OK, on all this: the health care choices people make for themselves basically involve pocket change; visits to the doctor, minor surgery, are not where the money is.

The big stuff is in hugely expensive procedures: heart bypasses, dialysis, etc.. These things either get paid by insurance, or they don’t happen at all.

So making sure that everyone has insurance won’t lead to significantly higher spending on care — and it will save huge amounts on bureaucracy (Medicare has overhead of 3 percent; private insurance companies have overhead of 14 percent)

Conservatives love the “moral hazard” argument that people consume too much care because they don’t pay for it, but when you do the numbers it turns out to be basically nonsense.

But isn’t it that people don’t spend the “pocket change” on primary and wellness care and instead spend it on bacon cheeseburgers and Big Gulps that leads to the bypasses and dialysis?

It seems to me that making primary care in-your-face available is where our opportunity to reduce overall healthcare cost (aside from administration) really lies, by simply keeping people healthier. Besides spreading risk and cost as widely as possible, this seems like the best practical reason to do single-payer universal.

My personal peeve — it plays a role in the story I tell in COAL — is the way the right has managed to spin a few bad years in the late 1970s US, mainly the result of oil shocks, into “proof” that progressive policies don’t work — this in spite of the fact that the 30 years after the New Deal were the best economy America has ever had.

Probably too late to get a reaction but….this has been a particular pet peeve of mine too. Not only is it unfair to hold a four-year, OPEC-driven slump against Carter as proof of the “failure” of liberalism but, as the Times emeritus columnist Russel Baker once pointed out, Carter was a conservative Democrat.

But idealogues have never let facts get in the way of a good story.

Two points, what you said in 164 has been the situation in Australia for the last 20 years. About 30 percent of the population have private cover for things that are not covered by medicare and the federal goverment has tried to boost that with such things as tax rebates.

Second, what do you make of Chairman’s Hu speech in China where he said that from now on, China will rely less on exports and more on increasing its domestic market. To me, that spells trouble for the US economy because that implies they would have less incentive to buy our debt. What do you think ?

Paul Krugman @ 43

The other thing may be the difference between the interests of the company and those of its executives. Advocating universal health care might save GM, but get its CEO blackballed from the country club. Decisions, decisions.

I think this explains a lot about why our economy is headed where it is. People who think “what’s good for me is good for General Motors” shouldn’t be running General Motors. Short term thinking to inflate profits, and thus their bonuses and options, made us techies grind our teeth in the ’90s and would still do it in this decade if we had any teeth left.

A large part of this has to come from the practice of giving CEO’s stock and stock options so that their performance is tied to — actually to their own personal wealth rather than to the performance of the stockholders. CEOs should be wage slaves like the rest of the employees of the corporations. Then they would be less likely to lie to the stockholders.

progressive @ 171

Thanks for spending some time with us.

In regard to your lack of interest in “vengeance” (at 100) following the alleged improper activities of GWBush and colleagues, do you discount the value of “deterrence?”

If Richard Nixon (following Watergate) and Ronald Reagan (following Iran/Contra) had continued their public service as involuntary long-term guests of the federal government, do you see any possibility that Bush and colleagues would have given more consideration to the possible consequences of their actions?

Not at all. It would be salutary to put at least one of these people behind bars. But I do expect mass pardons 15 months from now.

Those mass pardons should be accompanied by a deep investigation of everyone that receives such a pardon and mass distribution of the results.

A public airing of the crimes of this administration would be at least as much a deterrent to its recurrence as would prison time.

It would also make a hell of a good book. “Criminals pardoned by criminals and a description of their crimes.”

SanderO @ 128

Simple questions:

Are you a believer in capitalism?

If so how is that different from what we have now?

Um, there’s capitalism and then there’s capitalism. Sweden is capitalist — most of the economy is market-driven, profits are a key signal driving investment decisions, etc, etc.. But there’s also a strong safety net so that nobody goes without adequate food, shelter, and necessary health care; there are institutions like strong unions that police excesses in the private sector; and so on.

I’ve got the conscience of a liberal, not the belief system of a socialist. I think markets are a great way to organize a lot of what goes on in the economy. But the market system is a tool to be used when appropriate, not a deity to be worshipped without question.

“the conscience of a liberal, not the belief system of a socialist”

SanderO @ 128

Simple questions:

Are you a believer in capitalism?

If so how is that different from what we have now?

Um, there’s capitalism and then there’s capitalism. Sweden is capitalist — most of the economy is market-driven, profits are a key signal driving investment decisions, etc, etc.. But there’s also a strong safety net so that nobody goes without adequate food, shelter, and necessary health care; there are institutions like strong unions that police excesses in the private sector; and so on.

I’ve got the conscience of a liberal, not the belief system of a socialist. I think markets are a great way to organize a lot of what goes on in the economy. But the market system is a tool to be used when appropriate, not a deity to be worshipped without question.

Again, yes and thanks.

Like Stephen Colbert, I don’t see race, but people I trust have told me that you’re white. If so, even more kudos to you for getting those issues out there.

Well, I am white — though Ann Coulter says I need to be perfected.

Seriously, when I started researching Conscience of a Liberal, I had no idea race would play such a huge role in the story. But it just jumps out of the cold, hard data. Without the white backlash against civil rights, and especially the great southern switch to the GOP, none of the right-wing triumphs of the past 30 years would have happened.

And once you start to look at modern American political economy with that in mind, the picture you see is nothing like the happy legends. I spend a lot of time in COAL on the real Ronald Reagan; he wasn’t an avuncular old fellow who advocated true conservatism — for most of his career, he was primarily a clever, insinuating race baiter, who found ways to appeal to racist sentiments — welfare queens driving Cadillacs, etc.. — without actually using the n-word.

Again, thanks. In the sixties a great many white people were absolutely unashamed about expressing their racist sentiments. Now most people soft-pedal their racism in conversation but not in the voting booth.

JeffCO @ 87

Dr. Krugman, thank you again for all your work.

I saw you on the tour for The Great Unravelling and recall your stressing that the Bush administration has a great deal to hide and are very motivated to remain in office. Should a Democrat make it into the WH, and even if they do not destroy every bit of evidence, do you believe we will ever find out the truth of the multitude of crimes of the Bush/Cheney regime? Does anyone have the guts to hold them the accountable?

Another good question. There will be a howl from the Very Serious People inside the Beltway about how wrong it would be to go over trivial past things like lying the country into war — and there’s a risk the next president will listen. I’ve long thought that Bill Clinton’s biggest mistake was to let the evidence on Iran-Contra lie, out of fear of seeming vindictive.

This time, I hope we’ll all demand a Truth and Reconciliation Commission, or the equivalent thereof. I don’t want vengeance — but I do want the American people to know what was done in their name.

Yes, oh yes. Thank you for calling for this.

four legs good @ 34

Dr. Krugman, a serious question- wouldn’t universal healthcare be good for american businesses? Wouldn’t it help them to be more competitive?

Why doesn’t anyone ever make that argument? It seems so ridiculous to me- the republicans are against universal healthcare because government handouts are “against their principles” but they have no problem with industry bailouts.

yes, this is a real puzzle. The Big 3 auto makers are, in fact, enthusiastic supporters of single-payer health care — in Canada. (They send letters to the Canadian government warning that any tampering with the system would greatly hurt their competitiveness.) So why don’t they do the same here?

My take is that it’s two things. One, fear of retribution: as I wrote in my last column, for about a decade Tom DeLay and his friends did a pretty good job of turning K Street into an appendage of the GOP, not the other way around, and big companies were probably afraid to challenge the free-market line.

The other thing may be the difference between the interests of the company and those of its executives. Advocating universal health care might save GM, but get its CEO blackballed from the country club. Decisions, decisions.

Thanks for pointing this out. It’s easy to forget that divided loyalties (and realistic, sophisticated fears) are so common. Yes, the Republicans’ middle name (or is it their first principle?) is Retribution. Toe the line, or else! The movie Enemy of the State displays the panoply of punishments they’re eager to resort to. Of course most of the time, their methods are necessarily more low-tech than the ones in the film.