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'Social justice and progress can go hand in hand'

Paul Krugman delivers some real talk on Europe's growth rates, employment numbers and all the rest of it. Tyler Cowen makes some interesting points in reply. The eighth item is particularly important, though I think Cowen overestimates how much our country's political outcomes are the reflection of cultural preferences rather than the system's structural biases.

By Ezra Klein  |  January 11, 2010; 1:30 PM ET
Categories:  Europe  
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Comments

I'd say point 5 is actually the big one:

"There has never, ever been a well-functioning social democracy -- in the European sense -- with the size, population, and diversity of the United States or if you wish make that any two of those three."

Posted by: DaffyDuck2 | January 11, 2010 3:17 PM | Report abuse

We just had a year long health reform debate in which a demonstrably superior health care model was rejected in large part because it is used by every social democracy. We're determined to do the dumb thing just so we can call it uniquely American.

Posted by: bmull | January 11, 2010 3:31 PM | Report abuse

"We just had a year long health reform debate in which a demonstrably superior health care model was rejected in large part because it is used by every social democracy. We're determined to do the dumb thing just so we can call it uniquely American."

I have no idea what you mean. The reform we're likely to end up resembles the Swiss, Danish, and German systems. Germany's system has only been around since the 19th Century. Single Payer is the exception, not the rule.

Posted by: steveh46 | January 11, 2010 4:03 PM | Report abuse

" have no idea what you mean. The reform we're likely to end up resembles the Swiss, Danish, and German systems"

That is not even remotely true. A fundamental precept of all successful systems is that they are *universal*: everyone is in the same boat and that coverage is transportable.

A "solution" in which people are required pay for insurance with after-tax dollars while others get a tax-free ride as long as they stay bound to a specific employer is not universal. Nor is plan that depends on a patchwork of programs with varying amounts of coverage and out-of pocket expenses.

If you go to Switzerland, everyone has the same basic coverage. While it all managed through individual, private insurance, when someone needs treatment, everyone involved already knows what is covered by the plan and how much it will cost the insurer and the patient. No one incurs debt to get needed treatment and employment decisions are not made to get coverage. The same thing is true of every other universal care system -- regardless of the financing model.

As someone with direct experience in both single-payer and all-payer (e.g. French and German) systems, I much prefer the latter. IMHO, it would make much more sense to replace the employer exemption with a payroll tax to finance care independent of employment than to avocate the poorly conceived "cadillac" tax. Employees would be able to keep the coverage without the employment strings and everyone would have the same options.

I think that we have been poorly served by liberal politicians and journalists who have focused almost exclusively on single-payer vs private insurance and completely missed the boat when it comes to understanding a) what universal healthcare means and b) how what we have might be transitioned to a functioning universal system.

Posted by: Athena_news | January 11, 2010 4:44 PM | Report abuse

I understand the comments.
But Krugman's original contention was that Europe is not a total economic disaster because of socialism. In fact, it does pretty well.

Krugman's column is in response to the Right Wing's claim that socialism will totally destroy the US.

If I accept the various arguments, then Europe is not the example Krugman thinks, nor is it the example the Right Wing thinks.

Posted by: gratis11 | January 11, 2010 9:53 PM | Report abuse

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