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A number of even leftish observers, including me, have occasionally wondered lately if Uncle Paul is getting a bit off-course. (And really, I can’t blame him; this stuff drives me to drink as a mere amateur, so I can only imagine the effect if I had a Nobel-level grasp of economics and yet had to regularly swim against the surging tide of unreality as part of my job.)

Whether or not Krugs needs a vacation, though, he can still do a remarkable job sorting reason from insanity and lies. His review of the basic logic behind health care systems, today, is almost beautiful in its logic and simplicity. Reading it, I couldn’t help wondering why Democrats didn’t try to spell things out this way during the 2009/10 round of this endless war. Of course, I know that it probably wouldn’t have helped because even this simple, sensible explanation would inevitably be warped and distorted by America’s debased, Twitter Age media-political-complex.

Still and all, this is a fine piece of writing by Krugman, at least momentarilly appeasing even many of my doubts and complaints. (Krugman’s vision certainly strikes me as far more convincing than, say, this recent alternative proposal by the vexing Iowa City blogger WW. Which is either every bit as much wishful-thinking gobbledygook indulgence of dogma as it seems, or else it’s simply going completely over my head and, while I’ll sound like an asshole for saying so, if I can’t understand it then I can pretty much guarantee you it’s not politically saleable to the general American public.)

Of course, even in the reality-based community, there is at least one immediate protest left unanswered by Uncle Paul’s recital, i.e. “all of this seems entirely reasonable, Mr. Krugman sir. I’m convinced of your logic. But health insurers are still bleeding us dry—?!”

I assume that responses would probably include some or all of the following:

• The fact that most key provisions of “Obamacare” haven’t really gone into effect yet probably comprises about nine-tenths of any sound answer, frustrating or no.
• Health insurance is not, at present, very sensitive to competitive pressure on prices. For one thing, shopping for health insurance as an individual is an absolute nightmare; the ridiculous number and complexity of plans makes meaningful comparisons seem hopeless, and the frightening risk of getting poor coverage adds to hesitation at pursuing lower rates. For another, most people don’t shop for health insurance, but simply take the plan offered by their employer, which complex situation probably makes the employer relatively reluctant to do much bargain-shopping, either. I’m not sure that much has been done to address these issues, and wish that there would be.
• Health insurance companies are, per ample evidence, simply evil and greedy, probably even above and beyond the American corporate average. In the absence of any firm restraint, they are presumably going to keep gouging as much as they can. It may further be the case that reform has prompted them to gouge even more deeply because they either see the transition period as a chance to get away with something, and/or because they feel like somehow or other the jig is nearly up for them, and they’d best grab as much as possible in the short term. (This last would seem dubious, given that reform as it stands should drive millions of new customers to insurers, but I’m not sure that this logic would necessarily convince insurers, given corporate America in general’s similar detachment from reality in its conviction that George W. Bush and Republicans are their best friends and that Obama is a socialist who is actively “hostile to business.”)

Still, the theory does seem remarkably sound, the way that Krugs explains it.