The case for Bidencare

Paul Krugman in the NYT: “But while Biden is indeed proposing incremental change rather than Medicare for All, we’re talking about some big increments. Independent estimates suggest that under Biden’s plan, 15 million to 20 million Americans would gain health insurance. And premiums would fall sharply, especially for middle-class families. …

“None of this [Biden’s proposals] amounts to revolutionary change — in contrast to Trump’s efforts to kill Obamacare, which would drastically change American health care, for the worse. But Bidencare would still be, as Biden didn’t quite say when President Barack Obama signed the A.C.A. into law, a pretty big deal.

“True, America would still fall somewhat short of achieving what every other advanced country has — universal health care. But we’d get a lot closer, and many who currently have insurance coverage would see their costs fall and the quality of coverage improve.”

Don?t dismiss it because it isn?t Medicare for All.

The Swedish approach to Corvid-19 revisited

From the NYT: “Normalcy has never been more contentious than in Sweden. Almost alone in the Western world, the Swedes refused to impose a coronavirus lockdown last spring, as the country’s leading health officials argued that limited restrictions were sufficient and would better protect against economic collapse.

“It was an approach that transformed Sweden into an unlikely ideological lightning rod. Many scientists blamed it for a spike in deaths, even as many libertarians critical of lockdowns portrayed Sweden as a model. During a recent Senate hearing in Washington, Dr. Anthony S. Fauci, the leading U.S. infectious disease specialist, and Senator Rand Paul, Republican of Kentucky, angrily clashed over Sweden.

“For their part, the Swedes admit to making some mistakes, particularly in nursing homes, where the death toll was staggering. Indeed, comparative analyses show that Sweden’s death rate at the height of the pandemic in the spring far surpassed the rates in neighboring countries and was more protracted. (Others point out that Sweden’s overall death rate is comparable to that of the United States.)

“Now, though, the question is whether the country’s current low caseload, compared with sharp increases elsewhere, shows that it has found a sustainable balance, something that all Western countries are seeking eight months into the pandemic — or whether the recent numbers are just a temporary aberration.”

After having weathered high death rates when it resisted a lockdown in the spring, Sweden now has one of Europe?s lowest rates of daily new cases. Whether that is an aberration remains to be seen.

Maybe the individual mandate wasn’t so crucial

From the NYT: “Many experts now view the individual mandate as a policy that did little to increase health coverage — but did a lot to invite political backlash and legal challenges.

“The newest evidence comes from census data released Tuesday, which shows health coverage in the United States held relatively steady in 2019, even though Congress’s repeal of the mandate penalties took effect that year. …

“Obamacare’s insurance subsidies, via tax credits, brought more stability to the marketplace than originally expected. The credits are structured to keep premiums affordable for low- and middle-income Americans even when the base price of insurance rises. The vast majority of Obamacare enrollees — between 80 percent and 90 percent, depending on the year — buy their coverage with these credits.

“It’s also possible the mandate did have some effect during its brief life in making the purchase of health insurance more of a norm. When the Kaiser Family Foundation surveyed the public on the issue in 2018, it found that only half of respondents knew the penalties had been repealed. The mandate penalty may live on in Americans’ minds, even after Congress wiped it off the books.’

Many experts now view the individual mandate as a policy that did little to increase health coverage — but did a lot to invite political backlash.

Treasonable noticing of seditious facts

Nicholas Kristoff in the NYT: “The newest Social Progress Index, shared with me before its official release Thursday morning, finds that out of 163 countries assessed worldwide, the United States, Brazil and Hungary are the only ones in which people are worse off than when the index began in 2011. And the declines in Brazil and Hungary were smaller than America’s. …

“The United States, despite its immense wealth, military power and cultural influence, ranks 28th — having slipped from 19th in 2011. The index now puts the United States behind significantly poorer countries, including Estonia, Czech Republic, Cyprus and Greece.”

A measure of social progress finds that the quality of life has dropped in America over the last decade, even as it has risen almost everywhere else.

A horror tale from our frelled up healthcare system

Our system of commercial medicine, dominated by private insurance, regional groups of private hospitals, and other powerful interests, looks more and more like a numbers racket. We would like to think we have health care that incidentally involves some wealth transfer; what we actually have is wealth transfer that incidentally involves some health care. In America today, malady is physical illness and the political evil that surrounds it. We are ill in a way that costs us freedom, and unfree in a way that costs us health.

The schadenfreude is strong

After all, depriving millions of Americans of their health insurance in the middle of a pandemic is a remarkably stupid idea, even for this administration. Republicans deserve to suffer at the polls for this.

The solicitor general says a vote for the GOP tax cuts was a vote to eliminate protections for preexisting conditions.

Lesson from the past

From the NYT: “But America’s experience with polio should give us pause, not hope. The first effective polio vaccine followed decades of research and testing. Once fully tested, it was approved with record speed. Then there were life-threatening manufacturing problems. Distribution problems followed. Political fights broke out. After several years, enough Americans were vaccinated that cases plummeted — but they persisted in poor communities for over a decade. Polio’s full story should make us wary of promises that we will soon have the coronavirus under control with a vaccine. …

“Granted, there are countless differences between the fight against the coronavirus and the long-ago fight against polio. The global capacity for vaccine research and development is far greater than it was in the 1950s. Drug approval and manufacturing safety protocols have been refined since then, too. Already, just months into the current pandemic, there are far more vaccines in development against the coronavirus than there ever were against polio.”