Paul Krugman writes:

As I’ve written before, the pieces of reform are interdependent. You can’t do one or two pieces on their own. Ban discrimination based on medical history, and you get an adverse-selection death spiral, in which healthy people opt out and premiums soar. You can’t solve that without both requiring that healthy people buy insurance and helping those with lower incomes afford the premiums. In short, you basically end up with the Senate bill. Hasn’t anyone been paying attention here?

There is a small problem here. Given that the individual mandate in the Senate and House bills are very weak, the reform proposal that Krugman endorsed will could very well lead to “an adverse-selection death spiral, in which healthy people opt out and premiums soar.” Krugman has devoted little if any effort to strengthening the individual mandate, which is puzzling. If we don’t intend to use reinsurance or high-risk pools to change the incentives around adverse selection — if we use a crude ban — a strong mandate is vitally important. Of course, a stronger mandate would be very unpopular for the Democrats.

There are two conclusions one can draw: (a) Krugman is more interested in achieving a partisan victory and the actual policy outcome is secondary or (b) he hasn’t been paying attention.

I actually don’t think that Krugman is a reflexive partisan. He detests the right, yes, but he won’t support Democrats in every instance. Yet I also find it hard to believe that he hasn’t been paying attention, as he now focuses his efforts on policy debates rather than his old research agendas on trade, economic geography, etc., and he clearly has a high metabolic rate when it comes to consuming information. What we have here is a puzzle wrapped in an enigma.

It could be that I am overestimating the importance of a strong mandate, and that the normative pressure associated with a nominal fine would be enough to make “young invincibles” ignore the powerful incentives to free-ride. But surely that is an argument worth having.