USA | Nobelpristagaren Paul Krugman, som varit en av Barack Obamas starkaste kritiker på vänsterkanten, har omvärderat presidenten.
I en längre artikel i Rolling Stone om Obamas år i Vita huset lyfter Krugman framför allt fram hälsovårdsreformen, hanteringen av den finansiella krisen och ekonomin som de områden där presidentens politik haft störst positiv effekt.
När det gäller Affordable Care Act, eller Obamacare, skriver han bl.a. följande:
We won’t have the full data on 2014 until next year’s census report, but multiple independent surveys show a sharp drop in the number of Americans without health insurance, probably around 10 million, a number certain to grow greatly over the next two years as more people realize that the program is available and penalties for failure to sign up increase.
It’s true that the Affordable Care Act will still leave millions of people in America uninsured. For one thing, it was never intended to cover undocumented immigrants, who are counted in standard measures of the uninsured.
Still, Obamacare means a huge improvement in the quality of life for tens of millions of Americans – not just better care, but greater financial security. And even those who were already insured have gained both security and freedom, because they now have a guarantee of coverage if they lose or change jobs.
What about the costs? Here, too, the news is better than anyone expected. In 2014, premiums on the insurance policies offered through the Obamacare exchanges were well below those originally projected by the Congressional Budget Office, and the available data indicates a mix of modest increases and actual reductions for 2015 – which is very good in a sector where premiums normally increase five percent or more each year. More broadly, overall health spending has slowed substantially, with the cost-control features of the ACA probably deserving some of the credit.
In other words, health reform is looking like a major policy success story. It’s a program that is coming in ahead of schedule – and below budget – costing less, and doing more to reduce overall health costs than even its supporters predicted.
Of course, this success story makes nonsense of right-wing predictions of catastrophe. Beyond that, the good news on health costs refutes conservative orthodoxy. It’s a fixed idea on the right, sometimes echoed by ”centrist” commentators, that the only way to limit health costs is to dismantle guarantees of adequate care – for example, that the only way to control Medicare costs is to replace Medicare as we know it, a program that covers major medical expenditures, with vouchers that may or may not be enough to buy adequate insurance. But what we’re actually seeing is what looks like significant cost control via a laundry list of small changes to how we pay for care, with the basic guarantee of adequate coverage not only intact but widened to include Americans of all ages.
Tidskriftsomslag: Rolling Stone den 23 oktober 2014.