NYT on healthcare – Krugman and Douthat duel

They’re not totally “dueling” on healthcare reform, at least not until you get to a single-payer type publicly run option for healthcare. At that point, Paul Krugman is certainly on a different page from Russ Douthat.

That said, though, while I think we need a single-payer option, I don’t disagree with everything Douthat said.

First, though, that single-payer option’s necessity. For business-based, business-mentality-based reasons, a German-style voucher system simply wouldn’t work here. I used to think it had a chance, but I’m firmly convinced that the American health insurance industry would find any and every way it could to either gut it, or else scam it. (That’s another reason Obama’s refusal to call for a federal insurance regulation bureau in his proposed financial regulation reform bill upset me.)

Back to our dueling columnists.

Krugman has the cannons of his ire trained on the sellout Senate Democrats like Ben Nelson, who had flatly opposed single-payer until he got ads run against him back in Nebraska, and Kent Conrad, who had this idea of insurance co-ops that Big Insurance was sure to game.

Krugman also says the cost doesn’t concern him a lot.

Well, it does concern Douthat; in fact, that’s the focus of his column.

And, I agree with him that, while it might not be quite like Great Britain or Canada (the degree of actual rationing they have, not the conservative bloviosphere’s healthcare urban legends), that Americans either need to be prepared to wait more, or to shell out more in taxes. He even raises the dark specter of California when liberals and conservatives fail to “square a circle” everybody thinks they will.

This dynamic is particularly pronounced in health care, but it holds true across almost every domestic policy debate. Voters demand low taxes and generous services, and neither party has found a way to say no and stay politically viable while saying it.

That said, despite Obama’s neoliberal tendency to over-tout the “waste, fraud and abuse” money savings angle, there is something to be said with that, on things such as standardized paperwork forms, etc.