Krugman on Health Care

Krugman is fighting an uphill battle. The media refuses to present the case for health care reform. So most Americans are confused. Obama gave a masterly presentation in his recent news conference, but the media, as usual, talked about "style" while ignoring "substance". From Krugman's NY Times op-ed article:

The talking heads on cable TV panned President Obama’s Wednesday press conference. You see, he didn’t offer a lot of folksy anecdotes.

Shame on them. The health care system is in crisis. The fate of America’s middle class hangs in the balance. And there on our TVs was a president with an impressive command of the issues, who truly understands the stakes.

Mr. Obama was especially good when he talked about controlling medical costs. And there’s a crucial lesson there — namely, that when it comes to reforming health care, compassion and cost-effectiveness go hand in hand.

... compassion means not closing your eyes to the human consequences of rising costs. When health insurance premiums doubled during the Bush years, our health care system “controlled costs” by dropping coverage for many workers — but as far as the Bush administration was concerned, that wasn’t a problem. If you believe in universal coverage, on the other hand, it is a problem, and demands a solution.

...

At one point in his remarks Mr. Obama talked about a red pill and a blue pill. I suspect, though I’m not sure, that he was alluding to the scene in the movie “The Matrix” in which one pill brings ignorance and the other knowledge.

Well, in the case of health care, one pill means continuing on our current path — a path along which health care premiums will continue to soar, the number of uninsured Americans will skyrocket and Medicare costs will break the federal budget. The other pill means reforming our system, guaranteeing health care for all Americans at the same time we make medicine more cost-effective.

I find it funny how right wing commentators in the US present a nightmare vision of Canadian health care. I've had experience on both sides of the border. I had far longer wait times in the emergency room in the US than in Canada. I've seen good and bad doctors on both sides of the border. There are, from time to time, problems with waits for procedures in Canada. (This was mostly a problem of the mid 1990s because of the brutal cuts to social spending to bring the deficit and debt under control.) The only significant differences in medical care I see between Canada and the US:

• There is no pile of paperwork to do before I get treated. I simply show my medical care card if I go to a new place, they record it, and that's the last of "the paperwork".


• There are not hordes of poor clogging the emergency room in Canada. The system is more rational because everybody gets access. In the US the poor avoid the medical system until the situation is dire and then everything costs more. Plus, in the US all medical bills are padded to cover the cost to the medical system for giving "free" care to those who can't afford it.


• There is complete freedom of choice about medical care on both sides of the border. The only limit to "choice" in Canada is that you have to go through your primary care physician before you can get access to specialists. In the US, the specialists want you to see them first to maximize their income, but since they are the most expensive medical care, this is irrational. Canada's insistence that you go see you primary care physician means that there is somebody who maintains "the big picture" of your health and the care that you are getting. The Canadian system doesn't prevent you from seeing a specialist (except for those irrational people who "know" they need a specialist while their primary care physician tells them they don't and tries to treat them at lower cost to the system).