... because he doesn't need to outrun the bear.

Paul Krugman, Nobel Prize winning professor and New York Times columnist, has got running shoes so fabulous that they've probably got wings, and it's you and me he's leaving to be eaten by the health non-care bear.

Krugman does, however, offer some kool-aid to those of us who are about to get eated.

Wednesday, in Illusions and Bitterness --

There’s enormous disappointment among progressives about the emerging health care bill — and rightly so. That said, even as it stands it would take a big step toward greater security for Americans and greater social justice; it would also save many lives over the decade ahead.

Lives saved? yeah well, letsgetitidone casts a jaundiced eye on that claim. Greater social justice? The Robert Wood Johnson Foundation [yeah, that RWJF] suggests not so much: check out the income levels of the insured and and uninsured here. Whether it's going all year without insurance, or just part of the year, those under 300% of poverty level are doing without much more than are those with more money. This is echoed by the experiences of the Swiss and the Dutch, the two systems most often likened to what we are supposedly going to get. Who are the few remaining uninsured in both those countries? Hint: it's not the rich.

That’s why progressive health policy wonks — the people who have campaigned for health reform for years — are almost all in favor of voting for the thing.

No, "progressive" policy wonks want a complex solution so they'll all have full employment for years and years. This isn't just the Insurance Industry Protection Act.

And the truth is that health care reform was probably doomed to be deeply imperfect. As Ezra Klein pointed out a few weeks ago, we’re basically in a hostage situation: progressives really, really want to cover the uninsured, while centrists whose votes are needed can take it or leave it. So the centrists have a lot of power — which in the case of Joe Lieberman means the power to double-cross and indulge his pettiness.

Deeply imperfect! Bwaaahahahahahaha! Well, he's got that part right, even if it's an understatement. And yes, Joe Lieberman gets to positively luxuriate in pettiness, but he's just a sock puppet.

And yeah, the progressives want to cover the uninsured, we all agree on that. There's a problem though, in that health insurance does not equal health care, and it's care that people need. If you force people to buy unaffordable or barely affordable insurance, you've freed the hostages from the gunmen only to have some number of them then walk into the booby traps that were also set out by the hostage takers.

As further assurance that we'd be doing the hostages a favor by passing health care deform reform, he trots out this favorite line of progressives everywhere:

I’d also point out that highly imperfect insurance reforms, like Social Security and Medicare in their initial incarnations, have gotten more comprehensive over time. This suggests that the priority is to get something passed.

oh, puh-leeze. Social Security and Medicare were both flawed to start with, granted, but they were both programs where taxpayer dollars were funneled through the government into taxpayer pockets. They were most assuredly not funneled through the greedy, grasping hands of fatcat corporate robber barons. People weren't forced by the original flawed Social Security Act to choose between tithing to a 401k account or facing the IRS, for example.

Not to mention that these improvements were largely the work of one man:

Robert M. Ball, who served as Commissioner of Social Security from 1962 to 1973, has been an important participant in every Social Security development of the past 60 years. He first went to work for Social Security in 1939, leaving seven years later to teach Social Security policy at the American Council on Education University-Government Center. Then, as staff director of the 1947-48 Advisory Council on Social Security on the Senate Finance committee, he played a key role in shaping the 1950 legislation that greatly expanded coverage and benefits.

After rejoining Social Security in 1950, he served as the agency's top civil servant from 1952 to 1962, a period in which disability insurance was added to Social Security and benefits and coverage were further expanded. He then served as Commissioner under Presidents Kennedy, Johnson, and Nixon. His responsibilities included setting up Medicare and administering it during its first seven years of operation. It was during this period as well that Social Security benefits were substantially increased and automatic cost-of-living adjustments adopted.

So we pass legislation now, wait four years for a few people to benefit from it, then wait another 20 or so years for another Bob Ball to come along and fix it. So how many millions of lives are we saving again?

So there’s a lot of bitterness out there. But please, keep your priorities straight.

By all means denounce Obama for his failed bipartisan gestures. By all means criticize the administration. But don’t take it out on the tens of millions of Americans who will have health insurance if this bill passes, but will be out of luck — and, in some cases, dead — if it doesn’t.

It's not my priorities that are fucked up.

Then there's his followup on Thursday, Health care and Iraq.

... for the most part the debate among progressives about whether the final product on health reform is worth supporting has been edifying. Serious people are making serious arguments, in a way that puts conservatives, who have offered nothing but smears and lies, very much to shame.

That said, some of the arguments here annoy me — in particular the line I’ve been hearing from some quarters that progressives who say we should hold our noses and pass the flawed Senate bill are just like the “liberal hawks” who supported the Iraq war.

Yep, it's been edifying alright.

That said, no we are not arguing that hold-your-nose progressives are just like liberal hawks, we're saying that they're the exact same people. I haven't been keeping a list of who's who, but other people have apparently, and it's all Third Wayers, all the way down.

The same progressives who think that making people pay unaffordable chunks of their income so that they'll self-ration their own medical care, think not, or perhaps only fleetingly, of the heartache they engender by asking these same people to send their sons and daughters, brothers and sisters, mothers and fathers off to wage multiple wars. And furthermore, deficit spending on wars is a good thing, but any improvements in health insurance coverage, no matter how modest, must help decrease the deficit. Butter good, guns better [progressives] is, for some, an improvement over guns, not butter [rabid warmongers] but what Ian said bears repeating:

It is also noteworthy that spending billions on turning brown people into a fine red mist (aka. the Afghan war) is acceptable, but health care (aka. saving actual American lives) is something which can’t cost money. What an interesting, and clearly evil, set of priorities that reveals.

Oh but hey! These liberal hawks and their ilk aren't selling us health care deform insurance reform because it will further their careers! This is for our own good!

Look, I don’t know for sure what motivated the liberal hawks; you’ll have to ask them. Some, I hope, were genuinely naive: despite all the signs that we were being sold a bill of goods, they just couldn’t believe that an American president would start a war on false pretenses. Others, I suspect, were being careerists, aligning themselves with where the power seemed to lie; sad to say, their career calculations were justified, since to this day you’re generally not considered “serious” on national security unless you were wrong about the war.

What’s going on with health care is very different. Those who grudgingly say “pass the thing” — a camp I have reluctantly joined — aren’t naive: by and large they’re wonks who have looked at the legislation quite carefully, understand both its virtues and its flaws, and have decided that it’s a lot better than nothing. And there isn’t much careerism involved: if you’re a progressive pundit or wonk, the risks of alienating the people to your left are at least a match for the risks of alienating people to your right.

Not careerists? If their careers were safe, they'd be talking up single payer left, right, and center, every chance they could get.

Not careerists? Hard for me, uninsured and in need of lots of medical care, living paycheck to paycheck at 40-something to look at the likes of Ezra Klein and Matt Yglesias, who at 20-something can afford to buy homes in Washington fucking DC and have employer-paid health insurance right now, and NOT think that it all depends on their willingness to shill for a bunch of Republicans who are masquerading [and just barely at that] as Democrats and liberals.

Not careerists? Have I mentioned that we're arguing over the Health Wonk Full Employment Act here? I do believe I have.

Understand its flaws? I don't think so. If I unplug from the internet, turn the cats out into the street, and go and live in my car, I'll be able to afford both the 7 or 8 or 9% of my income the insurance companies will be allowed to suck out of my pockets and the 10 or 12% of my income that it will cost me to actually use that insurance, beginning 4 or 5 or 6 years from now, but I'm thinking the non[ha!]careerists really have no understanding of this at all.

Anybody calling themselves "wonk" should have seen all this coming years ago, and anybody claiming to not be a careerist should have been backing single payer and only single payer from, like, 2006. Even I, an accidental wonk [I wanted to do farm policy, not health policy], could see 3 years ago what needed to be done.

Now, the pass-the-thing people could be wrong. Maybe hopes of improving the new health care system over time, the way Social Security has been improved, will prove to have been fantasies; or maybe rejecting this bill and trying again, a strategy that has failed many times in the past, would work this time.

Stop with the Social Security non-analogy, and yeah, starting over could fail yet again, but as long as I have to get my health care "free" at the emergency room for 4 more years, I'm willing to risk that failure.

But it’s a carefully thought-out, honest position. And arriving at that position has, in my case at least, required a lot of agonized soul-searching.

Probably they don't give Nobel prizes to people who don't think carefully, but they do give Nobel prizes to to people who turn out to have thunk wrongly in the course of their careers [cf Milton Friedman].

And maybe I’m being unfair, but I don’t seem to see the same degree of soul-searching on the other side.

I don't need to do any soul-searching, I'm living what you can only think about.

Too much of what I read seems to come from people who haven’t really faced up to what it will mean for progressive hopes — not to mention America’s uninsured — if health care reform crashes and burns, yet again.

Well, fuck your progressive hopes, and you're probably reading the wrong people to boot.

This is a moment of truth; it’s not a time for cheap shots or name-calling.

A moment of truth? Like how highly the people in Massachusetts think of their "reform"? Not.

And let me just point out something to you that Massachusetts has to teach us about the reversibility of asymptotically approaching universality:

What this suggests is that the really important thing, for reformers, is to get the principle of universality established. Once that happens, there’s no going back.

When the chips are down

people overwhelmingly want the law to stay in effect for themselves, but are alarmingly willing to throw others under the bus.

It's not too late to follow in Bob Ball's footsteps and join us in calling for, at the very least, the expansion of Medicare, perhaps in conference, perhaps by reconciliation, as part of this otherwise unpalatable legislation.

From its very beginnings, Medicare has reflected the competitive nature of America’s democracy and its penchant, ultimately, to compromise. Its original architects were strong advocates of universal health insurance, as one of them, Robert M. Ball, discussed several years ago (Health Affairs, Winter 1995): “We all saw insurance for the elderly as a fallback position. . . . Although the public record contains some explicit denials, we expected Medicare to be a first step toward universal national health insurance, perhaps with ‘Kiddicare’ as another step.”

Srsly, Joe Lieberman can go fuck himself.