Barack Obama: naive health-care surrender-monkey

Paul Krugman accuses Barack Obama of being a tad bit wet behind the ears:

Over the last few days Mr. Obama and Mr. Edwards have been conducting a long-range argument over health care that gets right to this issue. And I have to say that Mr. Obama comes off looking, well, naïve.

The argument began during the Democratic debate, when the moderator — Carolyn Washburn, the editor of The Des Moines Register — suggested that Mr. Edwards shouldn’t be so harsh on the wealthy and special interests, because “the same groups are often responsible for getting things done in Washington.”

Mr. Edwards replied, “Some people argue that we’re going to sit at a table with these people and they’re going to voluntarily give their power away. I think it is a complete fantasy; it will never happen.”

This was pretty clearly a swipe at Mr. Obama, who has repeatedly said that health reform should be negotiated at a “big table” that would include insurance companies and drug companies.

On Saturday Mr. Obama responded, this time criticizing Mr. Edwards by name. He declared that “We want to reduce the power of drug companies and insurance companies and so forth, but the notion that they will have no say-so at all in anything is just not realistic.”

Hmm. Do Obama supporters who celebrate his hoped-for ability to bring us together realize that “us” includes the insurance and drug lobbies?

O.K., more seriously, it’s actually Mr. Obama who’s being unrealistic here, believing that the insurance and drug industries — which are, in large part, the cause of our health care problems — will be willing to play a constructive role in health reform. The fact is that there’s no way to reduce the gross wastefulness of our health system without also reducing the profits of the industries that generate the waste.

As a result, drug and insurance companies — backed by the conservative movement as a whole — will be implacably opposed to any significant reforms. And what would Mr. Obama do then? “I’ll get on television and say Harry and Louise are lying,” he says. I’m sure the lobbyists are terrified.

As health care goes, so goes the rest of the progressive agenda. Anyone who thinks that the next president can achieve real change without bitter confrontation is living in a fantasy world.

To me, Paul Krugman is the one who comes off sounding, well, like a guy who has a rather spotty grasp of how actual politics works. It's the old joke about economists:

Castaway: We are stranded on a desert island with a bunch of cans and no equipment with which to open them. Whatever shall we do?

Second Castaway, who happens to be an economist: That's easy! First, we assume a can opener . . .

When designing a policy program, you cannot just assume away the interest groups--nor, except in Paul Krugman's imagination, can you simply overcome them through your steely-eyed willingness to engage in "bitter confrontation". Drug companies make lifesaving drugs that people need, which of course tends to breed resentment when they charge what the market will bear, but also gives them a rather powerful weapon to deploy in the PR war. Similarly, most people are quite content with their current insurance; if you attempt to destroy the insurance companies outright, they will do their best to get all those people worried about what will happen under your new program. These industries are also very important to several highly populous states with powerful senators and congressmen; threaten them and you threaten your coalition.

I mean, these tactics are fine by me; I don't want national healthcare. But is Paul Krugman interested in making policy, or just making an expressive statement about his youthful ideals?