idea, but as every health economist knows, it’s also nonsense. For a ban on medical discrimination would lead to higher premiums for the healthy, and would, therefore, cause more and bigger death spirals.
So California’s woes show that conservative prescriptions for health reform just won’t work.
To which we say: yep, even though Krugman starts with a straw-man in there. Some? How about “GOP leaders in the House and Senate say” or any other construction there? Some? That’s Bush league usage.
But, I think the synthesis of these two articles is what actually provides the way forward. We’ve said it before: Democrats can’t bring themselves to move good policy and the GOP categorically can’t resist bad policy, so combine the two. Spend a few years “preparing the ground” just as the GOP did on forcing government into the present fiscal situation in hopes of eviscerating the New Deal once and for all. Make it such that, when the inevitable happens, the end result will require the desired policy solution.
This means that you just pass into law the super-popular and death-spiral inducing community rating and tack on whatever meaningless and ineffective tort and state-lines “reform” the GOP wants to make that poison pill pass. Both sides celebrate. Then wait five years. Even conservatives agree that:
the country will face a choice: allow the numbers of uninsured to continue shooting up, or enroll more and more people directly in taxpayer-funded government insurance plans.
At the collapse of health insurance in this country, the GOP will be forced to roll out Medicare for all; after all, there will be no functional private insurance industry left to protect. Even the very rich will be priced out. Nothing gets the GOP’s attention more quickly than a situation like that.
Just think of the day that Single Payer is finally signed into law by President Palin. Likewise, the new Democratic majority will return to a Senate free from the filibuster as, everyone knows, that will be the first thing to go once the GOP is back in charge over there.
Somewhere, off in the distance, a dog barked.