Paul Krugman effectively takes Hillary Clinton's side against Bernie Sanders over health care in Health Reform Realities New York Times 01/18/2016. He advises against a new Democratic President pushing for single-payer health care, though he frames it as a priority issue rather than echoing the misleading claims of the Clinton campaign. Still, Krugman notes, "If we could start from scratch, many, perhaps most, health economists would recommend single-payer, a Medicare-type program covering everyone."
Krugman's argument here strikes me as playing into one of the most serious weaknesses of the Democratic Party in framing issues. If the Republicans get only part of what they want on an issue, they keep going back to the well to get more. They've been trying to ban abortion since 1978 or so. And they've come a long way toward that goal. They have succeeded in seriously restricting access to abortion. And the number of "coathanger" style abortions are rising again. But the Republicans aren't saying, "Hey, we've already got some of these sinful wimmin going for coathanger abortions. So let's move on to making someone else's life miserable." No, they want to continue on this issue (while simultaneously making others miserable) until *only* back-alley abortions are available.
The Democrats, on the other hand, tend to do what Krugman seems to be advising on health care and say, "Well, we got something accomplished, so let's just move on to the next thing." The Dems need to learn the virtues of defending their own accomplishments while demanding improvements. They are often strangely weak on both counts.
They also need to take into full account the Republicans' incremental approach to undoing programs they don't like. The Affordable Care Act (ACA, Obamacare) is particularly vulnerable to this approach. As Krugman accurately observes, "Obamacare is, however, what engineers would call a kludge: a somewhat awkward, clumsy device with lots of moving parts," problems which he expects "will probably always cause a significant number of people to fall through the cracks."
The Republicans are pursuing a very visible strategy of trying to sabotage the ACA by knocking off one part after another. The rightwing Supreme Court put the Medicaid expansion, which was one of those "awkward, clumsy" features Krugman references, partly at the mercy of ideological Republican Govenors completely opposed to the ACA. The Congressional Republicans are now pushing a scheme to remove a critical aspect of the law, the mandatory coverage provision. Removing that would make the private plans more expensive and thus serve to discredit the ACA further.
The best way for the Democrats to hold the line against these tactics, even if that's all they really want to do, would be to push for improvements. And if they want improvements, it would be better to push for what they really want, or even more than they really want. Adding a public option is the obvious next step, as Krugman indicates. But if the Dems want that, they are more likely to get it by pushing for single payer and accepting a public option as a fallback position.
Krugman repeatedly and rightly criticized Obama for his pre-compromise approach to the financial bailout in 2009. That is, he proposed about half of what was really needed, and then compromised it down from there. Supposedly, he started out from a position he thought a significant number of Republicans in Congress would accepted. Hence, pre-compromised. But even in 2009, those bipartisan-minded Republicans mainly existed in Obama's imagination. Now, we're in the Age of Trump, when Sarah Palin will soon count as a sober political analyst at the rate we're going.
It's time for the Democrats to jam their message home to the voters. Note to sit back and play defense while the Republicans keep pecking away at their accomplishments when they are not in the position to rapidly roll back the wheel of progress.
On his blog, though, Krugman takes a more bluntly pro-Clinton position in Weakened at Bernie’s 01/19/2016. He argues that Sanders' health-care plan promises too much and that his financial-reform plan doesn't adequately address the problem of shadow banking.
Still, there's an undertone of advising the Democrats to be more timid than Sanders wants to be.
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