This op-ed by Paul Krugman, which appeared in the July 26th edition of The New York Times, deals with the incoherence of the position held by the so-called Blue Dog Democrats on health care reform. But it is especially notable for its description of the four pillars of health care reform: regulation, mandates, subsidies and competition. Take away any one of the pillars, Krugman warns, and the whole project collapses.
Interestingly, Krugman concisely and clearly sum my ire at those who, in his words, game the system: Americans who are uninsured because they are currently healthy and who sign up only when they need care. Young Americans, mostly, but not only. These are the people who give health insurance companies legitimate ground to stand on when they come up with exclusion lists based on pre-existing conditions. That is why the congressman who said that no young and healthy son of his should be forced to subsidize health care for everybody else by being forced to buy insurance is dead wrong: if everyone must be insured from birth, regardless of their age or health situation, then there can be no "pre-existing condition" excuse to deny coverage to those who need it.
Of course, even this obvious reality still does nothing to contain costs because it does nothing to control or limit the amount of money that ends up in the pockets of health insurance fat cats; but, as Krugman says, effective reform has four pillars: Take any one of them away, and the whole reform effort collapses. And corrupt politicians and their sponsors are the only ones who can continue to thrive among the ruins of America's health care.