Krugman:

Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.

In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.

And in Massachusetts, where the mandate was another bailout for the insurance companies, compliance is falling because people don't like being forced to buy junk insurance*. Who knew?

So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.

Look, I admire the hell out of Krugman for filling the messaging void, here, but shouldn't somebody in the administration or the Congressional leadership be pointing this out?

If we were starting from scratch [Now, where have I heard that before?] we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.

Really?

The new 'Obamacare' plan that's getting crudely cobbled together right now in Congress features a system of mandates that are supposed to accomplish a number of key goals. These wonderful mandates -- we are told -- 'ensure universal coverage,' and 'drive down costs,' -- by 'preventing individuals and companies from gaming the system.'

Are any of these assessments accurate? Do these mandates actually ensure healthcare for everyone? Can they drive down and/or contain runaway costs in healthcare or lower overhead?

In a word, no.

Or, no - at least, if we are to judge these mandates based on their track record from places they've been previously implemented such as Massachussetts, California, Oregon, Pennsylvania and Maine.

That's according, anyway, to John Geyman, MD, Physicians for a National Health Plan.

So - let's look at some of the facts. . (via Progressive Review)

Recently I had a passionate discussion with a friend about health care reform. You know where we stand on this blog: It immoral and uncivilized and expensive to have a for-profit health care industry. Everyone should have complete coverage, and it should be paid for from a common fund of taxdollars, paid directly to providers for the widest range of services, at fair rates which encourage the best people to go into health care, and an emphasis should be placed on getting people as much preventative care as possible. Right there, you save billions. I further posit that the elimination of a couple of military boondoggles like Star Wars will fund the start-up of such a program without significant immediate tax increases, although I favor taxing the shit out of health insurance companies and executives too. They are sitting on trillions that people paid for care, and frequently never got.

Now, my friend told me that "we can't just eliminate insurance companies overnight" and cut them the fuck out of health care altogether. He argued that if we were to do so, millions of investors would lose value in their stock portfolios, not just "investor class" people but municipalities and retirement funds, who are heavily invested in insurance companies. He also argued that many insurance company workers would lose their jobs, and together a quick death to for-profit health insurers, that would mean real economic upset for all.

You can probably guess my reaction.

But I suppose I can see his point, but I think smart policy planners could find a way to offset some of this, and I will even admit that if there is no other way, I support a "phased" withdrawl, in which people are given time to change out their investment portfolios over some period of time. I would also support limited and temporary subsidies to former insurance workers as they train for or look for new jobs. Workers, not golden parachute, billion dollar compensation package-getting execs. They can fuck off and die.

However, you can see why I believe what I do, as you read this bit from Mass doctors, who are at the front of "health care reform." My guy, Edwards, really blew it by going along with the consultant's advice and not his wife's, because people don't want this kind of "reform." If he'd been brave enough to say so plainly from the get go, he would've done better than he has so far in various races, media blackout or no. Americans are dying, screaming out for real health care reform. Not this shit:

Over 250 Massachusetts doctors have signed an open letter to the country warning that the health reform model enacted by Massachusetts is failing and that a single payer program is the only alternative.

“It is urgent that the rest of the country know that Massachusetts is a living laboratory for the health care reforms being pushed in California and by the Obama/Clinton/Edwards campaigns. Right now the Gov. Romney/Massachusetts’ plan gets a failing grade on the ground,” said Dr.Rachel Nardin, Assistant Professor of neurology at Harvard Medical School.

Here is what to expect from plans like these and other plans in which insurance companies are kept in the overall equation. Higher costs, the poor getting really screwed, and people still being forced to make impossible choices. Unlike some, I'm happy to be in the front of the line "pushing insurance companies into the sea." I worked for one, and the physicians in my family deal with them daily. They Are Evil. So long as we continue to worry about all those poor, sad little insurance company execs not making enough money by denying children with rare cancers life saving treatment because it's "experiemental," we won't have a solution.