Here’s an analogy. Suppose someone proposed making the Medicare payroll tax optional: you could choose not to pay the tax during your working years if you didn’t think you’d actually need Medicare when you got older — except that you could change your mind and opt back in if you started to develop health problems.
Can we all agree that this would fatally undermine Medicare’s finances? Yet Mr. Obama is proposing basically the same rules for his allegedly universal health care plan.
So how much does all this matter?
Mr. Obama’s health plan is weaker than those of his Democratic rivals, but it’s infinitely superior to, say, what Rudy Giuliani has been proposing. My main concern right now is with Mr. Obama’s rhetoric: by echoing the talking points of those who oppose any form of universal health care, he’s making the task of any future president who tries to deliver universal care considerably more difficult.
http://www.nytimes.com/2007/12/07/opinion/07krugman.html?_r=2&oref=slogin&oref=sloginOver all, the Obama-type plan would cost $4,400 per newly insured person, the Clinton-type plan only $2,700.
That doesn’t look like a trivial difference to me. One plan achieves more or less universal coverage; the other, although it costs more than 80 percent as much, covers only about half of those currently uninsured...
If Mr. Obama gets to the White House and tries to achieve universal coverage, he’ll find that it can’t be done without mandates — but if he tries to institute mandates, the enemies of reform will use his own words against him.
If you combine the economic analysis with these political realities, here’s what I think it says: If Mrs. Clinton gets the Democratic nomination, there is some chance — nobody knows how big — that we’ll get universal health care in the next administration. If Mr. Obama gets the nomination, it just won’t happen.
http://www.nytimes.com/2008/02/04/opinion/04krugman.html?_r=2&hp&oref=slogin&oref=slogin