[This is rhetorically kind of interesting. It's phrased entirely in terms of the public option and market competition, making it seem less radical than single payer. Except it's talking about a government run hospital complex with hopes that it would eventually take over. It strikes me as a surprisingly cool idea, and surprising to come from Krugman.]
http://krugman.blogs.nytimes.com/2011/04/12/why-not-a-public-option-for-medicare/
Paul Krugman - New York Times Blog
April 12, 2011, 9:27 am
Why Not A Public Option for Medicare?
So, people are always asking what I would do about health care costs.
One answer is that I would do all the things that are in the Affordable
Care Act, and more.
But if you want a really radical proposal -- but one that, unlike
privatization, actually has strong evidence on its side -- why not add
a true public option to Medicare?
What do I mean by that? I mean creating a network of hospitals and
clinics actually run by the government -- a civilian VA, as Phillip
Longman puts it -- and giving Medicare recipients the option of using
that system.
The public option would be required to spend significantly less per
risk-adjusted recipient than traditional Medicare. And if it couldn't
provide care that seniors wanted given that restricted budget, it would
have no takers and would close.
But the actual experience of the VA suggests, of course, that such a
system would have major cost advantages -- and that it could be used to
achieve major cost savings.
Look, I know this isn't politically feasible, at least not now. But
neither is Ryan's system of inadequate vouchers. And this one has the
virtue of being something that experience suggests would actually work
if we could overcome the political hurdles.
I'm sure the trolls will be screaming as soon as this is posted. But
notice that neither I nor Longman are suggesting that anyone be forced
into such a system. It would have to win patients in a fair competition
with both traditional Medicare and Medicare Advantage.
And what would terrify the right, of course, is the likelihood that
genuine socialized medicine would actually win that competition.