I heart Paul Krugman

He's at it again. The Nobel Prize-winning economist always makes me teary-eyed. In a good way.

Today's NY Times sees Krugman waxing poetic about the failed conservative arguments against government spending to kick-start the economy. Which gets me thinking about health care financing, of course.

One of the core functions of any public health system is assurance - as in assuring a level of equitable, quality of care to the people. In the US where our public health system lies in tatters, this task has fallen to the states, and they struggle with it as we know all too well in NM.

Paul Krugman uses the example of the air traffic control system to assure safe flights, and they do a remarkably good job given the task, and when they don't, the force of the national people's voice assures that they have the science and technology to get it right and prevent all-out mid-air catastrophe. In health care, our states don't have the same assurance from the feds because we haven't demanded it well enough at the federal level. There's many reasons for that, but we'll stay on the economic one.

Q: Why don't we follow the air-traffic controller example and assure a level of primary and specialty care to all in the US when it clearly averts catastrophes in families every day by preventing unnecessary trips to the ER and related costs, suffering and deaths? A: Profits are made from sick people. (No one profits when a plane crashes.)

So, Krugman posits today that some governmental intervention is essential for safety and for stimulus. In our health care financing example, the safety argument is clear. On the stimulus side, the medical hi-tech industry profits when governmental programs shuttle customers... er, I mean, patients, their way via Medicare and Medicaid. They will always make a comfortable living and have money to reinvest in new technologies when people demand quality health care. So where's the reciprocity?

This sounds like a good deal to me: In return for a stable customer base, Big Medicine should back-off of the health policy ‘biz and let the people’s choice for real universal access take shape, complete with its inherent purchasing pool, quality control assurances and people-powered mandate.