Paul Krugman argues in his Death
by Ideology that “lack of insurance is responsible for thousands, and
probably tens of thousands, of excess deaths of Americans each year.” Romney
and Ryan, he claims, “want to repeal Obama care and slash funding for Medicaid
— actions that would take insurance away from some 45 million nonelderly
Americans, causing thousands of people to suffer premature death.” Moreover,
any plan to replace Medicare by vouchers “would deprive many seniors of
adequate coverage, too, leading to still more unnecessary mortality.” And what
if the amount of money in a “voucher care” program were not enough to buy a
decent policy? Krugman lectures that “going to the emergency room when you’re
very sick is no substitute for regular care, especially if you have chronic
health problems.”
It would be good if Krugman did a little gathering of facts
before he writes. If he had read my Krugman’s
Sick Numbers, he would know that there are virtually no uninsured poor, that
most of the uninsured are relatively young and can afford health insurance but
choose not to. For them, health insurance is simply not a good deal. He seems
not to know that those who substitute the emergency room for a regular
physician are primarily those on the government Medicaid program. They are insured
but few medical care providers want the measly fees the government offers them.
As an economist, Krugman should know that the real question
is not whether there would be enough money in a voucher program “to buy a
decent program.” Instead, he should ask, based on developing experience,
whether government health insurance programs offer providers enough money so
that they do not have to treat the government insured at a loss? If this is the
case, the poor will not be able to get a doctor. Judging from the emergency
room visit statistics, that is exactly what is happening.
Could it be that government insurance is “death of ideology?”
