Paul Krugman: The Hype Behind the #HealthCare #Scandal – NYTimes

Paul Krugman

You’ve surely heard about the scandal at the Department of Veterans Affairs. A number of veterans found themselves waiting a long time for care, some of them died before they were seen, and some of the agency’s employees falsified records to cover up the extent of the problem. It’s a real scandal; some heads have already rolled, but there’s surely more to clean up.

But the goings-on at Veterans Affairs shouldn’t cause us to lose sight of a much bigger scandal: the almost surreal inefficiency and injustice of the American health care system as a whole. And it’s important to understand that the Veterans Affairs scandal, while real, is being hyped out of proportion by people whose real goal is to block reform of the larger system.

The essential, undeniable fact about American health care is how incredibly expensive it is — twice as costly per capita as the French system, two-and-a-half times as expensive as the British system. You might expect all that money to buy results, but the United States actually ranks low on basic measures of performance; we have low life expectancy and high infant mortality, and despite all that spending many people can’t get health care when they need it. What’s more, Americans seem to realize that they’re getting a bad deal: Surveys show a much smaller percentage of the population satisfied with the health system in America than in other countries.

How and why does health care in the United States manage to perform so badly? There have been many studies of the issue, identifying factors that range from high administrative costs, to high drug prices, to excessive testing. The details are fairly complicated, but if you had to identify a common theme behind America’s poor performance, it would be that we suffer from an excess of money-driven medicine. Vast amounts of costly paperwork are generated by for-profit insurers always looking for ways to deny payment; high spending on procedures of dubious medical efficacy is driven by the efforts of for-profit hospitals and providers to generate more revenue; high drug costs are driven by pharmaceutical companies who spend more on advertising and marketing than they do on research.

Rima NYT Comment SmallClick here to read my appeal to Professor Krugman to return to a discussion of macroeconomics:

Dear Professor Krugman,

I greatly miss your columns on macroeconomics. I am quite sure my fellow readers do too.

No one writes about the economic issues of the day as you do. The economy is still a mess. Many of us are still in the trenches with little hope of getting out, while the lazy congresscritters are readying campaigns based on lies and our economy just floats along, without a captain in a rudderless ship. Our students could have gotten some help with Senator Warren’s student debt reform. We still have no jobs bills. The unemployed, who knows how they are surviving. 

The vets deserve every benefit we can give them. We owe them. But the advice given to parents to take care of themselves so they can care for their children applies here too.

Click here to read my regular comment in reply to Professor Krugman’s op-ed.

The rot permeates every institution at the highest levels and the lowest depths. Such is the nature of decay. Such is the aim of those who would and could turn a democracy into a plutocracy. The unseen hand of the plutocrat, the seeming chaos of our politics, and the single-minded purpose of funneling every single dollar of taxes, low wages, and high speculative profit into the pockets of a relative few individuals.

That the Vet has been a mess for a long time. One way to fix it – in fact, the only way – to fix it and everyone else’s healthcare, is to adopts universal healthcare. We should unify all of our disparate healthcare systems into one.

Everyone should have access to healthcare, no matter the reason. Healthcare is a human right. 


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