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Krugman: Obamacare appears to be here to stay

  • (DANA SUMMERS / Tribune Content Agency)

At this point, the crisis in American governance has taken on a life of its own. Some Republicans are now saying openly that they want concessions in return for reopening the government and avoiding default, not because they have any specific policy goals in mind, but simply because they don't want to feel “disrespected.” And no endgame is in sight.

But this confrontation did start with a real issue: Republican efforts to stop Obamacare from going into effect. It's long been clear that the great fear of the Republican Party was not that health reform would fail, but that it would succeed.

And developments since Tuesday, when the exchanges on which individuals will buy health insurance opened for business, strongly suggest that their worst fears will indeed be realized: This thing is going to work.

Wait a minute, some readers are saying. Haven't many stories so far been of computer glitches, of people confronting screens telling them that servers are busy and that they should try again later? Indeed, they have. But everyone knowledgeable about the process always expected some teething problems, and the nature of this week's problems has actually been hugely encouraging for supporters of the program.

First, let me say a word about the underlying irrelevance of startup troubles for new government programs.

Political reporting in America, especially but not only on TV, tends to be focused on the play-by-play. Who won today's news cycle? And, to be fair, this sort of thing may matter during the final days of an election.

But Obamacare isn't up for a popular referendum, or a revote of any kind. It's the law, and it's going into effect. Its future will depend on how it works over the next few years, not the next few weeks.

To illustrate the point, consider Medicare Part D, the drug benefit, which went into effect in 2006. It had what was widely considered a disastrous start, with seniors unclear on their benefits, pharmacies often refusing to honor valid claims, computer problems and more. In the end, however, the program delivered lasting benefits, and woe unto any politician proposing that it be rolled back.

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