HEALTH REFORM: Krugman's View on Why It's So Urgent

"The whole world is in recession. But the United States is the only wealthy country in which the economic catastrophe will also be a health care catastrophe—in which millions of people will lose their health insurance along with their jobs, and therefore lose access to essential care."

That's how Paul Krugman began his latest column, reminding us what's at stake. Today's economic indicators are grim, and the headlines are full of more job cuts.

Krugman asks, "Why has the Obama administration been silent, at least so far, about one of President Obama's key promises during last year's campaign—the promise of guaranteed health care for all Americans?" We aren't quite as impatient. The inauguration was only 10 days ago, HHS Secretary-designate Tom Daschle hasn't been confirmed, we know there's a ton of preparatory work being done on the Hill, and we've been hearing for a while that health reform wouldn't really start moving until March anyway.

But it's still worth listening to Krugman's reminder of why we can't be lulled into thinking health reform can wait:

Let me address three arguments that I suspect Mr. Obama is hearing against moving on health care, and explain why they're wrong.

First, some people are arguing that a major expansion of health care access would just be too expensive right now, given the vast sums we're about to spend trying to rescue the economy.

But research sponsored by the Commonwealth Fund shows that achieving universal coverage with a plan similar to Mr. Obama's campaign proposals would add "only" about $104 billion to federal spending in 2010—not a small sum, of course, but not large compared with, say, the tax cuts in the Obama stimulus plan...

...Second, some people in Mr. Obama's circle may be arguing that health care reform isn't a priority right now, in the face of economic crisis.

But helping families purchase health insurance as part of a universal coverage plan would be at least as effective a way of boosting the economy as the tax breaks that make up roughly a third of the stimulus plan—and it would have the added benefit of directly helping families get through the crisis, ending one of the major sources of Americans' current anxiety.

Finally—and this is, I suspect, the real reason for the administration's health care silence —there's the political argument that this is a bad time to be pushing fundamental health care reform, because the nation's attention is focused on the economic crisis. But if history is any guide, this argument is precisely wrong.

Precisely wrong is right on target.