Is Krugman Stupid, A Troll Or A Stupid Troll?

Paul Krugman — fresh off his I’m smarter than you post (I have a few tasty comments in that thread that riled the libs something fierce), says this today in response to the Oregon study:

Fire Insurance Is Worthless!

After all, there’s no evidence that it prevents fires.

But strange to say (as Mark Thoma points out in correspondence), people seem to think it’s a good idea anyway.

I leave the relevance of this thought to the Medicaid discussion as an exercise for readers.

This is the most common defense being dragged out in response to the Oregon study: that maybe health insurance doesn’t actually improve health. But it saves people from being financially ruined by a health crisis! Isn’t that good?

Let’s put aside that the liberals have spent the last four decades insisting that a lack of insurance kills tens of thousands of Americans every year. Let’s put aside that they will drag that bogus stat back out from behind the barn if the next Oregon study shows health gains from Medicaid (and probably even if it doesn’t). No, let’s concentrate on this:

This is what conservatives and libertarians have been saying for a very very long time.

This what is David Goldhill said in his excellent essay four fucking years ago. This is what I have said many many many times. I have specifically asked people to imagine how much car insurance would cost if it paid for every gasup (and how efficient our cars would be). I have specifically pointed out how expensive fire insurance would be if it covered every burnt meal. A number of us have called specifically for catastrophic health insurance that is more modelled after fire insurance than our current “first dollar coverage” model, at least on the government side. For that, we have been mocked as heartless and clueless. We’ve been told that health insurance is fundamentally different from other forms of insurance (which it is, when you consider it a handout).

Now the liberals want to pretend that this is a novel argument? They want to pretend they have discovered that the real benefit of health insurance is risk mitigation, not magical health fairies? Seriously?

I suppose I should be happy. This is progress in liberal thinking, after all. But no, I’m not happy. Because they have turned to this explanation as an excuse for why the Oregon study hasn’t yet shown the huge benefits they thought Medicaid expansion would produce. The minute the wind turns, the minute the next study shows even minimal health gains, they will tack and suddenly start saying that insurance is the only thing that keeps people from dropping dead in the street.

Comments are closed.

  1. salinger

    I believe this whole debate boils down to two viewpoints.

    Either one believes that healthcare is a right, or one believes it is a privilege.

    These two viewpoints are polar enough – it seems to me – that neither side will convince the other to adopt their stance. So we’ll just have to see which opinion ends up adopted by the majority in the end.

    I also believe there is some credence in the idea that Obamacare was rolled out knowing that it would eventually crash and burn due to all the restrictions imposed upon it in order to get it passed, so that one payer universal care would seem more feasible in the end.

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  2. Hal_10000 *

    Salinger, I think there is a way to split the baby on the right vs. privilege thing. Australia, for example, guarantees a minimum healthcare while allowing people to buy better insurance and, with it, access to better hospitals. It’s also consumer oriented since the consumer pays and then government reimburses. Had Obama gone in that direction, I would have been … well, maybe not supportive but certainly less opposed. We kinda have that system anyway between Medicaid and writeoffs but less efficiently.

    This is basically what Goldhill advocated: a high-deductible plan for the uninsured with vouchers. Not ideal, but not nothing either.

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  3. Seattle Outcast

    I think “brainwashed, deluded, Keynesian-Marxist asshole” is a better description of Krugman. He truly believes the BS he spews out.

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  4. salinger

    Hidden due to low comment rating. Click here to see.

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  5. ScottE

    Because what I read stated that cars were more likely to go to the mechanic, more likely to be admitted into a shop, more likely to continue to need tuning, and more likely to continue on needing more coolant topped off and more likely to report their cars in good health. Depression was cited at 30% less than non-insured and increased the use of preventive care, including an increase in oil pressure monitoring of 50 percent and a doubling of emissions tests.

    Does that sound like someone with a piece of crap car or one in good health?

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  6. salinger

    one could just as easily, and with as much validity, have said:

    Because what I read stated that cars were more likely to go to the mechanic for preventative maintenance, more likely to have regular oil changes,more likely to be kept tuned up, and more likely to continue to keep coolant topped off and therefor more likely to report their cars in good health.

    Does that sound like someone with a piece of crap car or one in good health?

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  7. HARLEY

    Either one believes that healthcare is a right, or one believes it is a privilege.

    It is not a right, it is a Service….

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  8. salinger

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  9. Seattle Outcast

    Healthcare is neither a right or a privilege – it’s a commodity, like food, water, beer, or pussy…

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  10. HARLEY

    believe medical care should be a right. A person should not go bankrupt or unduly suffer due to lack of insurance. That’s what I believe.

    no sir, what you are saying is that you do not want to pay for a service, if it is more than x ..

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  11. InsipiD

    I believe medical care should be a right. A person should not go bankrupt or unduly suffer due to lack of insurance. That’s what I believe.

    To each according to his need, from each according to his ability.

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  12. salinger

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  13. stogy

    Exactly. I’ve always wondered how a “right” can be derived from another’s work or job.

    Generally, “positive” rights (although I don’t like the term, it generally means rights that impose a substantive financial obligation on governments) such as a right to health impose a minimum obligation on governments to provide access to a service – not on individual doctors etc to provide that service.

    A right to health (not just healthcare) is actually written into the South African constitution, and some people have (successfully) sued the government for inequitable distribution of HIV medication, for example in preventing perinatal transmission of HIV from mother to child.

    What constitutes a minimum obligation is contested (as it should be), but showing inequitable (as opposed to unequal) distribution of services is generally considered a to be a stronger case.

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  14. FPrefect89

    being served at a lunch counter or any retail establishment.
    purchasing property
    consideration for employment.
    attending educational institutions
    buying a gun

    Lets just quickly go through your list…..

    1) I don’t have a right to be served in a retail establishment. A business can refuse to serve me, just as an example .

    2) I have a right to own property, but not the right to FORCE somebody to sell it to me.

    3) I have no right to FORCE somebody to consider to hire me.

    4) There is only a right in the US to go to a public school. With the shape most of them are in, I would gladly give up that right and go to private school. However I do not have the right to FORCE a private school to accept me.

    5) Ahhh, guns…. I have the right to keep and bear arms, but no right to FORCE somebody to sell one to me.

    To me a right cannot be dependent on the service of another. If it is, then that person who is servicing my “right” cannot ever stop. If that person were to stop servicing my “right”, then where would I get my “right” from…. May sound a bit far fetched, but I think I have defined the new, tolerant form of “slavery”. Define something I want as a right.

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  15. salinger

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  16. Hal_10000 *

    Salinger, the reason I don’t think healthcare is a right is because you can’t have a right to things. Things are limited and when you exercise your “right” to them, you take them. If we all have a “right” to get surgery but there is only one doctor, whose right prevails? Generally, it’s that of the politically powerful. The same is not true of other rights. My right to free speech does not take away or interfere with yours.

    Putting these things in a rights perspective is also problematic because things have to be in a market. The price of something is how the market gives us information about how scarce something is. It makes coronary bypasses expensive because they are hard to get. But band aids are cheap because they’re easy to make. When you start going around saying people have a right to these things, you start injecting noise into the pricing mechanism and cause shortages.

    The thing is you don’t need to proclaim a right to healthcare to support universe healthcare. I don’t think people have a “right” to food but I think we should feed the hungry (both privately and publicly). We have enough food and wealth that we can provide for people who are starving. We don’t do this because they have a “right” to it. We do it because we are wealthy and good people who can afford that luxury. The same with housing. I don’t think people should end up on the streets. Not because they have a “right” to a home but because it’s not too great a burden to put a roof over their heads, even if is a temporary one. (Although in both cases, I generally private assistance over public.)

    As for the Oregon study, I mentioned your points yesterday. Utilization was up and depression was done. But the several key marker of health did not budge. We were sold Medicaid expansion on the principle that people were dying without it. If Obama (and Bush, for that matter, who also expanded Medicaid) had pitched it to us as “this won’t improve people’s health, but it will make them a little happier and make them use more care” it would never have passed.

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  17. stogy

    Salinger, the reason I don’t think healthcare is a right is because you can’t have a right to things. Things are limited and when you exercise your “right” to them, you take them.

    This is why positive rights are so contentious – they are not based on absolutes, or strict lines of what constitutes a right and a non-right. They are (dare I say it) progressive minimum standards of care. By progressive – I don’t mean in the liberal sense – I mean it in the future sense.

    For example, what constitutes a right to a minimum standard of health in a rich country is never going to be attainable in a poorer country, where resources are much more constrained. However, this is why inequity as the fundamental principle is so important. If for example, your country is giving much better care to one religious or ethnic group, then they have a case for a right to health claim. But no-one is going to accept an argument that someone in a Mogadishu is going to be able to sue because they couldn’t get an appointment with a specialist on 5th avenue.

    A right to food doesn’t mean that everyone can eat caviar, but means that governments have an obligation to set up a system/programs to ensure that there isn’t mass starvation. No one gets to walk into a restaurant and demand a sit down meal.

    They’re also not something that can just be realized instantly, (they aren’t something that just pops up as soon as ratified) and working toward them may take decades – even hundreds of years. And by the time they are realized, what constitutes a minimum standard is likely to have shifted anyway.

    Guess what? Even with these rights, children still go hungry, people don’t get to see doctors.

    So you are right when you say “things are limited”, but this has been considered carefully in the way that progressive rights are being framed and used. Slightly different, but still the same in some ways, The Millennium Development Goals are legally binding – governments of every country in the world have to progressively work towards their realisation – reducing poverty by half, ensuring girls go to school at the same rate as boys, immunisation. The MDGs are really problematic in many ways (arbitrary targets), but in terms of making these commitments legally binding, they have contributed more to the absolute reduction of human misery than just about anything in the history of mankind.

    We’re a lot better off with them than without them.

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  18. Mook

    The MDGs are really problematic in many ways (arbitrary targets), but in terms of making these commitments legally binding, they have contributed more to the absolute reduction of human misery than just about anything in the history of mankind.

    That is a stunningly delusional claim. Of course you could never support that statement on a factual basis, but it sounds good to repeat it among your fellow like-minded travelers, doesn’t it?

    buying a gun

    So according to this twisted simpleton-logic, forcing taxpayers to pay for the “right” to healthcare for others en masse is equivalent to the right to buy a gun? Really? Whenever a private citizen exercises his 2nd amendment rights to purchase a gun, he is not obligating others to pay for it.

    And regarding the claim that a few dead children are the “cost” for the right to buy guns, the overwhelming amount of evidence suggests the exact opposite.. that if MORE law abiding people owned and carried guns, including teachers and movie-goers, there would be LESS dead children. Gun-free zones are a target of violent predators for the obvious reason that they are relatively defenseless.

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  19. stogy

    Hidden due to low comment rating. Click here to see.

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  20. Mook

    The full 2012 report is linked to here.

    Please provide cause-and-effect evidence that MDG has done any good, much less contributing more to the absolute reduction of human misery than just about anything in the history of mankind (your absurd claim).

    If fewer people starve in Iraq or Zimbabwe, does MDG take credit? If so, on what possible basis? Just curious as to the extent of how delusional your “thought” process is.

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  21. Mook

    Since the UN’s MDG has blocked genetically altered foods and effective pest controls like DDT in poor countries that would have reduced the spread of malaria and other diseases, can’t it be reasonably argued based on those facts that MDG has in fact INCREASED human misery and death rather than reduce it?

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  22. stogy

    Since the UN’s MDG has blocked genetically altered foods and effective pest controls like DDT in poor countries

    Mook, you are wrong on both claims. DDT is manufactured in India and is used in developing countries, including the one I am in right now. It is not banned by the UN or the WHO for that matter. And the MDGs don’t actually refer to GMOs at all.

    If fewer people starve in Iraq or Zimbabwe, does MDG take credit?

    Er… no. The governments who have signed up and deliver annual reports on their progress do. What exactly do you think ‘MDG’ is? It’s not actually an organization that can take credit for anything?Did you read any of the report I linked to?

    Your last two comments are completely fact free. Delusional even…

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  23. stogy

    Please provide cause-and-effect evidence that MDG has done any good,

    Just to point out the obvious: governments sign onto the MDGs, announce policies to attain them, measure and report the results, the results are verified independently… we know that these things have happened. Not everything that has been done has been successful, but overwhelmingly, things are better than they were before.

    And whether you like it or not (and I suspect you won’t), the MDGs are strongly connected with the right to development.

    If you are interested in evidence for MDGs in Zimbabwe, there is abundant evidence of effectiveness., Start with the Multi-Indicator Monitoring Survey report.

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  24. salinger

    So according to this twisted simpleton-logic, forcing taxpayers to pay for the “right” to healthcare for others en masse is equivalent to the right to buy a gun? Really?

    No – not really.

    I said nothing about the two being alike. I said exactly what I said.

    Buying a gun is a right that usually involves another person (a seller) to be manifest – and that in many instances the person selling the gun is being paid to to do. This was one of five examples cited in response to someone asking how the manifestation of a right could possibly require another individual’s service.

    Again, I think stogy is doing a better job than I explaining this.

    So am left to assume, again, that the response I am replying to here is deliberately obtuse.

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  25. Jim

    being served at a lunch counter or any retail establishment.
    purchasing property
    consideration for employment.
    attending educational institutions
    buying a gun

    These are all rights in which manifestation often relies on the actions of another who is most likely being paid for a job.

    Oh wow – you’ve run circles around me logically.

    Let’s see – a dress code trumps civil rights laws – because that is obviously what I was talking about. – not the act of refusing service due to race or religion. Thanks for clarifying.

    And you’re shrewd deductive skills sussed out that I was talking about someone being forced to sell their house or business – not discriminating against a buyer due to race or religion – you got me again.

    Yeah… here’s the thing: discrimination laws directly infringe upon natural rights in favor of perceived rights. Buying goods or services isn’t a right, it is a privilege. Just as a business does not have a “right” to customers, neither do customers have a “right” to that business. I have never been given a satisfactory answer as to why I have a “right” to buy anything.
    I would much rather know what business owners would discriminate due to race, religion, whatever, so that I can better decide if I want to give that person my money. Then, if you don’t like the fact that Bob’s Bongo Emporium refuses to sell bongos to Eskimos, you can buy your bongos elsewhere, or build your own, or, if you are ambitious, start Joe’s Bongo Emporium and make sure everyone knows that you most certainly *will* sell to Eskimos.
    The same goes for the rest of the things on your list. Maybe I’m too old fashioned when it comes to Free market capitalism, but being a 4th generation small business owner I’ve picked up a few insights in regards to workers’ “rights” and employers’ “rights”. The pendulum has swung way too far to one side at the cost of the other. I’m not sure why I should lose my rights simply because I sell a service or good. Don’t like my product? Don’t buy from me. Don’t like my hiring policies? Don’t buy from me. Don’t like my service policies? Don’t buy from me. Etc etc. If enough people do that, one of the following happens:
    I adjust my policy.
    I accept the profit loss.
    Another business opens that caters to more people.
    I go out of business.

    I remember the days of the sign “We reserve the Right to refuse service to anyone.” But now, if you try to exercise that right for any reason, you can be sued. We have had people come in to our establishment and cuss out clerks because they were not happy with X, Y or Z. Our policy is that our clerks don’t have to put up with abuse and they can tell the customer to leave. Can you imagine the nightmare if that customer happened to be a minority and then sued claiming racial discrimination? These laws are flat-out out of hand. Let the market decide and go from there.

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  26. stogy

    These laws are flat-out out of hand. Let the market decide and go from there.

    That’s all very well, but this has absolutely nothing to do with a right to health, or any other positive right for that matter. Once again, positive rights are agreements that governments have to provide minimum standards of care in an equitable fashion.

    And for those of you of a more conservative bent, this doesn’t have to mean “big government”. It can be done through the private sector. Governments enact policies and set up monitoring mechanisms for, say water, ensure that water is clean, accessible and free from infectious disease or chemical pollutants. Private companies charge consumers for the service. The government may need to subsidize poorer users in paying for the service, and allow homeless people access to some water as well. By this, governments have thereby met their “right to water” obligations.

    But if the company increases water rates by say 300%, and the poorest people can no longer get water or they are stopped them from being able to harvest water themselves (as has happened), then they might have a case for breach of the right to water.

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  27. stogy

    Here’s the Constitution. Let me know when you find the “right to water”.

    So the constitution embodies the principles of international law? No, I didn’t think so (some constitutions actually do). The US hasn’t actually even ratified most international positive rights laws (the main one being the Convention on Economic, Social and Cultural Rights – which includes a right to health, water etc.). However, it might well be argued that these constitute customary international law as they have been around so long. So it may not matter whether the US ultimately ratifies it or not.

    Many of the laws that are in the US constitution are in the other main international legal document (the so called ‘Negative’ rights), the Convention on Civil and Political Rights – things such as freedom of speech, right to a fair trial. My guess is you wouldn’t argue that some of these things didn’t exist simply because they weren’t in the US constitution. Nothing on torture in the US constitution. Does that mean it’s legal? It has been argued that torture doesn’t actually fall under “cruel and unusual punishments” in the 8th amendment. The UN convention, to which the US is a signatory (Reagan signed it in 1988), is much stronger in defining and outlawing it.

    So I take your point about the constitution, but it isn’t the only set of laws that applies. Sorry.

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  28. Iconoclast

    That’s all very well, but this has absolutely nothing to do with a right to health, or any other positive right for that matter. Once again, positive rights are agreements that governments have to provide minimum standards of care in an equitable fashion.

    It sounds like you’re saying that these “positive rights” come from government(s), which means that government(s) can just as easily take them away. The rights outlined by the Declaration of Independence come from “Nature and Nature’s God”, and are “inalienable”, which means they cannot be taken away by government, but must be secured by government.

    The problem with manufacturing all of these so-called “positive rights” is that they intrinsically empower governments to have more control over people’s lives. If you claim that people have a “right” to health care, that simply means someone is forced — at some level — to provide it. Same with housing, water, and all those other so-called “positive rights”.

    The “right to health” simply doesn’t exist in nature. Some people are simply born with poor genetics that hinder them with poor health, and others are just the opposite. There is nothing in Nature that guarantees good health for anybody. This means that this “right” comes from man, and man can easily take that “right” away.

    And for those of you of a more conservative bent, this doesn’t have to mean “big government”.

    Perhaps not, but in practice, it ends up being just that. There are too many folks who honestly seem to believe that government is the answer to all societal problems. Thing is, to conservatives and libertarians, the biggest societal problem we have is big government fostering dependence of the masses on its “services” and programs.

    But if the company increases water rates by say 300%…

    Why would the company do that? Do you assume that companies are evil and greedy? Because they are made up of evil greedy people? What makes government bureaucracies any different?

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  29. Miguelito

    Xetrov… heh, from your linked article:

    “Our old home wasn’t even being flooded for the project and we were asked to leave. No one wanted to leave.”

    Yeah.. “asked.” I’m sure it was all cordial and there was no force (or threat thereof) involved. Not that we haven’t moved people in the US (my grandmother’s birth town doesn’t exist anymore, there’s a reservoir there now) but here we have laws, compensate people and specific requirements need to be met. Well… the latter, not so much since the Kelo decision.

    The US hasn’t actually even ratified most international positive rights laws (the main one being the Convention on Economic, Social and Cultural Rights – which includes a right to health, water etc.).

    Hopefully we never will. As others have pointed out, needing to spell out everything is a problem in itself as it assumes you don’t have inalienable rights granted you, but only allowed by a gov’t. On top of that, most of these things are progressive/marxist/take your pick “rights” written to make sure to steer the entire globe towards a one-world gov’t eventually anyway.

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