Paul Krugman: "Golden State Gamble"

We're back on the very necessary subject of health care and more. Let me also refer you back to Krugman's earlier column, "First, Do No Harm." Read it all at Rozius Unbound or take the snippet that I offer:

A few days ago. Gov. Arnold Schwarzenegger unveiled an ambitious plan to bring universal health insurance to California. And I’m of two minds about it.

On one side, it’s very encouraging to see another Republican governor endorse the principle that all Americans are entitled to essential health care... And if California — America’s biggest state, with a higher-than-average percentage of uninsured residents — can achieve universal coverage, so can the nation as a whole.On the other side, Mr. Schwarzenegger’s plan has serious flaws. Maybe those flaws could be fixed once the principle of universal coverage was established — but there’s also the chance that we would end up stuck with those flaws...

Furthermore, in the end health care should be a federal responsibility. State-level plans should be seen as pilot projects, not substitutes for a national system. Otherwise, some states just won’t do the right thing. Remember, almost 25 percent of Texans are uninsured.

To understand both what’s right and what’s wrong with Mr. Schwarzenegger’s plan, let’s compare what he’s proposing with ... a single-payer health insurance system for the state ... similar to Medicare...

[T]he governor ... appears to sincerely want universal coverage, but he also wants to keep insurance companies in the loop. As a result, he came up with a plan that, like the failed Clinton health care plan of the early 1990s, is best described as a Rube Goldberg device — a complicated, indirect way of achieving what a single-payer system would accomplish simply and directly.

There are three main reasons why many Americans lack health insurance. Some healthy people decide to save money and take their chances (and end up being treated in emergency rooms, at the public’s expense...); some people are too poor to afford coverage; some people can’t get coverage ... because of pre-existing conditions.

Single-payer insurance solves all three problems at a stroke. The Schwarzenegger plan, by contrast, is a series of patches. It forces everyone to buy health insurance...; it provides financial aid to low-income families...; and it ... basically [requires insurance companies] to sell insurance to everyone at the same price.

Go here for the rest.

I agree with Krugman here. Vermont also has this "force people to buy" plan that has yet to go into operation. But if people can't afford to buy - and the state doesn't make it affordable enough so the many barely-minimum wage folks can pay it - what the heck do they do?

We know what they do. They die early or they get treatment that ultimately costs them a hell of of a lot more than everyone else and often turns into a problem for the health care facility or state.