30 Oct 2013

Krugman: ObamaCare Rollout the Fault of Private Insurance; Single Payer Would Fix Everything

Health Legislation, Krugman 163 Comments

A lot of us have been warning that ObamaCare is a system that even many of its proponents knew would fail, but in so doing would pave the way for their true objective: the elimination of private health insurance to be replaced by the federal government as a “single payer” for all medical care.

In that context, check out Paul Krugman’s recent efforts to explain the unfolding disaster of the Healthcare.gov rollout:

Obamacare isn’t complicated because government social insurance programs have to be complicated: neither Social Security nor Medicare are complex in structure. It’s complicated because political constraints made a straightforward single-payer system unachievable.

It’s been clear all along that the Affordable Care Act sets up a sort of Rube Goldberg device, a complicated system that in the end is supposed to more or less simulate the results of single-payer, but keeping private insurance companies in the mix and holding down the headline amount of government outlays through means-testing. This doesn’t make it unworkable: state exchanges are working, and healthcare.gov will probably get fixed before the whole thing kicks in. But it did make a botched rollout much more likely.

So Konczal is right to say that the implementation problems aren’t revealing problems with the idea of social insurance; they’re revealing the price we pay for insisting on keeping insurance companies in the mix, when they serve little useful purpose. [Bold added.]

163 Responses to “Krugman: ObamaCare Rollout the Fault of Private Insurance; Single Payer Would Fix Everything”

  1. konst says:

    Seems Krugman has lost touch with reality if he ever had it. It’s the Keynesian way of thinking where you pull a lever and magically things work out.

    • joe says:

      How has he lost touch with reality? Private health insurance is basically a corporation placing a bet with you on your health. There is no way the corporation can know as much as you about your potential to get sick. That means they have to rip people off to make a profit.

      • Major_Freedom says:

        You’re not concerned with people getting ripped off, and you’re not concerned with people getting hurt or killed by disease.

        You’re concerned with how to get the individual to cease having control over his own life and property, so that others, namely those in the state, can have control over his person and property. That way, you can get what you want, at the cost of people you don’t care about getting ripped off, hurt and/or killed.

      • Richie says:

        Another idiot that knows not the first thing about how insurance (in the actuarial sense; not what poses as “insurance” now) works.

      • konst says:

        Others can explain it way better than I can so here are 2 short articles to read:

        Government Medical “Insurance” by Murray Rothbard
        https://mises.org/daily/6099

        and

        The Social Function of Insurance by Robert P. Murphy
        https://mises.org/daily/5178

      • konst says:

        And by the way, while we wait for that comment to be approved cause it has 2 links instead of one,

        There is no way the corporation can know as much as you about your potential to get sick.

        Yes there is! That’s why insurance, real insurance, works. You can actually calculate probabilities of some events, like getting certain illnesses, so you can put a price on insurance for a group of people.

      • konst says:

        @joe

        I’ll just post the articles in separate links in 2 comments:

        Government Medical “Insurance” by Murray Rothbard
        https://mises.org/daily/6099

      • konst says:

        @joe

        and the second article:

        The Social Function of Insurance by Robert P. Murphy
        https://mises.org/daily/5178

      • Ken B says:

        How many errors can you pack into one one short comment? On this board joe that’s a pretty high bar, there’s some fierce competition. But you are definitely a contender. If you could just be a bit pithier, cut back on those flabby abjectives like “basically”, and learn to use pronouns, and the prize will be yours for the taking.

        • Andrew Keen says:

          I don’t know… My money is on the guy who thinks “basically” is an “abjective.”

          • Major_Freedom says:

            Someone better call the amberlamps.

      • Andrew Keen says:

        It’s a good thing that the government never rips anyone off. Otherwise, we wouldn’t be able to rely on them to solve all of our problems. Can you imagine?

  2. Tel says:

    Hang on, last time it was a good thing that the website was failing because it showed so many people were interested. Now we can’t pretend it’s good any more, must be time to find someone to blame it on.

    It’s complicated because political constraints made a straightforward single-payer system unachievable.

    Yeah, diluting your socialism with the appearance of a marketplace makes things a whole lot messier. We give orders, you follow, why make this hard?

  3. Nick says:

    Could see this coming from 10 miles away. The single-payer drumbeat has begun.

  4. Keshav Srinivasan says:

    This is isn’t a new point. Krugman has been saying for a while that Obamacare is an imperfect simulation of single-payer:

    http://krugman.blogs.nytimes.com/2009/12/23/simulating-single-payer/

    • Richard Moss says:

      In your link PK says a new system (ACA) would be imprefect vs. single payer, but still better than the current one.

      I think Bob’s ‘new’ point is that the purpose of the ACA is to make the system worse than it is currently, which will in turn make single payer more politically palatable.

    • nick says:

      Right, the same terrible, imperfect plan that he said would”

      “The plan, this thing is going to work, it’s going to be extremely popular, and it’s going to wreak havoc with conservative ideology.”
      http://krugman.blogs.nytimes.com/2013/07/17/obamacare-is-the-rights-worst-nightmare/?_r=0

  5. Andrew_FL says:

    Yeah that makes sense doesn’t it, it’s the insurance company’s fault that the plans that people can’t keep are no longer legal to sell to anyone.

    Isn’t this the sort of thing that should make it kind of obvious when someone is a partisan hack and not a legitimate, serious analyst?

    • valueprax says:

      That’s just like, your opinion, man.
      ~Daniel “The Economic Dude” Kuehn

      • Bob Roddis says:

        But where problems are raised (aside from silly accusations that Obama somehow lied about keeping coverage) it’s usually around the coverage mandates and what they’re doing to private plans.

        http://factsandotherstubbornthings.blogspot.com/2013/10/thoughts-on-health-reform.html

        • Tel says:

          There’s a fine distinction between telling lies and broken promises.

          Mind you, Obama is after all the President of the USA, so he could choose to fulfil his promises if he wanted to. The conclusion being that his oath breaking is wilful.

      • Bob Roddis says:

        The weird thing is I feel like I’ve been getting a lot of flack from libertarians lately despite my shared sense that I’m on a libertarian posting binge.

        They feel threatened by the competition, I guess 😉

        http://factsandotherstubbornthings.blogspot.com/2013/10/thoughts-on-health-reform.html?showComment=1383162094714#c285959202886214523

        • valueprax says:

          It’s funny that he and his guest Ken P think that subsidizing things is libertarian. What an oddly delusional world DK lives in where anything is everything and everything is nothing. If you can be a libertarian while calling for subsidies, why can’t you be a libertarian while calling for nationalization? Or sending your political enemies to concentration camps?

          • Daniel Kuehn says:

            Well not THAT one. It was more a reference to the minimum wage post and… oh… I don’t know talking about how I’m going to vote for a libertarian next week.

            Even on the subsidies case, you are far to strong. Lots of libertarians support subsidies like basic incomes, negative income taxes,etc. You’re (apparently) caught up in the anarchist/minarchist wing of things.

            But I tend to agree with you – I wasn’t thinking of my health care post as especially libertarian. I thought we were referring to my vote post.

            • Major_Freedom says:

              DK, stop butchering the meaning of libertarianism.

              Libertarianism is grounded on the practical principle of non-aggression.

              Clearly, subsidies are paid for by aggressive financing, i.e. taxation, and hence are anti-libertarian.

              If you disagree, show me via deduction from libertarian principles, how subsidies is consistent with it.

              There is no being “caught up in the anarchist wing of things.” If you’re not an anarchist, you’re not a libertarian. The meaning of libertarianism cannot accommodate initiating violence against person and/or property.

              Where that goes, in terms of logical conclusions, is really besides the point.

          • Ken P says:

            No valueprax, I said it looks like more of a compromise plan than a libertarian plan.

            • Ken B says:

              You misunderstand Ken P. Compromise defiles, and no True Libertarian ™ would ever submit to such as horror as compromise. They understand that there is no important difference between the gulag and public sidewalks.

              • valueprax says:

                Nice equivocation there, as usual, Ken B.

                While we’re at it, I think I’ll “compromise” with you and agree that 2+2=3. I don’t want to get caught up in mathematical absolutism and all that. Sticky stuff. No fun for anybody.

          • Ken B says:

            I saw — and laughed at — amny libertarians who voted for Obama. The word has a wide meaning.

            • Ken P says:

              It’s fine if Valueprax wants to say I’m not a True Libertarian ™ for saying that Daniel’s plan makes economic sense, but he’s incorrect when he says I called DK’s plan “libertarian”.

              i also suggested a few changes that people tend to ignore: Getting rid of AMA doctor limits, eliminating state regulation of medical equipment purchases and eliminating barriers to non-profits providing free medical care.

              • valueprax says:

                I said neither of the things you accuse me of saying.

                I pointed out that libertarianism has nothing to do with granting subsidies.

                And I also think it’s idiotic to suggest that there is something “sensible” in an economic sense about promoting subsidies.

                It doesn’t matter if you’re a “True Libertarian(tm)” or not– you’re wrong that libertarianism includes subsidies as a policy position and you’re wrong that subsidies make economic sense.

              • valueprax says:

                I do see on rereading that YOU didn’t call DK’s plan libertarian, so, TEN POINTS FOR GRYFFINDOR! on that one.

                But you still did say it was “pretty economically sound”, which shows you don’t understand economics well, like DK.

                So, TEN POINTS FROM GRYFFINDOR! on that one.

                Since I’m all about compromise, though, I’ll just give you the benefit of the doubt and say +10-10=+100. Because I am sympathetic to the plight of the intellectually impoverished.

      • Bob Roddis says:

        It also occurred to me that there’s a strong probability I’ll have to vote for the libertarian in the governor’s race. I mentioned that to Kate last night and she said “oh it’s that bad, huh?”. It made me think that it wouldn’t turn out so bad – he’s not off the walls, and anyway the General Assembly wouldn’t let him do anything to crazy. Libertarians in a divided government might do alright. And then I remembered the shutdown and how many libertarians online were actually encouraging that as a good thing – and in that case all it took was giving libertarians a small foothold in the Congress. So I don’t know…

        http://factsandotherstubbornthings.blogspot.com/2013/10/two-brief-political-thoughts.html

      • Bob Roddis says:

        EBSA Final Rules

        Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act; Interim Final Rule and Proposed Rule [6/17/2010]

        Using these turnover estimates, a reasonable range for the percentage of individual policies that would terminate, and therefore relinquish their grandfather status, is 40 percent to 67 percent. These estimates assume that the policies that terminate are replaced by new individual policies, and that these new policies are not, by definition, grandfathered.

        Filed 6-14-10; 11:15 am

        http://webapps.dol.gov/FederalRegister/HtmlDisplay.aspx?DocId=23967&AgencyId=8&DocumentType=2

    • Daniel Kuehn says:

      I’d have thought it’s whoever made it illegal’s fault.

      • Andrew_FL says:

        So it would be fair to say you disagree with Krugman. Good for you I suppose.

        • Daniel Kuehn says:

          That’s kind of an odd reading of Krugman.

          Krugman is just saying a a non-hybrid system would be easier to manage. That’s probably true. That’s not really a “fault” issue so much as an expected complications issue.

          You were commenting on a completely different issue – who was at fault for plan cancellations.

          • Andrew_FL says:

            Well I suppose you would think what you thought Krugman said makes more sense than what someone else thought he said. However if I am being frank I think you are over-parsing his words in an attempt to find an interpretation more defensible than what he probably meant.

            But the reading is not “strange.” It’s readily apparent that it is the interpretation our host has taken as well, and a great many people have interpreted Krugman as saying, including I would wager a great many people who *agree* with what he is calling for. If Krugman meant something else he should probably clarify. Not that it makes much difference, seeing as his (erroneous) point leads to the same conclusion either way.

            • Daniel Kuehn says:

              Tell me how to parse it then.

              He never even brought up cancellations so how the hell do you expect me to not think your view is strange.

  6. Gamble says:

    I know Obama-care is a failure and will result in single payer, an even bigger failure.

    But why was the system pre Obama so horrible? It was broken then and will be broken now in a different way.

    I think it all starts with State occupational licensing and the 1974 Federal HMO laws. IT has only went down hill since…

    And an even bigger question, is insurance of any type for any reason really all that smart? IT seems like insurance simply makes cost of everything go up and in a strange way is a form of voluntary communism/suicide?

    • Matt M (Dude Where's My Freedom) says:

      I think it dates back even further – to wage controls during the New Deal. Employers were legally prohibited from offering raises to existing employees, or raising wage rates to attract new ones. So, they got around the law by offering benefits, such as health insurance, instead.

      The wage controls went away eventually, but the practice of getting insurance as part of your job stayed around within the collective consciousness.

    • Andrew_FL says:

      One can’t place *all* the problems with insurance on the *federal* government, I’d say state insurance regulations play their role, too.

      Also the artificial trade barriers between the states the Constitution was supposed to eliminate exist-arguably unlawfully-in the insurance market. Now what happens when you erect barriers to trade again? I think everyone here knows.

      As for whether insurance is a good or bad idea, well, people should decide that for themselves, don’t you think?

      • Gamble says:

        Yes the customer should decide for themselves however there are laws that mandate insurance. Also, you may well be priced out of a dysfunctional market. Doctors and healthcare related business increase their prices to the maximum insurance will pay. This prices out the cash paying customer.

        No?

    • Rick Hull says:

      Gamble > I think it all starts with State occupational licensing and the 1974 Federal HMO laws. IT has only went down hill since…

      Earlier than that, the healthcare became bound to employment, unnaturally, with the punitive postwar payroll tax regime. Rather than be subject to that tax, large employers started competing with benefits and perks instead.

      • Gamble says:

        Rick Hull.

        I do think it is beneficial to have insurance you take with you, no matter employment.

        I have had a personal insurance policy with high deductible, and tax preferred savings plan since Bush created them( 1 of few good things Bush jr. did).

        Obamacare has removed most of the tax benefits of my savings account and will probably cancel my insurance soon.

        A market was starting to develop because of the MSA- HSA setup, they knew this and destroyed it before it could grow legs.

        So much for being an early adapter…

  7. Innocent says:

    Okay, and please let me know if I am simply way off base here. I thought the only reason Single Payer worked in pretty much all of those other countries is because they CAP what can be paid on services. Now, and again this is just me thinking out loud, when you cap costs does this not do a couple of things.

    1 ) remove the ability to REALLY compete as cost caps are typically down to a point where no one dares compete?

    2 ) cause market distortions that may not be apparent for YEARS to come?

    3 ) Remove the ability of the consumer to choose something different?

    Finally, every one needs food why not create a single payer system for that as well? Hey, why not make a single payer system for EVERYTHING? I mean why have a competitive marketplace at all, after all the state is going to make the choices on everything right? And if you introduce enough regulation that is what you have anyway.

    • Andrew_FL says:

      I would say don’t go giving them ideas, but actually the idea is not actually without precedent in communist societies.

    • Dyspeptic says:

      You forgot –

      4) Price controls also lead to supply shortages since they encourage over consumption. The over consumption problem is then solved with bureaucratic rationing mechanisms like death panels. It’s really hard to consume stuff when your dead after all.

      • Andrew_FL says:

        I wasn’t sure if that was what he meant by distortions or not. Technically, that could fall under 2.

    • Tel says:

      I thought the only reason Single Payer worked in pretty much all of those other countries is because they CAP what can be paid on services.

      Or they just limit the services that you can get, like in Australia certain fairly innocuous treatments are banned from being sold at all, under any circumstances… even though they are OK in other countries. For example, you cannot buy ursodeoxycholic acid just to improve poor bile flow…. but you can take it if you are diagnosed with cirrhosis of the liver. This is regardless of whether you are willing to pay for it.

      We now have private health insurance that includes provision to send patients overseas for treatment.

    • Richie says:

      Capping costs is something I always point out when people like to point to single-payer systems spending less than the U.S. on sick care.

    • moodydon says:

      Single payer food?

      Interesting thought…. no competition on price, cuz all prices are set by the government? So Nanny Bloomberg could ration how much Pepsi I drink per day by making it more expensive? Baskin & Robbins, Ben & Jerry’s would be a whole paycheck, cuz these are bad for me?

      Fruits and veggies would be almost free? Or in short supply cuz everybody was eating only fruits and veggies?

      I wonder how much a gym membership would cost?

  8. Cosmo Kramer says:

    Liberals are only happy if someone else pays the bill.

    I hope Obamacare fails, but fails enough so that single payer isn’t what is demanded in its place.

  9. MG says:

    “(K)eeping insurance companies in the mix, when they serve little useful purpose”.

    So not only is the single payer system (for health care) baked in the cake, but according to Krugman (and he gets to define what “when” means) you should be ready for HomeIns.gov, AutoIns.gov, LifeIns.gov, etc…

    • Gamble says:

      Those controls been here for a long time, now they will be taking to the internet. Maybe it is a good thing they are coming out of the shadows?

      1913 was the trifecta death nail for Lady Liberty.
      1. Direct election of Senators.
      2. Fed reserve.
      3. Income tax.

      • Samson Corwell says:

        Why was the direct election of senators bad? I can get the Federal Reserve (I suppose) and the income tax, but not the problem with the Seventeenth Amendment.

        • Gamble says:

          Which direct elected Senators went on to become President?

          Prior to the Seventeenth, the State legislator elected the States US Senators. It was a better system of checks and balances. It was the way the original Constitution was designed. It was not a problem prior to 1913, they changed it for advantage sakes. WJB was a weirdo.

          • Samson Corwell says:

            I don’t know, but does it really matter? Representatives can go on to become President, and the House is just the other half of the legislature. And you say that “was the way the original Constitution was designed”. That’s not a good reason for going back. The Fourteenth Amendment wasn’t part of the original design of the Constitution, but it’s a good thing that it’s around now.

            • Richie says:

              The direct election of Senators shifts power away from localities to the ever-growing Federal government. More democracy, which leads to more tyranny.

              • Samson Corwell says:

                And how the hell does it do that when the people electing the Senators are same people who elect the state legislatures that used to elect those same Senators?

            • Gamble says:

              Warren G. Harding
              Harry S. Truman
              John F. Kennedy
              Lyndon B. Johnson
              Richard M. Nixon
              Barack Obama

              Let me guess, you referenced the 14 so you could then brand me a slave trader? Read about the 14th. And just because 1 change may be good, does not make all changes good.

              http://mises.org/freemarket_detail.aspx?control=282

              • Samson Corwell says:

                First, Truman was VP before he became President, so he doesn’t count. Second, I’m not quite sure what JFK did that is of critical importance besides screwing Marilyn Monroe. Third, I mentioned the Fourteenth Amendment, not the Thirteenth Amendment. The Thirteenth Amendment was the one that dealt with slavery, so I don’t see where you could get the idea that I was implying that you were a slave trader. Fourth, the truth about the Fourteenth Amendment is that it WAS ratified. Thomas DiLorenzo’s hackish attack on it is like those made by the kinds of people who imply a single comma makes a substantive difference. If he’s a historian, then I’m a professional basketball player.

            • Gamble says:

              Regarding your comment about Representatives going on the be Prez and the House simply being the other half.

              This attitude is precisely the problem. The distinction was supposed to mean something. The House of Representatives was suppose to be the “peoples” half of the government and was suppose to control the purse strings.

              The senate on the other hand, well let the guy who purported to have tamed the tiger, explain. “The man who is possessed of wealth, who lolls on his sofa, or rolls in his carriage, cannot judge of the wants or feelings of the day laborer. The government we mean to erect is intended to last for ages. … unless wisely provided against, what will become of your government? In England, at this day, if elections were open to all classes of people, the property of the landed proprietors would be insecure. An agrarian law would soon take place. If these observations be just, our government ought to secure the permanent interests of the country against innovation. Landholders ought to have a share in the government, to support these invaluable interests, and to balance and check the other. They ought to be so constituted as to protect the minority of the opulent against the majority. The senate, therefore, ought to be this body; and to answer these purposes…” James Madison

              I get a quick out people who blissfully support ” a representative form of government” and a “democracy” yet do not understand the original design and how far we have strayed.

              Really though, all of this if for not, because before the ink dried, liberty was in decline…

              • Samson Corwell says:

                I understand that Madison was certainly no Jefferson. You do understand that a republic is a representative democracy, correct? And what do you mean “liberty was in decline”? You mean before the Constitution was ratified? Pray tell you’re not one of those people who longs for the Articles of Confederation. We got a lot better in some areas and worse off in others.

    • Bob Roddis says:

      And Ministryofleftbrownshoes.gov.

      • Bob Roddis says:

        If there is a separate ministry each for left and right shoes, it will increase employment and thus GDP.

        • Matt M (Dude Where's My Freedom) says:

          Of course, they’ll first set up a separate ministry for each color shoe and each separate foot. When that fails to deliver shoes in an efficient manner, they’ll have to create the Department of Shoe Quality Control in order to facilitate these disparate shoe organizations to share information and increase coordination.

        • Major_Freedom says:

          But Roddis, because there is at least one unemployed person in the world, and at least one object the owner of which is frustrated in finding a buyer willing to pay the price he wants, those facts alone justify mutli-trillion dollar coercive monopolies who are regarded by our progressive friends as legitimate judges of their own killing of innocent women and children, as collateral damage.

          That is why we must look to employment and GDP, and away from the violence and destruction. As long as employment rises the way they want, as long as GDP rises the way they want, you should shut up and take it like a good little citizen.

          • valueprax says:

            “There is a light in you that you have forgotten. People think that millionaires, movie stars, athletes, and politicians light the world. You understand that they are nothing but fire flies; they glow for a second and then are gone. You wonder why others don’t see you as you are. I will let you into the secret: they do. They sense who you really are and hate you for your light. They see you and fear. You are indeed the fugitive.

            What do you think government is all about? People once lived in order, but there were some disagreements and controversies. People invented morality, but that didn’t work. Then they created the law and found that the law was only made things worse. They submitted themselves to a state and crime became rampant. Finally, they all offered themselves to the great god totalitarianism. The results were chaos and universal law-breaking. All this makes sense only if you see it for what it is. They had no other aim in mind but to subjugate you and keep you under control.

            Sociology and psychology have one purpose and one purpose only: deceiving you. They want to take away your real name and name you themselves. They call you deviant or well-adjusted. They name you father or lower-middle-class. They can put you in a little box and display you on their shelves when you accept the false name they force upon you. The Navajos have a joke about it. They say that the Navajo family unit consists of 6 members: the mother, the father, the 2 children, the maternal grandmother, and the anthropologist. If you can’t remember your real name, let me suggest one for you: sociopath.

            The religions and philosophies of the world all disagree with each other; sometimes their adherents turn to violence and kill each other for the sake of their beliefs. However, they all agree on one point: You are the problem. There is something fundamentally wrong with you. They will tell you that they love you, but they actually hate you. They love what you could become if you would only follow their prescriptions. They tell you that if you could only get rid of those attributes that are particular to you, you could be perfect. If you could only crack open your head like a walnut, put your brain into a blender, and add it to some universal mind, then everyone would approve. They’d call you a virtuous man or a sage, but you refuse to do that: You remain the fugitive. Somewhere in the back of your mind, you know that there is something wrong with them.

            […]

            Do you suppose that they want to keep you alive with all their rules and regulations? Die of AIDS. Die because you didn’t buckle up. Die from drug abuse. They love your death. You provide a useful object lesson to society. Do you think they want you to obey their laws? Of course not. They want you to break the law so that you will walk about with a vague sense of guilt. Do you believe they want you to be honest and truthful? You are mistaken. They want you to lie. Why does a person lie? He lies because he is afraid; and here’s a secret: lying makes you fearful. Above all else, they want you to be afraid.”

            ~Allen Thornton, “The Fugitive”

  10. Major_Freedom says:

    “…the implementation problems aren’t revealing problems with the idea of social insurance; they’re revealing the price we pay for insisting on keeping insurance companies in the mix, when they serve little useful purpose.”

    If we accept the argument that initiating violence against those who did not initiate it themselves is morally wrong, then it would not be wrong to argue that insurance companies do actually serve a useful purpose: They partly decide (every other private property owner are the other part deciders) whether Krugman himself is worth insuring, and, if applicable, deny him a potentially life saving affordable insurance contract, all of which is made possible by every individual in the country being free to decide how much of their private property to consume and how much to save and release to the investment markets whereby others such as Krugman could purchase for healthcare reasons.

    If the released resources are more valued elsewhere, according to private property owners, and this fact makes it too costly for Krugman to purchase the resources from a healthcare coverage that he wants, then since it is better for individuals to not be aggressed against, it is indeed more useful for Krugman to live in a world of private property insurers than a single payer system where the payers are forced at gunpoint to benefit him.

    The depravity of Obamacare isn’t primarily internet glitches and poor design. It’s a violent, morally vicious piece of garbage that has no place in a civilized society.

    • Dyspeptic says:

      “The depravity of Obamacare isn’t primarily internet glitches and poor design. It’s a violent, morally vicious piece of garbage that has no place in a civilized society.”

      But of course, we no longer live in a civilized society. We live in a dictatorial and predatory Welfare-Warfare State run by mass murdering technocrats who think like Krugman. Most Americans don’t seem to mind this because they are perpetually distracted by the panum et circenses of our loathsome, brain dead and morally depraved popular culture.

      As Pat Buchanan has been pointing out for several decades, when you lose the culture war you lose, period. The only hope at this point is that the whole repulsive system collapses suddenly from it’s inherent flaws, as with the Soviet system. There is no guarantee that this will make things better but it is the only thing that could save us.

      • Samson Corwell says:

        Oh, I just love rants about degraded culture. Nothing more pointless than arguing over the state of mass media.

    • Samson Corwell says:

      Violent? You must have a strange definition of “violent”? I’m not defending the Affordable Care Act, but there is no violence unless someone starts kicking or punching you, so saying it is violent sounds like Marxist nonsense about “structural violence”.

      • Rick Hull says:

        Every government mandate is backed by violence. Don’t want to comply with the insurance mandate? You get an IRS fine. Don’t want to pay the fine? You get put in a steel cage. Don’t want to go in the cage? The guns come out.

        I know it’s an unpleasant to consider, and it’s easier to imagine that such things are not possible, never happen, or only to bad people.

        It’s a logical fact that every government mandate is backed by the point of a gun, held by state agents who are itching to pull the trigger.

        • Samson Corwell says:

          If you put it that way, then sure every law is “violent”. Eventually. I think you’d be better off saying that it shouldn’t be mandatory rather than “it’s violent”.

          • Richie says:

            Every law is backed by violence. Sorry, deal with it.

            • Samson Corwell says:

              No **** every law is “backed” by violence. That’s the entire point of a legal system. The point is figuring what should and should not be law.

              • Richie says:

                Break a law then, and see what happens to you.

              • Richie says:

                Sorry, misread your comment. Explain how, in a purely private system, a law would be backed by violence (of the state-monopolized fashion).

              • Samson Corwell says:

                You’re joking, right? Are you even talking about a legal system?

              • Major_Freedom says:

                Samson:

                Try to distnguish between threats of violence in response to potential initiations of violence, and threats of violence in response to no initiation or threat of violence.

                There’s a difference between a victim of theft threatening the thief with violence, and a thief threatening the victim with violence if they don’t obey.

              • Samson Corwell says:

                Ah, now that makes more sense.

      • Major_Freedom says:

        Samson, if a husband threatens his wife with physical abuse if she decides to choose what to buy for herself, using her own earnings, then I would rightly call that a violent relationship. It doesn’t matter if he doesn’t actually use physical abuse because she keeps obeying him.

        It’s the threat of violence that is the problem.

        I just lump it all into the same word of violence. But you’re right, technically speaking it’s “coercion”, not violence per se.

        • Samson Corwell says:

          Thanks. I appreciate the clarity. Political discussions are probably the ones most likely to get mucked up by semantic issues. I’ll have to take issue with applying your married couple analogy to government as I think it parts of it are different in kind and other parts of it are different in degree.

  11. trent steele says:

    “…when they serve little useful purpose.”
    Is this guy even an economist?

    • Andrew Keen says:

      Not really, but I don’t think he meant that insurance was never useful under any circumstances. He was attempting to say, “If we are going to have a redistributionist health care system anyway, then what is the point of filtering it through insurance companies?”

  12. Dan says:

    Man, he’s a total scumbag.

  13. Bob Roddis says:

    Not to sound like a broken record or anything, but don’t you agree that Krugman seems unfamiliar with the knowledge problem, the pricing process and economic calculation?

    And as a result of his lack of intellectual curiosity, we Austrians are all a bunch of idiots, right?

    • valueprax says:

      Krugman’s analysis serves as a prime example of the consummate failure of all (winces) Keynesian efforts– they start in the middle of the problem, as it exists right this very moment, and they completely ignore everything that came before it.

      That’s why he can make a comment like the private insurance companies serving little useful purpose. He can just ignore the genesis of private insurance companies (another law) etc. etc. and keep recommending new fingers in the dyke.

    • Ken P says:

      Yes, Bob R. You put your finger on it: “the pricing process and economic calculation” is exactly the gaping hole I see when I read his articles/blogs.

  14. Jason Bonner says:

    I just got in the mail ten minutes ago a letter from my private insurer telling me my insurance rate come 2014 won’t be based on my own particular health status, but that of a collective of people who buy individual insurance. “As a result, some individuals will see lower rates for this new coverage in 2014, while others will see higher rates”. I’m rated the healthiest, at a 1, on their scale, so now I have to subsidize the collective. It’s awesome. It’s sort of like earning a higher income and having to pay more taxes except my income hasn’t risen.

  15. Edward says:

    This disaster, if it shows one thing, shows the breathtaking stupidity of Ted Cruz and his band of wing nuts. All the Tea Party and Cruz had to do was wait, and they would have had an incredibly unpopular president facing the scandal of the website WITHOUT government shutdowns, and possible defaults, for which people blamed Republicans.

    Its also important to ascertain which intervention leads to which bad outcome. Its not enough to say, “violence and coercion is bad,” stomp one’s foot, and then go home.

    Conservatives were offering no real solutions to the problem of health care in this country, and in many cases, worse solutions, like Heritage in the 80’s

    Its simple. three things cause the terrible inefficiency in health care that we have today.

    1. Community Rating- treating healthy and sick people the same. No other insurance industry allows group coverage like that. Imagine if there was a law that stated that home insurers had to charge the same rate to people from bad neighborhoods as they did from good neighborhoods. Enough said.

    2. Employer based Health Insurance. The dumbest, stupidest thing on the face of the planet, created by accident by a 1940’s IRS. Cut the corporate tax to zero, and get rid of this employer socialism. (At least Obamacare is good for one thing.) EBHI also ties in with community rating. In order to qualify for the tax loopholes in the corporate income tax, companies have to offer policies that cover all types of employees as a group. Insanity.
    Unfortunately, I never heard conservatives complain about this! They probably think EBHI is a GOOD thing!

    3. occupational licensure- Which severely restricts the supply of physicians out there.

    Instead of focusing on these three evils like a laser, conservatives have offered completely irrelevant solutions, like HSA’s and allowing you to buy insurance across state lines.

    Also, instead of challenging the individual mandate, they should of challenged community rating on Fourteenth Amendment grounds. Community rating punishes the young and healthy, and those who make good life choices, in favor of the accidentally and willfully sick

    • Ken B says:

      “This disaster, if it shows one thing, shows the breathtaking stupidity of Ted Cruz and his band of wing nuts.”

      Yes indeed. The sinking of the Titanic showed the stupidity of those who counselled against building it.

      • Edward says:

        ken b.

        You clearly don’t understand the difference between tactical objections and other types of objections

        • Ken B says:

          Yup. If there’s one issue that had nothing to do with the Tea Party it’s Obamacare.

          • Major_Freedom says:

            Every now and then Ken B, you write zingers that I enjoy.

          • valueprax says:

            To rain on the parade a little, Edward is the kind of guy that puts handballs on the tee. So, when Edward comes along and slugs it out of the park it’s less impressive than it could be given the circumstances… but it’s definitely a spectacle as it sails into the stands anyhow.

        • Major_Freedom says:

          You clearly don’t understand the difference between blaming those who are responsible for a success or failure, and blaming those you don’t want to blame because your’e an ideological basketcase who is so emotionally and psychologically wedded to the idea of party over principle that he would rather make a fool of himself pretending that others or stupid enough to accept his partisan hackery.

    • moodydon says:

      Where do I start? There has been no federal budget for 4+ years. Somebody, be it Ted Cruz, the Tea Party, whomever, has to do something to force the issue, as we can’t afford the government spending that is happening today. You don’t seem to have a problem with Harry Reid stopping House bills from getting a hearing in the Senate. Why? Yet the Tea Party and the Ted Cruz’s of the Right are the only problem in Washington DC, today?

      Employer based health insurance: Do you know how it got started? A benefit to attract employees. But if this benefit is a bad idea, perhaps we should rethink vacation days, paid holidays, pensions, and some of the benefits employers offer their employees. Our congressman and senators seem to have a lot of vacation days and a really nice pension system. Plus we will pay 75% of their health insurance. Isn’t that employer based health insurance?

      You mentioned that conservatives failed to deal with the health care problem. What problem? 85% of Americans had / have health insurance and see doctors as needed.

      Now you passed a federal law that impacts 310 million Americans when the problem was about the needs of 10 million or so. And it’s federal, one size fits all, when the needs of each citizen is different and the demands vary from state to state. So any fixes to any of the problems will have to be done on a federal level, by a divided Congress? Or by some bureaucrat in a foul mood? Good luck with that one.

      IF there was or there is a problem getting affordable health insurance, then this is a state by state problem. Not a problem for the federal government. And there are some states that provided low cost insurance. Those programs cease to exist Jan 1 2014. The new plans require more services be offered, thus will be more expensive. There is NO free lunch. There are NO free services. Somebody, probably the taxpayers, will pay for this, eventually.

      You mentioned the supply of doctors. You just added 30 million more people who now need a doctor and the law passed does nothing to increase the number of doctors. Wanna blame the Tea Party for this problem too?

      You object to HSA’s and buying insurance across state lines. Part of the reason for Obamacare was to keep the cost of health insurance low and avoid costs that would cause people to file for bankruptcy. HSA’s allow people to save for the future, much like IRA’s and 401k plans, which are another employer sponsored benefit, especially when they match some of the money you, the employee, saves.

      Buying across state lines, increasing competition keeps prices low. And the whole idea behind Obamacare is reducing costs to those who buy insurance, right?

      And this law demands that everybody buy insurance? Why? I’m American citizen. No other law demands I buy goods and services or pay some penalty, tax or mandate. Call anything you want, it still comes out of my pocket.

      Obamacare is flawed. Health care is an issue for the individual states to resolve and for those states to provide for their respective citizens. IF the citizens of that state decide they want the state to provide insurance for it’s citizens.

      The federal government is filled with so many problems they can’t or won’t fix and the Dems want to add even more… Why?

  16. GabbyD says:

    but if obamacare fails, how could it pave the way to single payer?

    • Richie says:

      It’s very simple: The Democrats will blame the greedy, profit-seeking evil insurance companies for raising premiums to rape people that buy insurance. Thus, “we” need a single-payer system to eliminate the evil profit motive.

      • GabbyD says:

        oh, but if obamacare fails, why will premiums rise?

        i thought failure of obamacare merely meant that premiums will be unaffected by obamacare.

        further: if obamacare raises premiums, presumably single payer will increase them more. wont that lead to the ultimate failure of single payer?

        • Rick Hull says:

          If Obamacare fails, it will likely take the form of the Death Spiral, which will completely wreck the private health insurance market by sending premiums through the roof.

          google: mcardle obamacare death spiral

          for more details.

        • Ken P says:

          If enough healthy people don’t sign up, premiums will skyrocket. If ACA fails, the law will remain, including coverage for pre-existing conditions. That will put major strain on insurance companies to raise premiums.

          The impact of single payer is primarily to limit payments: cap how much can be charged, limit procedures (especially tests). The result is likely to be shortages and long waits with less increase in premiums.

        • Bob Roddis says:

          A cartoon in Liberty Magazine from about 10 years ago:

          http://www.flickr.com/photos/bob_roddis/4465886028/

        • Richie says:

          “oh, but if obamacare fails, why will premiums rise?”

          Obamacare’s failure will be blamed on the rise in premiums, which will lead to the situation in my comment above.

    • peter says:

      First rule in golf: never follow a bad shot with a stupid shot.
      First rule in government: make a bad shot, so you can follow it with a stupid shot.

      • Samson Corwell says:

        This one made me smile.

  17. Samson Corwell says:

    How dumb is Krugman? It doesn’t take an economist to know that the Affordable Care Act was more tangled than a spider web.

  18. Edward says:

    MF,

    Gibberish as usual 🙂

    • Richie says:

      You just don’t understand it. That’s your fault.

    • Major_Freedom says:

      Oh come on Edward. I know you’re weak minded, but I didn’t think you’d prove it to me once again.

      If it’s too complicated for you, then that’s your problem.

  19. Julien Couvreur says:

    “(K)eeping insurance companies in the mix, when they serve little useful purpose”.

    He has a point. Once an industry is so caught in the staright-jacket of regulations and price controls, there is not much benefits clinging to the idea of private property, individual decisions and free enterprise. We might as well call the crony fascist-socialist system what it is. Stop pretending and give up.

    • Tel says:

      But at least some person in the process needs to know what they are doing.

    • Samson Corwell says:

      Um, all property is subject to regulations of some sort. I don’t think the random jackass down the street should be free to set off bombs in his backyard. A small amount of regulation doesn’t suddenly make it not free enterprise.

      • Richie says:

        Depends on who is doing the regulating.

        • Samson Corwell says:

          We’re talking about government.

          • Richie says:

            Exactly.

            • Samson Corwell says:

              Huh?

              • Major_Freedom says:

                Does a rapist have a legitimate right to threaten everyone with violence if they seek protection against rape from someone else other than the rapist?

              • Samson Corwell says:

                Last time I checked governments don’t sodomize those who fail to pay taxes.

              • Rick Hull says:

                Right, they just toss you in their holding pen full of sodomizing rapists and leave you to fend for yourself.

                But their hands are clean, CLEAN I tell you!

    • Bob Roddis says:

      The pre-existing common law rules against the initiation of force (laws against murder, robbery, burglary, unwanted touching etc…) and fraud are “regulations”.

  20. Gamble says:

    Samson Corwell wrote “And how the hell does it do that when the people electing the Senators are same people who elect the state legislatures that used to elect those same Senators?”YOU HAVE TO LOOK AT HOW STATE LEGISLATORS ARE PLACED INTO POWER. YOU ALSO HAVE TO LOOK AT HOW STATE LEGISLATORS WOULD APPOINT A SENATOR COMPARED TO HOW THE GENERAL POPULATION WOULD ELECT A SENATOR. THE OUTCOMES WILL BE VASTLY DIFFERENT.

    Sampson Corwell wrote” First, Truman was VP before he became President, so he doesn’t count. Second, I’m not quite sure what JFK did that is of critical importance besides screwing Marilyn Monroe. YOU GLOSSED OVER JOHNSON,NIXON,OBAMA. Third, I mentioned the Fourteenth Amendment, not the Thirteenth Amendment. The Thirteenth Amendment was the one that dealt with slavery, so I don’t see where you could get the idea that I was implying that you were a slave trader. 13,14 AND 15 WERE THE RECONSTRUCTION AMENDMENTS, THEY ALL DEALT WITH SLAVES AND PAST SLAVES. Fourth, the truth about the Fourteenth Amendment is that it WAS ratified. Thomas DiLorenzo’s hackish attack on it is like those made by the kinds of people who imply a single comma makes a substantive difference. If he’s a historian, then I’m a professional basketball player. DILORENZO IS NOT A HACK, HE IS A MASTER PARADIGM FLIPPER…

    IF YOU WANT TOTAL DIRECT DEMOCRACY, JUST SAY SO. LET US CLEAR THE SLATE, DEFINE THE WINDOW OF PUBLIC POLICY, SET IT IN STONE AND LET THE PEOPLE HAVE ALL THE SAY, MAJORITY RULES.

    • Samson Corwell says:

      Excuse me, but my first name has no “p” in it. Who the hell spells it like that anyway? Also, stop typing so loudly.

      You observe that the thirteenth, fourteenth, and fifteenth amendments were passed during Reconstruction. Whoopee. Do you want a cookie?

      Thomas DiLorenzo is a whore. Full freaking stop.

      Pray tell, show me where I want “total direct democracy”. I’m no advocate of majoritarian rule. You seem to be reading things that I didn’t write.

      • Richie says:

        “Thomas DiLorenzo is a whore.”

        A whore for whom? The state? And are we supposed to believe that because you say so?

        • Samson Corwell says:

          He thinks the fact that the initial/first reason that the North went to war to preserve the Union instead of free the slaves is news to anyone. Hello, I learned that in third grade. In a public school.

          • Major_Freedom says:

            That’s Tom’s point.

            • Major_Freedom says:

              Meaning, he wasn’t talking about you specifically.

            • Samson Corwell says:

              He thinks it’s a major revelation when it really isn’t.

              • Major_Freedom says:

                Oh but it is.

                He faced a ton of flak when he first started writing about it.

                You ask the guy in the street, and he’ll likely say it was to end slavery.

                I think you’re maybe conflating your personal life, with everyone else’s lives.

                A major reason he keeps writing about it, including quotes such as “If I could save the Union but not end slavery, I would do it…” is because it is so surprising to many.

                You should read Woods. He writes about a LOT of authors who preach the “end slavery” story.

              • Samson Corwell says:

                I really don’t think I need to read Woods. My opinions on the Civil War are very different from his.

              • Samson Corwell says:

                I do believe that slavery was the *root* cause of the issue, though. That should be obvious to anyone with a modicum of intelligence.

          • Richie says:

            So how does that make him a “whore”?

            • Samson Corwell says:

              I goofed. Wrong word popped into my mind.

          • Richie says:

            And for whom?

          • Peter says:

            Public school. Got it.

            • Samson Corwell says:

              Don’t belittle me. Public school isn’t like what some numbskulls portray it to be. Ancaps say it’s communist indoctrination while leftists (real leftists) say its capitalist indoctrination, but both are wrong.

              • Andrew_FL says:

                Eh, it depends on your teachers, mostly. I had some teachers that were openly Marxist, a couple I thought were right leaning, and a majority who were liberal but didn’t, for the most part, make anything of it-although a few did. I won’t jump to the conclusion I had a representative sample but I think it’s fair to say you could easily go through a public school education for 13 years without that much propagandizing. But the real issue with public school isn’t that it brainwashes people. It’s that it doesn’t work very well.

              • Gamble says:

                So then what is it, according to Samson Corwell?

              • Ken B says:

                Gamble, if I say the moon ios not made of blue cheese, and not made of cheddar cheese, is it a sensible retort to ask me “what is it made of then according to Ken B?”

              • Samson Corwell says:

                Outright Marxist in primary/secondary education? I could understand how that could be so in college, but not when it comes to elementary, middle, or high school.

              • Samson Corwell says:

                Gamble says: “So then what is it, according to Samson Corwell?”

                Err, you’re joking, right? Exactly the opposite of what you it is.

                FL says: “But the real issue with public school isn’t that it brainwashes people. It’s that it doesn’t work very well.”

                That is certainly a possibility.

          • Samson Corwell says:

            Furthermore, Gamble, I am a supporter of the incorporation doctrine.

            • Gamble says:

              Okay you want/appreciate the Bill of Rights to apply to State governments, not jus the Fed but you never explained what you think K-12 is? You said it is the opposite of what I think it is but you do not know what I think it is.

              What do you think K-12 is?

              • Samson Corwell says:

                My view: K-12 isn’t any kind of indoctrination.

      • Gamble says:

        Samson,

        I merely uses all caps so you and others would understand who said what. If I could have highlighted my words in blue, I would have. So no I was not typing loudly.

        Glad we both agree 13,14,15 were ” reconstruction” amendments. Do you want a cookie?

        Why is Tom DiLorenzo a whore? I am fairly certain Tom has never engaged in sexual acts for money.

        I suggested you are fan of direct Democracy because you said the seventeenth amendment was no biggie and a good amendment. I made the original claim that the year 1913 was a bad year for Liberty because of the Fed Reserve Act, 16th and 17th amendment. You said 17th was good and I said it must be because you like direct Democracy because the at is indeed what the Seventeenth Amendment is as compared to the original process for appointing US Senators. Pre17, Senators were appointed by the Sate Legislator, post 17 Senators were elected by a majority citizen vote. If not for 17, Barrack Obama would never have become Senator nor President. Johnson would not have escalated Vietnam and Nixon would not have taken us of gold.

        Please stop taking us on tangents and stop performing the liberal 2 step, which I must admit you perform flawlessly.

        Why do you think the 17th was positive rather than a negative?

        • Samson Corwell says:

          Several ptoblems here:
          1. I did not make a positive claim about the Seventeenth Amendment. I stated that I don’t understand why some folks consider it to be such a big deal.
          2. It is not clear at all what difference a senator going on to become president makes for the presidency. It is also not clear that the Seventeenth Amendment is the reason for why five senators have been elected president.
          3. “Liberal 2 step”? I’m not sure what that is and I know that I’m not a liberal. Is that name in a grab bag of various others that you use when you need to engage a suspected ideological opponent in debate?
          4. Thomas DiLorenzo is a dishonest hack. I should have said that instead of calling him a whore. Although I wouldn’t doubt that there might be times he’d except money to write about a topic from an assigned perspective.

          • Richie says:

            “Thomas DiLorenzo is a dishonest hack.”

            Prove it.

  21. Bob Roddis says:

    The problems with Obamacare are all caused by trying to assuage the concerns of “conservatives” and pro-market types.

    Democrats created this mess for themselves. Conservative Democrats are responsible for many of the program’s flaws, and, perversely, their attempts to shield themselves from public outrage ended up creating a law that will lead to more public outrage than a more government-oriented program would’ve. But the program was designed by moderate and even liberal Democrats. They were working to appease the conservatives, yes, but we should have long since learned that a conservative congressional Democrat will only ever agree to something if you promise to make it a little bit, or a lot, worse. In other words, the ask should’ve been bigger.

    http://www.salon.com/2013/10/31/obamacare_is_a_mess_and_liberals_need_to_fix_it/?source=newsletter

    • Major_Freedom says:

      In communist countries, the problems are ALWAYS caused by those who just refuse to lick the boots of the party.

      If only everyone were boot lickers. Then the plans would actually work.

  22. Andrew Keen says:

    Step 1: Find a problem.
    Step 2: Blame the private sector.
    Step 3: Create or embellish a governing body to deal with the problem.
    Step 4: Identify a problem caused by the new government powers.
    Step 5: Go to step 2.

    • Major_Freedom says:

      Step 1: Create a monopoly on protection and legislation
      Step 2: Cause conflict
      Step 3: Rule in favor of yourself, and thus grow in power.
      Step 4: See Step 2.

  23. Gamble says:

    I just realized So many existing private insurance policy’s are being canceled in an attempt to generate Obamacareless enrollee’s.

    So anybody touting government enrolment numbers must preference or better yet subtract the number of cancellations…

  24. Gamble says:

    “The thing that gets me,” says Stadler, who voted for Obama in the 2012 presidential election, “is I thought Barack Obama was the only guy I could trust in Washington. He ended up lying to me because he said, if I like my insurance, I could keep it.”

    Under Stadler’s expiring policy, his premiums are $411 a month, for coverage that always seemed adequate to him. “It’s not a substandard policy,” he says. “I thought it was a great deal.” The premium for the new policy offered by his insurer will be $843 a month, with coverage that’s more or less the same as far as he’s concerned. But new policies are required to include free preventive services such as mammograms and colonoscopies, and they can’t be canceled or priced higher for sicker people, which is why the cost of some policies is going up.

    http://finance.yahoo.com/news/healthcare-shoppers-aren%E2%80%99t-as-dumb-as-obama-thinks-195824524.html

  25. Gamble says:

    Obama also continues to point out that many people whose insurance is being cancelled will get a better deal through one of the new exchanges, because of federal subsides offered to lower-income people to help them pay for coverage. The real losers, by contrast, are people like Stadler who won’t qualify for subsidies, and will no longer be able to buy “substandard” policies, either. Many such people will face higher costs for better coverage they wouldn’t choose to pay for on their own, which is exactly the type of Washington-knows-better policymaking that outrages Tea Partiers and many independents who think the government has become too invasive.

    Distrust of Obamacare and the people running it has been compounded by the malfunctioning web site and the sheer complexity of the law and its many requirements. Jeanne Patterson of Drexel Hill, Pa., will be losing coverage at the end of the year, and her insurance carrier told her she must choose another plan by Nov. 20 or she won’t be able to get coverage for 2014. The White House, meanwhile, has said it may take until Nov. 30 to fix the crash-prone federal web site. The ACA gives people who choose a plan through an exchange until Dec. 15 to purchase coverage that would take effect Jan. 1, but like many others, Patterson hasn’t been able to navigate the buggy site to find out what her options are.

    http://finance.yahoo.com/news/healthcare-shoppers-aren%E2%80%99t-as-dumb-as-obama-thinks-195824524.html

  26. Gamble says:

    The law of moral hazard will eat us all out of house and home after this single payer is fully implemented.

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