In a fascinating coincidence, postings with the headline "Why Krugman is wrong ..." are the lead both here at TPMCafe and at DailyKos. However, Dean's contribution here at TPMCafe is much more reasoned and thoughtful. However, Dean is terribly wrong.

Dean spends most of his posting acknowledging the truth about Krugman's main point, that without universal mandate, there will be no universal health plan. Without universal mandate, there will be adverse selection, a disaster that condemns health plans to increasing costs as people try to "game the system" - as Dean describes.

Dean says that Krugman is wrong because Dean has some other way to prevent people from gaming the system, namely a "penalty." Dean never describes how such a penalty would work. How do you enforce a penalty on someone who thought they were healthy, thought they had a job, and discovered one day that neither is true? Add the "penalty" to the list of debts owed in bankruptcy court?

Right now, the system extracts the most cruel of penalties on people who fall sick, in the form of astronomical medical bills, bankruptcies, loss of home, descent into poverty, and so forth. Right now the system adds to these penalties with excruciating waits for care, denial of care, and failure at even a pretense of healthcare continuity.

We have penalties right now, Mr. Dean, and they are horrible, and they don't work.

Here is a very short list of mandates that work: social security, unemployment insurance, sales tax, income tax. The argument that mandates are unworkable is a sham, and more upsetting, the argument is an insurance industry sham.

Posted at February 4, 2008 9:10 AM in response to Krugman Wrong on Obama and Mandates