Revisiting Krugman's "Conscience of a Liberal"

The striking thing about that book is how it kicks conservatism in the scrotum.  You would think that someone who claims to be interested in good relations between the liberals and conservatives would take a more conciliatory approach.  But this book does not.

He sees nothing good from the Reagan years.  But they were a whole lot better than what Carter served up.

My first read of this book engendered a negative response, so I wrote a pretty critical review of it.  Going back, I wondered if there was anything in the book that may have some validity.

On the topic of health care, he describes something that can give a clue about how to go forward.  But this isn't something he directly advocates, he just meanders around the swamp of big government liberal solutions.  The idea that can be useful is the idea of preventive care.  It is the one way in which health care costs can be brought down, and it is the one way in which the government might have a useful role, in my opinion.

One problem in the system is that the incentives are out of whack.  He does a fair analysis of how that is so, but he is fixated on single payer as a solution.   Another solution is just to get everybody on a preventive care program- just have the government set up the tax code so as to incentivize behavior so that everyone will get with that program.

You see, it just isn't necessary for the government to take over.  Nor should the government mandate that everybody buy insurance.  Just encourage people to do so thorough the tax code.  For example, you could give tax credits for people to have certain screens done for health care risks.  Two out of three deaths are due to cancer and heart disease.  Screen for those risks, and health care risks are reduced substantially.  Risks are more manageable if they are known.  If they are unknown, how can they be managed at all?  It would seem like common sense to have things checked out and then you know where you stand.  Why can't something simple like this be done?

Also, don't ask the insurance industry to provide care.  That's not their job.  Their job is to manage financial risk, not to provide health care.  The insurance industry doesn't exist to pay for medical bills.  Liberals seem to have a problem with basic concepts like this.  No wonder they are anti-business.  They just don't understand it.  Insurance companies can just manage the financial risk of something that is unexpected.  That's what they do and it is all that they should do.  If the general population is well-screened for medical risks, then the relative risk for each individual should be manageable and therefore insurable.  Just basic common sense.

If Krugman was more interested in actually finding a good solution that everyone could agree on, he may have come up with something like this.  Instead, he is more interested in the combat of partisan politics.  A more conciliatory approach could lead to some solutions.  Or have a better chance of making progress.  Blaming others for partisanship when you engage in it yourself is not very persuasive.  But persuasion and problem solving is really not his game.