Oh the Irony -- Krugman on Obama and the Mandate back in 2007
On healthcare, candidate Obama was to the right of his rivals. He didn't go toward "universal" because he didn't want the mandate -- it's political dynamite. I get that. But what he proposed never made sense to me.
The idea was that people would buy insurance once it was affordable. When asked how it would be affordable without everyone buying in, there was no real answer. The whole answer was just "Affordable Public Option."
Now we have the mandate... but not the public option. How did we get here?
[div class = "excerpt"]http://www.nytimes.com/2007/11/30/opinion/30krugman.html
Mandates and Mudslinging
By PAUL KRUGMAN
Published: November 30, 2007
(snip) The central question is whether there should be a health insurance “mandate” — a requirement that everyone sign up for health insurance, even if they don’t think they need it. The Edwards and Clinton plans have mandates; the Obama plan has one for children, but not for adults.
Why have a mandate? The whole point of a universal health insurance system is that everyone pays in, even if they’re currently healthy, and in return everyone has insurance coverage if and when they need it.
And it’s not just a matter of principle. As a practical matter, letting people opt out if they don’t feel like buying insurance would make insurance substantially more expensive for everyone else.
Here’s why: under the Obama plan, as it now stands, healthy people could choose not to buy insurance — then sign up for it if they developed health problems later. Insurance companies couldn’t turn them away, because Mr. Obama’s plan, like those of his rivals, requires that insurers offer the same policy to everyone.
As a result, people who did the right thing and bought insurance when they were healthy would end up subsidizing those who didn’t sign up for insurance until or unless they needed medical care.
[div class = "excerpt"]
http://www.nytimes.com/2007/12/07/opinion/07krugman.html
The Mandate Muddle
By PAUL KRUGMAN
Published: December 7, 2007
Imagine this: It’s the summer of 2009, and President Barack Obama is about to unveil his plan for universal health care. But his health policy experts have done the math, and they’ve concluded that the plan really needs to include a requirement that everyone have health insurance — a so-called mandate.
Without a mandate, they find, the plan will fall far short of universal coverage. Worse yet, without a mandate health insurance will be much more expensive than it should be for those who do choose to buy it.
But Mr. Obama knows that if he tries to include a mandate in the plan, he’ll face a barrage of misleading attacks from conservatives who oppose universal health care in any form. And he’ll have trouble responding — because he made the very same misleading attacks on Hillary Clinton and John Edwards during the race for the Democratic nomination.
(snip)
I’d add, however, a further concern: the debate over mandates has reinforced the uncomfortable sense among some health reformers that Mr. Obama just isn’t that serious about achieving universal care — that he introduced a plan because he had to, but that every time there’s a hard choice to be made he comes down on the side of doing less.
