Letter
Published: February 9, 2008
Re “The Edwards Effect” (column, Feb. 1):
Paul Krugman ridicules John Kerry’s 2004 campaign as “cautious” and “without strong, distinctive policy ideas.”
Talk about a flip-flop that would even make Mitt Romney jealous: Mr. Krugman suggests that Mr. Kerry’s policies weren’t distinctive, but in 2004 when writing about health care policy he said, “The difference (from Bush) couldn’t be starker.” He wasn’t alone: Joe Klein of Time magazine called Mr. Kerry’s health care reinsurance plan the first new big idea of the campaign season.
The ripples of Mr. Kerry’s policy innovations can be seen across the Democratic field. Indeed this newspaper reported that “the Obama campaign revives an idea advanced by the Kerry campaign — using the federal government to cushion employers from sudden, disastrous spikes in health expenditures, by reimbursing health plans for the cost of catastrophic illnesses among their employees” (front page, May 30, 2007).
Every time candidates talk about a “Manhattan Project” for alternative energy, service for college plans or ending tax subsidies that encourage shipping jobs overseas, they echo principles that Mr. Kerry campaigned on in 2004.
How is it that so many of the same policies Mr. Krugman found “cautious” in 2004 have become “bold” in 2008?
David Wade
Washington, Feb. 1, 2008
The writer was national press secretary for Kerry-Edwards 2004.
moreBy PAUL KRUGMAN
Published: July 9, 2004
Will actual policy issues play any role in this election? Not if the White House can help it. But if some policy substance does manage to be heard over the clanging of conveniently timed terror alerts, voters will realize that they face some stark choices. Here's one of them: tax cuts for the very well-off versus health insurance.
John Kerry has proposed an ambitious health care plan that would extend coverage to tens of millions of uninsured Americans, while reducing premiums for the insured. To pay for that plan, Mr. Kerry wants to rescind recent tax cuts for the roughly 3 percent of the population with incomes above $200,000.
George Bush regards those tax cuts as sacrosanct. I'll talk about his health care policies, such as they are, in another column.
Considering its scope, Mr. Kerry's health plan has received remarkably little attention. So let me talk about two of its key elements.
First, the Kerry plan raises the maximum incomes under which both children and parents are eligible to receive benefits from Medicaid and the State Children's Health Insurance Program. This would extend coverage to many working-class families, who often fall into a painful gap: they earn too much money to qualify for government help, but not enough to pay for health insurance. As a result, the Kerry plan would probably end a national scandal, the large number of uninsured American children.
Second, the Kerry plan would provide "reinsurance" for private health plans, picking up 75 percent of the medical bills exceeding $50,000 a year. Although catastrophic medical expenses strike only a tiny fraction of Americans each year, they account for a sizeable fraction of health care costs.
By relieving insurance companies and H.M.O.'s of this risk, the government would drive down premiums by 10 percent or more.
This is a truly good idea. Our society tries to protect its members from the consequences of random misfortune; that's why we aid the victims of hurricanes, earthquakes and terrorist attacks. Catastrophic health expenses, which can easily drive a family into bankruptcy, fall into the same category. Yet private insurers try hard, and often successfully, to avoid covering such expenses. (That's not a moral condemnation; they are, after all, in business.)
All this does is pass the buck: in the end, the Americans who can't afford to pay huge medical bills usually get treatment anyway, through a mixture of private and public charity. But this happens only after treatments are delayed, families are driven into bankruptcy and insurers spend billions trying not to provide care.
By directly assuming much of the risk of catastrophic illness, the government can avoid all of this waste, and it can eliminate a lot of suffering while actually reducing the amount that the nation spends on health care.
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