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Krugman on Obama -- then and now

From NBC's Mark Murray
No Democratic-leaning pundit, it seems, has been more passionate or serious on the need for health-care reform than the New York Times' Paul Krugman. As a result, people took notice when his column today blasted Obama's health-care plan, as well as the candidate's recent statements on it. "What seems to have happened is that Mr. Obama's caution, his reluctance to stake out a clearly partisan position, led him to propose a relatively weak, incomplete health care plan. Although he declared, in his speech announcing the plan, that 'my plan begins by covering every American,' it didn't — and he shied away from doing what was necessary to make his claim true."

But, channeling the Washington Post's Ruth Marcus, Krugman didn't always think so poorly of Obama's plan. Almost six months ago, in a June 4 column, he mostly praised it -- although he did criticize its lack of a mandate.

The substance of Krugman's two columns is essentially the same. The tone, however, is not.

Below is the second half of his June 4 column, which discusses Obama's health plan.

"First, the good news. The Obama plan is smart and serious, put together by people who know what they're doing.

"It also passes one basic test of courage. You can't be serious about health care without proposing an injection of federal funds to help lower-income families pay for insurance, and that means advocating some kind of tax increase. Well, Mr. Obama is now on record calling for a partial rollback of the Bush tax cuts.

"Also, in the Obama plan, insurance companies won't be allowed to deny people coverage or charge them higher premiums based on their medical history. Again, points for toughness.

"Best of all, the Obama plan contains the same feature that makes the Edwards plan superior to, say, the Schwarzenegger proposal in California: it lets people choose between private plans and buying into a Medicare-type plan offered by the government.

"Since Medicare has much lower overhead costs than private insurers, this competition would force the insurance industry to cut costs -- making our health-care system more efficient. And if private insurers couldn't or wouldn't cut costs enough, the system would evolve into Medicare for all, which is actually the best solution.

"So there's a lot to commend the Obama plan. In fact, it would have been considered daring if it had been announced last year.

"Now for the bad news. Although Mr. Obama says he has a plan for universal health care, he actually doesn't -- a point Mr. Edwards made in last night's debate. The Obama plan doesn't mandate insurance for adults. So some people would take their chances -- and then end up receiving treatment at other people's expense when they ended up in emergency rooms. In that regard it's actually weaker than the Schwarzenegger plan.

"I asked David Cutler, a Harvard economist who helped put together the Obama plan, about this omission. His answer was that Mr. Obama is reluctant to impose a mandate that might not be enforceable, and that he hopes -- based, to be fair, on some estimates by Mr. Cutler and others -- that a combination of subsidies and outreach can get all but a tiny fraction of the population insured without a mandate. Call it the timidity of hope.

"On the whole, the Obama plan is better than I feared but not as comprehensive as I would have liked. It doesn't quell my worries that Mr. Obama's dislike of 'bitter and partisan' politics makes him too cautious. But at least he's come out with a plan.

"Senator Clinton, we're waiting to hear from you." [Clinton unveiled her plan a few months later.]