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Showing posts with label Paul Krugman. Show all posts
Showing posts with label Paul Krugman. Show all posts

Wednesday, August 12, 2026

12: Paul Krugman

The U.S. Healthcare System is Already Mostly Socialized And there’s nothing radical about wanting to end insurance company parasitism ......... Yes, El-Sayed advocates Medicare for All, a position the usual suspects denounce as “socialism.” .............. El-Sayed doesn’t even call himself a socialist. On the contrary, he explicitly disavows the label, saying “I’m a capitalist who just knows about capitalism”. In fact, as I explained in a previous post, the policies that El-Sayed advocates qualify him as a social democrat, not a socialist. ........... much of U.S. healthcare is already socialist. In fact, the government’s role is so large that U.S. healthcare is better described as partially privatized socialism than as anything resembling a free market. .............. Americans receive health insurance either from private companies or from public programs, overwhelmingly Medicare and Medicaid. ................ While a majority of Americans with health insurance get it from private companies, well over 100 million of us are covered by government programs instead. And these government programs pay more total dollars for medical bills than the private insurers do. ................

Private health insurance in the U.S. is both highly regulated and heavily subsidized.

................. employment-based health insurance, which covers 161 million Americans, is far more of a government creation than most people realize. For employment-based insurance exists largely because of huge implicit government subsidies that come with major strings attached. .............. If your employer pays you $10,000, that’s taxable income. But if your employer pays $10,000 toward a company health insurance plan that meets certain criteria, it isn’t taxable. That’s a huge effective subsidy, running at more than $300 billion a year. Take that subsidy into account, along with the more than $100 billion per year spent subsidizing policies purchased under the ACA, as well as the outlays on Medicare and Medicaid, and net effect is that the government pays for more than two-thirds of Americans’ health insurance. ................... employment-based health plans can’t discriminate based on medical history — that is, they can’t deny coverage to employees with pre-existing conditions — and they also can’t offer the plans only to highly compensated employees — a health plan that is only for the C-suite is considered taxable income. ................. So given the restrictions of the federal tax code, employer-based health insurance is a lot like Obamacare, which also prohibits discrimination based on medical history and provides subsidies to make insurance affordable to lower-paid workers. The fact is that virtually all of private healthcare insurance is already well under some form of government control through regulation and tax subsidies. .............. is Medicare socialist? Don’t tell anyone, but the way Medicare operates — it covers every senior’s medical expenses, whatever they turn out to be, while being funded by taxes that depend on one’s income — could be summarized by the old Marxist slogan “From each according to his ability, to each according to his need.” And back in 1961, when Ronald Reagan was the face of a last-ditch effort by the American Medical Association to block the creation of Medicare, he denounced Medicare as “socialized medicine” and warned that it would destroy our freedom. .................... In reality, American freedom survived until Jan. 20, 2025, while Medicare is immensely popular, with an 82 percent favorable rating in the most recent KFF survey. Medicaid, government health insurance for lower-income Americans, comes in at 73 percent. This is in sharp contrast to public views about private insurers, who are widely disliked if not hated and accused of denying essential care. ............ The case for viewing insurers as parasites is strong. Many Medicare benefits are now delivered via Medicare Advantage, that is, plans paid for by the government but run through insurance companies. MedPAC, an independent advisory commission, estimates that last year Medicare Advantage plans were overpaid by $84 billion, thanks to practices such as “upcoding,” in which patients’ health problems are overstated to get larger sums from Medicare. .............. private insurers have substantially higher administrative costs than Medicare does. Furthermore, the complexity of private insurance, with multiple payers all trying to deny care when they can, is a huge burden both on providers — doctors, nurses, and hospitals — and on patients. ..............

What do private insurers offer to compensate for these costs? One must go through intellectual contortions to avoid the conclusion that they are, in fact, parasites.

...................... Americans are fed up with a system of unaffordable premiums, rampant claim denials, and byzantine claim administration. .............. El-Sayed’s healthcare platform is perfectly reasonable on the merits of cost, fairness and health efficacy. And with private insurers never more hated, while millions of Americans are losing their health insurance, 2026 may be its time.

The Rise of the Measles-Industrial Complex Why MAGA wants children to get sick and die ......... On Monday Donald Trump issued an executive order that, if implemented, would substantially reduce the number of vaccines American children receive and, in practice, how many of them are vaccinated at all. While it’s not clear whether Trump’s order has any legal force, it will reinforce public skepticism of and hostility to vaccines, which has led to declining vaccination rates. This decline has in turn led to a surge in infectious diseases that had previously been virtually eradicated, notably measles. As the chart below shows, cumulative cases in the first 30 weeks of this year already exceeded the total for last year, which itself was the worst measles year since 1991 ............

Trump justified his anti-vax decree by pointing to an alleged link between vaccines and autism. Yet dozens of careful scientific studies have failed to find any such link.

............... However, you know what does have a strong, well-documented correlation with autism? Air pollution. Childhood exposure to air pollution is clearly associated with higher rates of autism. Moreover, scientists have found a found a strong association between autism and pre-natal maternal exposure to particulate matter from fossil fuel pollution. ................ Trump’s campaign against vaccines won’t reduce autism, but it will cause many children to suffer devastating, possibly deadly, infections diseases. Meanwhile, autism rates will rise as a result of his crusade against clean energy and in favor of dirty energy. ............... we need to put Monday’s executive order in the context of the general right-wing turn against vaccines, and against science in general. ............... belief that vaccines are more dangerous than the diseases they prevent, a false belief that has soared in popularity — but, again, only among Republicans ............... Trump is very much taking an extremist position on vaccines. But it’s clearly a position that he believes will resonate with his base. .............. Anti-vaccine sentiment is a lot like climate change denial. In both cases, to understand the politics one must do two things. First, follow the money: look at which interest groups benefit financially from misinformation, and why those groups have power. Second, follow the culture war: ask why this particular misinformation resonates with the prejudices and grievances of a segment of the population. ................ At first sight, the monetary interests behind anti-vax politics are less obvious than the fossil-fuel interests backing climate denial. After all, nobody benefits directly when children get measles. .................. Peddling quack medicine is, however, a highly profitable business. And it’s a business deeply enmeshed with the right-wing media ecosystem: Ads for dietary supplements with no proven medical benefits and other forms of snake oil have for decades been a key revenue source for right-wing talk radio, conspiracy-theory websites, and more. So there is a longstanding connection between hucksters touting fake cures and hard-right politics. Some observers were startled to see Dr. Mehmet Oz — who has touted, among other things, the health wonders of bovine colostrum — named by Trump as administrator for Medicare and Medicaid, a job for which he has no relevant qualifications. But given the underlying monetary and political incentives, Oz’s appointment is no surprise. ................. The modern right is a deeply anti-intellectual, anti-science, anti-expertise movement that is highly receptive to conspiracy theories. And like RFK Jr during his recent interview with CNN’s Dana Bash, when confronted with scientific facts it flies into a sputtering rage. So the snake oil industry targets its marketing to the kind of person who listens to the rants of right-wing influencers, gets their news from Newsmax, and finds common cause with the neo-Nazi posters on X. By framing their false claims as “The Medical Miracles that the Elites Don’t Want You to Know About”, the snake oil hucksters create a receptive audience for conspiracy theories that malign actual medical miracles like vaccines. ................. Unfortunately, Covid greatly boosted anti-vaccine forces. The witch hunt against Anthony Fauci shows how strong a hold anti-medical-science conspiracy theories now have on the Republican Party. This was not, to be clear, because medical science failed. In fact, the clear negative correlation across the United States between rates of Covid vaccination and Covid deaths was an object lesson in how effective vaccines can be. But those Americans already inclined to believe that the elites are out to get them, already hostile to any notion of collective action for the common good, reacted to vaccine mandates with rage. And their rage quickly generalized beyond preventive measures against Covid to preventive measures against all diseases — including measles. ............. Thanks to Trump and the triumph of snake oil, many American children will get sick from preventable diseases, some of them dying. And autism rates will continue to go up.

Monday, April 20, 2026

Paul Krugman: The Harm from Hormuz

Iran: Podcasts

Paul Krugman: The Harm from Hormuz Why we should still fear a global slump from Trump’s Iran debacle ............... Another week, another false all-clear. ............... The Strait of Hormuz remains closed. It appears increasingly obvious that the 20 percent of world oil supply that normally flows through it to world markets won’t be restored to normal anytime in the near future — quite possibly for many months. What will this disruption do to the world economy? ...................

a full-on global recession is more likely than not if the Strait remains closed for, say, another three months, which seems all too possible.

.................... there is a wide range of price scenarios, from $99/bbl to

$372/bbl

............. One way or another, the world will have to burn significantly less oil in the near future than it would have if this war had been avoided. In the jargon of energy analysts, there will have to be large “demand destruction.” But how can oil demand be destroyed? ................... People can just do less overall — consume less, produce less. That is, we can reduce oil consumption by having a global slump. And demand destruction through a global slump can happen quickly. ...............

The closest parallel I know to the Hormuz crisis is the oil shock that followed the 1973 Yom Kippur War.

............. A comparable slowdown now would mean zero or negative world growth over the next two years, compared with the current IMF forecast of 3 percent. This would be a true global disaster. ............... First and foremost is the likelihood that a deal to reopen the Strait will in fact be struck. Basically, the U.S. can get the Strait reopened by loudly proclaiming victory while quietly accepting de facto defeat. All this will take is for Trump to accept reality, admittedly a hard climb. ..................

Given time — even a year or two — the world could make major shifts to other energy sources.


Paul Krugman’s April 20, 2026 Substack article “The Harm from Hormuz” frames the ongoing closure of the Strait of Hormuz as a self-inflicted U.S. strategic and economic disaster stemming from the Trump administration’s Iran policy (what he calls “Trump’s Iran debacle”).
The piece focuses primarily on the macroeconomic fallout: the strait normally carries ~20% of global oil supply, and its closure has created a physical supply shock comparable to (or worse than) the 1973 Yom Kippur War oil crisis. Krugman argues that even the IMF’s “slowdown” forecast is too optimistic; a full global recession is “more likely than not” if the strait stays closed another three months, with demand destruction occurring mainly through economic contraction rather than easy substitution. He notes lower U.S. oil intensity than in 1973 but emphasizes that remaining demand (suburban driving, trucking in emerging markets) is harder to compress quickly. The article implies a possible off-ramp—Trump “loudly proclaiming victory while quietly accepting de facto defeat”—but offers no granular details on negotiations, the nuclear program, or enriched uranium. It treats the closure as effectively permanent in the near term and the war as a lost cause for regime-change or maximalist goals.
To address some specific questions, here is a full, sourced timeline and analysis drawn from the war’s documented events, negotiations, and the strait’s status.Negotiations Timeline (Pre-Ceasefire Through April 20, 2026)Negotiations predated the war but were repeatedly interrupted by military action. The core issues have always been Iran’s nuclear program (enrichment rights, facilities, stockpiles) and, post-February 28, control of the Strait of Hormuz.
  • 2025 (pre-war phase): Indirect talks began in March–April 2025 after Trump’s letter to Supreme Leader Ali Khamenei demanding full dismantlement of enrichment, zero enrichment, and proxy disarmament in exchange for sanctions relief. Multiple rounds (Muscat/Oman, Rome) produced Iranian counteroffers: temporary enrichment caps (to 3.67%), stockpile dilution/transfer to a third country, IAEA inspections, and proxy concessions. The U.S. insisted on permanent zero enrichment and facility dismantlement (Natanz, Fordow, Isfahan). Progress was claimed but talks collapsed after Israeli strikes in June 2025.
  • Early 2026 (pre-war resumption): Indirect rounds resumed (Muscat Feb. 6; Geneva Feb. 26). Iran offered to dilute 60% enriched uranium; the U.S. demanded destruction of facilities and full stockpile handover. “Significant progress” was reported on verification, but talks ended with the U.S./Israeli strikes on Feb. 28.
  • Ceasefire (April 7–8, 2026): A two-week U.S.-Iran (and nominally Israel-involved) ceasefire was brokered by Pakistan, with China’s nudge to Khamenei’s successor. Iran agreed to safe passage through the strait as a core condition; Trump framed it as victory. The strait remained restricted, and disputes arose over whether it covered Lebanon fighting.
  • Post-ceasefire Islamabad talks (April 11–12, 2026): First face-to-face round (U.S.: Vance, Witkoff, Kushner; Iran: Araghchi, Qalibaf). Lasted ~21 hours; collapsed with “gaps on major issues” and “no trust.” Key proposals: U.S. demanded a 20-year suspension of all enrichment, dismantlement of facilities, and handover of the entire enriched-uranium stockpile (hundreds of kg of highly enriched material, some previously moved underground). Iran countered with a 3–5 year suspension (or 5 years per some reports), retention of peaceful enrichment rights on its soil, and no full dismantlement/handover. Hormuz management was the second major impasse—Iran sought a formal regulatory role; the U.S. demanded unrestricted open access.
  • Immediate aftermath (April 12–20): Trump announced an immediate U.S. naval blockade of Iranian ports and strait-linked shipping. Iran briefly announced a full reopening (April 17) for commercial ships, but reversed it within 24–48 hours (April 18), citing the ongoing U.S. blockade as a violation. U.S. forces seized an Iranian-flagged cargo ship (Touska) near the strait on April 19; Iran called it “maritime piracy” and vowed retaliation. As of April 20, Iran has “no plans” or “no date” for new talks; Pakistan is preparing possible follow-on rounds, but Tehran describes U.S. demands as “unreasonable.” The two-week ceasefire is expiring or under extreme pressure.

Ups and downs summary: Early 2025 showed constructive moments and Iranian flexibility on temporary limits/stockpile moves. Momentum repeatedly collapsed due to Israeli strikes (June 2025, Feb. 28, 2026), mutual mistrust (post-2018 JCPOA withdrawal), and maximalist U.S. demands. The April ceasefire was a genuine “up,” producing a temporary opening announcement, but the Islamabad round was a sharp “down”—the nuclear duration gap (20 vs. 3–5 years) and Hormuz control proved unbridgeable. Trump’s blockade move escalated pressure but triggered Iran’s re-closure, creating the current deadlock.Status of the Strait of Hormuz Since February 28, 2026
  • Feb. 28 onward (war phase): Iran immediately restricted or closed the strait to nearly all commercial traffic (>90% drop). Passage required Iranian permits, fees, or “safe conduct”; gunboats, mines, and warnings enforced compliance. Selective allowances were made for Iran-linked or negotiating-country vessels. This cut off ~20% of global oil flows.
  • Ceasefire period (April 7–17): Partial/selective easing occurred, but the strait never returned to pre-war open status. Iran cited continued Israeli actions in Lebanon as justification for restrictions.
  • April 17–18 reversal: Iran announced full reopening for commercial ships (April 17), boosting markets temporarily. Within a day it reimposed a full closure (April 18), firing warning shots and declaring no vessel movement without permission. Reason: U.S. blockade of Iranian ports and continued interdiction of strait traffic.
  • April 19–20 (current): Strait remains fully closed. U.S. Navy has seized at least one Iranian vessel; Iranian gunboats are active; commercial shipping is at a standstill. Oil prices have spiked again.
In short: closed/restricted since Day 1 of the war, with one very brief, aborted reopening.Where We Stand Now (April 20, 2026)Fragile two-week ceasefire is effectively on life support or expiring. The strait is closed, U.S. blockade is active, and direct talks are stalled with no confirmed next round (though Pakistan is trying). Iran retains significant leverage via the strait and has demonstrated it can impose global economic pain. The U.S. has not achieved regime change or nuclear capitulation. Krugman’s analysis captures the mounting pressure: prolonged closure risks a global recession that would hurt the U.S. and allies far more than Iran in relative terms.What Is Likely in the Near Future?Economic self-interest points toward de-escalation. Global oil markets, Asian fuel shortages, and recession risk create strong incentives for both sides to extend the ceasefire and reach a limited deal that reopens the strait. Trump has repeatedly signaled a desire for a quick “win” he can tout. A plausible outcome (Krugman’s hinted path): U.S. accepts a face-saving compromise—perhaps a short-to-medium enrichment pause (5–10 years), partial stockpile relocation (e.g., to Russia), enhanced IAEA access, and formal international guarantees on strait openness—while quietly dropping maximalist “zero enrichment forever” demands. Iran, bruised militarily but economically empowered by the strait weapon, is likely to accept sanctions relief and a face-saving “peaceful nuclear right” clause. Full war resumption is possible if talks collapse entirely, but the mutual pain (especially oil prices) makes that less probable than a messy, imperfect truce.Chances Iran Agrees to End Its Nuclear Program and Hand Over All Enriched UraniumLow (near zero in any realistic near-term deal).
Iran has repeatedly stated it will not surrender its “inalienable right” to peaceful enrichment on its own soil. Senior Iranian officials have explicitly ruled out any scenario in which Tehran “entirely give[s] up enriching uranium” as part of a peace deal. Pre-war and post-ceasefire proposals from Iran involved only time-limited suspensions (3–5 years) or dilution/transfer of portions of the stockpile—not zero enrichment, facility dismantlement, or full handover of all enriched uranium (estimated hundreds of kg of highly enriched material). U.S. demands for a 20-year ban plus complete stockpile surrender are viewed as surrender terms. Iran’s demonstrated Hormuz leverage, surviving the initial strikes, and deep mistrust after the 2018 JCPOA withdrawal make total capitulation politically impossible for its leadership. A deal that ends the war and opens the strait is achievable with compromises on duration, inspections, and partial stockpile moves—but not the maximalist outcome described.

Overall, the situation is a classic “mutually hurting stalemate”: Iran can choke global oil, the U.S. can sustain a blockade and inflict further damage, but neither can win outright without catastrophic costs. History (1973 oil shock, past nuclear talks) suggests an imperfect diplomatic off-ramp is the most probable path, even if it falls far short of the “end the nuclear program forever” goal. The next few days—expiry of the two-week ceasefire and any Pakistani-mediated follow-up—will be decisive.