Paul Krugman has been going after Obama for weeks. For the most part, Krugman has been audibly grinding axes and has been (for this loyal reader) a good deal less than credible. But the criticism of Obama is better expressed and more interesting in today's column. He looks at the mano a mano that's been taking place between John Edwards and Barack Obama, chiefly on the enormously important issue of health care.
Over the last few days Mr. Obama and Mr. Edwards have been conducting a long-range argument over health care that gets right to this issue. And I have to say that Mr. Obama comes off looking, well, naïve.
The argument began during the Democratic debate, when the moderator — Carolyn Washburn, the editor of The Des Moines Register — suggested that Mr. Edwards shouldn’t be so harsh on the wealthy and special interests, because “the same groups are often responsible for getting things done in Washington.”
Mr. Edwards replied, “Some people argue that we’re going to sit at a table with these people and they’re going to voluntarily give their power away. I think it is a complete fantasy; it will never happen.”
This was pretty clearly a swipe at Mr. Obama, who has repeatedly said that health reform should be negotiated at a “big table” that would include insurance companies and drug companies.
On Saturday Mr. Obama responded, this time criticizing Mr. Edwards by name. He declared that “We want to reduce the power of drug companies and insurance companies and so forth, but the notion that they will have no say-so at all in anything is just not realistic.”
Hmm. Do Obama supporters who celebrate his hoped-for ability to bring us together realize that “us” includes the insurance and drug lobbies?
And here's where I think Krugman loses the thread.
O.K., more seriously, it’s actually Mr. Obama who’s being unrealistic here, believing that the insurance and drug industries — which are, in large part, the cause of our health care problems — will be willing to play a constructive role in health reform. The fact is that there’s no way to reduce the gross wastefulness of our health system without also reducing the profits of the industries that generate the waste.
As a result, drug and insurance companies — backed by the conservative movement as a whole — will be implacably opposed to any significant reforms. And what would Mr. Obama do then? “I’ll get on television and say Harry and Louise are lying,” he says. I’m sure the lobbyists are terrified.
As health care goes, so goes the rest of the progressive agenda. Anyone who thinks that the next president can achieve real change without bitter confrontation is living in a fantasy world.
Which brings me to a big worry about Mr. Obama: in an important sense, he has in effect become the anti-change candidate.
I don't think so. Paul Krugman and I share a desire to see those mad dog drug and insurance companies bleeding and writhing in the sand. But that satisfaction would be enormously costly. Better to put a strong leash on them and get them back on track -- working for the interests of the people as well as their own and that of the economy.
The excesses of those two industries are part of the excesses of government itself and they are almost matched by excesses in the system right down to the level of the patient-consumer. How health care is used and corrupted at state, hospital, doctor and patient level is part of the problem. How a whole group of Americans really doesn't want to provide -- to "give away" -- health care to many in need is part of the problem. Ouch! None of us -- Paul Krugman included -- wants to face those issues!
But Barack Obama is the only one among a crowd of candidates who has worked in social services at that level. That's one reason why I think he has a grasp of the difficult issue, better even than Paul Krugman.
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