Paul Krugman: HELP Is on the Way

We can afford health care reform:

HELP Is on the Way, by Paul Krugman, Commentary, NY Times: The Congressional Budget Office has looked at the future of American health insurance, and it works.

A few weeks ago there was a furor when the budget office “scored” two incomplete Senate health reform proposals — that is, estimated their costs and likely impacts over the next 10 years. One proposal came in more expensive than expected; the other didn’t cover enough people. Health reform, it seemed, was in trouble.

But last week the budget office scored the full proposed legislation from the Senate committee on Health, Education, Labor and Pensions (HELP). And the news — which got far less play in the media than the downbeat earlier analysis — was very, very good. Yes, we can reform health care. …

[A] look at the U.S. numbers makes it clear that insuring the uninsured shouldn’t cost all that much, for two reasons.

First, the uninsured are disproportionately young adults, whose medical costs tend to be relatively low. The big spending is mainly on the elderly, who are already covered by Medicare.

Second, even now the uninsured receive a considerable (though inadequate) amount of “uncompensated” care, whose costs are passed on to the rest of the population. So the net cost of giving the uninsured explicit coverage is substantially less than it might seem.

Putting these observations together,… extending coverage to most or all of the 45 million people … without health insurance … should … add only a few percent to our overall national health bill. And that’s exactly what the budget office found when scoring the HELP proposal.

Now, about those specifics: The HELP plan achieves near-universal coverage through a combination of regulation and subsidies. Insurance companies would be required to offer the same coverage to everyone, regardless of medical history; on the other side, everyone except the poor and near-poor would be obliged to buy insurance, with the aid of subsidies that would limit premiums as a share of income.

Employers would also have to chip in, with all firms employing more than 25 people required to offer their workers insurance or pay a penalty. … And those who prefer not to buy insurance from the private sector would be able to choose a public plan instead. This would, among other things, bring some real competition to the health insurance market, which is currently a collection of local monopolies and cartels.

The budget office says that all this would cost $597 billion over the next decade. But that doesn’t include the cost of insuring the poor and near-poor… Add in the cost of this…, and we’re probably looking at between $1 trillion and $1.3 trillion…, less than 4 percent of the $33 trillion the U.S. government predicts we’ll spend on health care over the next decade. …

So fundamental health reform — reform that would eliminate the insecurity about health coverage that looms so large for many Americans — is now within reach. The “centrist” senators, most of them Democrats, who have been holding up reform can no longer claim either that universal coverage is unaffordable or that it won’t work.

The only question now is whether a combination of persuasion from President Obama, pressure from health reform activists and, one hopes, senators’ own consciences will get the centrists on board — or at least get them to vote for cloture, so that diehard opponents of reform can’t block it with a filibuster.

This is a historic opportunity — arguably the best opportunity since 1947, when the A.M.A. killed Harry Truman’s health-care dreams. We’re right on the cusp. All it takes is a few more senators, and HELP will be on the way.


Originally published at Economist’s View and reproduced here with the author’s permission.

2 Responses to "Paul Krugman: HELP Is on the Way"

  1. hsr0601   July 7, 2009 at 6:18 am

    People are so worried about losing their job, coverage, denial of treatment, which seems to increase bank deposit latetly. That means stimulus funding mainly goes toward bank deposit for a rainy day increasing jobless rate. It proves again that a healthy society yields better productivity, prosperity.It is time to ‘Change’ the notion of the public health as a fundamental human right and install ‘a safety system for all’ like all of the other industrialized nations, I think.

  2. Anonymous   July 10, 2009 at 4:55 pm

    It is being set up to allow the stealing to continue.If you want to believe help is on the way go right ahead – but it ain’t going to happen!Had a $65,000 kidney stone and was set up to be fired 4 days after getting back to work.No unemploment no severance after 17 years and no prospects 6 months later. Cobra is $500 per month. So I applied for a $5000 deductible and guess what – BC/BS excluded kidney stones for life.Guess I’ll just have to die – then the government won’t have give back my $250,000 social security taxes I paid in over the last 30 yearsAmerica is one huge cost shifting Ponzi scheme – period.The pigs get fatter as the workers gets slaughtered.