I've Been Saying!

 Krugman makes the political - as opposed to economic - case for allowing a public option within Medicare. The economics of single-payer are pretty well established. Yes, there is some rationing, but it is not based on ability to pay. There is, perhaps, some road in the US that leads to a baseline or floor of health care coverage that can be supplemented by private insurance. We travelled to Chile, where they have a universal system and a buy-in system. Everyone gets healthcare, but you can pay for private clinics. In an earlier post, Krugman notes that wealthy Canadians come south for some treatments.

At any rate, Krugman makes the political case that I've been making since Obamacare. We need a public option - not because it's the preferred policy outcome, but because it's a feasible policy outcome. If we allowed people and employers to buy insurance from Medicare the way they do from Aetna, then we should over time - if the theories are correct about costs and delivery - see more and more people elect to be covered by Medicare, until mandating the change only effects fewer than 10% of the population.

It would also allow the sort of gradual change that might prevent some of the problems that are attendant with big policy changes. When Obamacare rolled out, the system crashed. It was repaired, but first impressions and all that. Massively straining the Medicare system all at once would lead to the same poor first impression.

The other issue that would need to be addressed in the wake of Trump is how to insulate the new universal healthcare program from Republican fuckery. They will absolutely try and wreck whatever Democrats build and I'm not sure the American public has demonstrated that they are really smart enough to assign blame to the appropriate party. Slow rolling a public option would be perilous for this reason, but having corporate buy-in via cheaper costs could push back on this. If DynaCorp is paying 15% less in insurance costs, I would wager they'd be pretty eager to preserve that.

Finally, I have expressed by deep seething hatred of Joe Lieberman in over a decade, but man, what a horrific shitbag of a person he is. Yeah, Nelson of Oklahoma was also responsible for killing the public option in 2009, but Lieberman...man, I hate that guy.