I think Krugman cribbed this from Doug (giggles)

Charles

http://krugman.blogs.nytimes.com/2013/07/17/obamacare-is-the-rights-worst-nightmare/?_r=0


Paul Krugman - New York Times Blog
July 17, 2013, 5:09 pm 272 Comments
Obamacare Is the Right’s Worst Nightmare
News from New York: it looks as if insurance premiums on the
individual market are going to plunge thanks to Obamacare. This
shouldn’t come as a surprise; in fact, the New York experience
perfectly illustrates why Obamacare had to look the way it does. And
it also illustrates why conservatives should be terrified about this
legislation, as it takes effect. Americans may have had a lot of
misgivings in advance, thanks to vast, deliberately spread
misinformation. But I agree with Matt Yglesias — unless the GOP finds
even more ways to sabotage the plan, this thing is going to work, it’s
going to be extremely popular, and it’s going to wreak havoc with
conservative ideology.

To understand what’s happening in New York, you have to start with
what almost everyone at least pretends to believe: Americans shouldn’t
find it impossible to get health insurance because of pre-existing
conditions that aren’t their fault. Two decades ago, New York tried to
deal with this by imposing community rating: insurance is available to
everyone, and the price doesn’t depend on your medical history.

The problem was that this created a death spiral: young, healthy
people didn’t buy insurance, worsening the risk pool, driving up
premiums, driving out more relatively healthy people, etc., until you
were left with a rump of very ill people paying very high rates.

How do you deal with this? Well, ideally, Medicare for all. But since
that wasn’t going to happen, you improve the risk pool by requiring
everyone to buy insurance — the individual mandate. And since some
people won’t be able to afford that, you also offer subsidies. Voila!
ObamaRomneycare!

Where does the money for the subsidies come from? Partly by reducing
corporate welfare: reducing overpayments for Medicare Advantage,
reducing tax breaks for very generous insurance plans; partly with new
taxes on the wealthy.

And while a few people will be hurt — young, healthy individuals too
affluent to qualify for subsidies, wealthy taxpayers, etc. — a much
larger number of people will be helped, some of them enormously.

Does this amount to “redistribution”? Well, yes — not as an end in
itself, but yes, a lot of people will be made better off at the
expense of an affluent few.

And Yglesias is right: there will be bobbles along the way, but this
is going to become an immensely popular program. By the time Liz
Cheney challenges Hillary Clinton’s reelection campaign, there will be
signs at the rallies declaring “Don’t let the government get its hands
on Obamacare!”

Conservatives are right to be hysterical about this: it’s an attack on
everything they believe — and it’s going to make Americans’ lives
better. What could be worse?
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