Monday, August 03, 2009

Health Reform: Simple or Not?

Contrast the commentary of Paul Krugman and Keith Hennessey.

To Paul, the administration's health plan is simple and straightforward. To Keith, it is a nonstarter.

Why do these two smart commentators reach such opposite conclusions? The essence of the difference, I think, is that Paul is mainly concerned with universal coverage and is happy to put off discussion of the government budget constraint to another day, while Keith is focused on how the reforms will be paid for and, in particular, on the administration's claim that a major goal of health reform is to put the government on a more sustainable fiscal path.

A large part of the policy debate boils down to this: Are you more worried about the problem of the uninsured or about the long-term fiscal imbalance?

Update: Recent polling shows that the Krugman-Hennessey divide is representative of the nation more broadly and that more Americans are siding with Keith:

There is a huge partisan gap on perceptions of the U.S. health care system. Seven-out-of-10 Republicans rate it as good or excellent, but only one-of-four Democrats agree. Among those not affiliated with either major political party, 53% rate the current system as good or excellent while just 18% say it’s poor.

Over the past few months, as the health care reform debate has raged, confidence in the current system has increased significantly among Republicans and unaffiliated voters. There has been little change among Democrats.

Just 28% say they are willing to pay higher taxes so that all Americans can have health insurance. Sixty percent (60%) are opposed. Those figures are little changed since May.

Recent polling has shown that cost, not universal coverage, is the top concern about health care.