Matthew Holt

Is much more than we think really possible?

On THCB today Maggie Mahar basically tells the health reform crowd to be patient. But two members of the unreconstructed left in other venues don’t agree. In the NY Times Paul Krugman says that deficit spending is OK, and correctly points out that Obama has a real mandate to fix the underlying problems of middle America (and yes that would include health care). And yes polling data shows that on balance America is as liberal now as it was in the 1960s. 35 years of blind-ish belief in conservatism is more or less over.

And if you want to see the optimist’s view on what Obama might do, Jonathan Cohn has a long article in The New Republic called Surgical Prep explaining why now is the time for health care reform and how the brass knuckles approach is being put together to get it done.

I’m not sure I’m there but let’s not underestimate how big a political win this was.

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  1. Matthew–
    Krugman didn’t talk about deficit spending to help the middle-class. This is what he said:
    “Helping the neediest in a time of crisis, through expanded health and unemployment benefits, is the morally right thing to do”
    The “Neediest” are not the middle class. They are the very poor and near-poor. The Democrats have announced that they plan to help them: expanding SCHIP and investing more in Medicaid.
    As for healthcare, Krugman said that we could go ahead with talking about and planning for universal coverage because: “even if quickly enacted into law (national health insurance) probably wouldn’t take effect until 2011.”
    In other words, Krugman is not calling for universal coverage in 2009 or 2010.
    If tough legislation is passed, by 2011 we might have really contained health care spending– by using the research that the Comparative Effectiveness Institute pulls together.
    There is a lot of it evidence-based, unbiased reserarc hout there about some very common treatments–like statins, bypasses, angioplasties, tests to try to detect early-stage cancer– that would allow insurers to hike co-pays and deductibles for ineffective treatments, pay physicians much less for these treatments– or refuse to cover them together.
    But 2011 is, I suspect, optimstic. AS Krugman points out: “there’s no question that fighting the ‘financial’ crisis will cost a lot of money. Rescuing the financial system will probably require large outlays beyond the funds already disbursed. And on top of that, we badly need a program of increased government spending to support output and employment. Could next year’s federal budget deficit reach $1 trillion? Yes.”
    Moreover, it will take some time to persuade Americans that things they have been told that they All absolutely need– Statins, bypasses, angioplasties, tests to “detect cancer early” etc. are, in fact, helpful for only a small group of patients who meet a certain profile . .
    This is why Obama has always said that he hoped to roll out universal coverage “by the end of my first term” —
    four years from now.
    And he said that before the economic meltdown.
    Now, neither he (nor certainly I) know when he can do it. Maybe he could do it by 2011.
    But he has made it clear that he has other priorities that come first (Iraq, the vets, creating jobs while reparing infrastructure and building schools. ) In his victory speech, he never mentioned healthcare.
    pulls togethe
    And when he talks about spending money we don’t have (deficit spending ) he talks about helping the poor.

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