States of Cruelty

Aug 29, 2016 · 676 comments
pendragn52 (South Florida)
It's even more odious with something like microcephaly-stricken infants threatening Florida (Zika) where Marc Rubio has declared he doesn't support later term abortions for pregnant women carrying infected fetuses. One could almost buy this IF there were resources and the care level needed for this kind of problem. But, no, these people are against that, too. The thin layer of social services, poor as they are, are viewed as some kind of luxury the afflicted do not deserve. Cruelty barely begins to describe this.
Steve Donato (Ben Lomond, CA)
The next time Texas wants to secede, let them.
Saoirse (Loudoun, VA)
I have to assume that the women who want Planned Parenthood defunded are all virgins. Of course, some of them could have had radical "female" surgery during their preteen years, but that's a bit extreme even for the radical right.

Defunding Planned Parent only affects the poor, the people who are least able to afford private physicians and birth control pills which are not covered by private or public insurance.

The folks who need Planned Parenthood are trying to fight their way out of poverty. That's not easy under the best of circumstances. When you compound the challenge by adding a new baby to the family every 12-18 months, which is the obvious result of "defunding" Planned Parenthood, you demonstrate your narrow-minded hateful view of the poor.

I hope you and your preacher learn about payback.
Philip Grisier (San Francisco)
It's not about race, it's about cruelty towards the poor and destitute, pure and simple.
Sharon5101 (Rockaway Beach Ny)
"There's an important civics lesson here." declares Dr. Krugman. Dr. Kugman should read the article on the OP Ed section analyzing why we stopped teaching political science. Somehow political science and civics became antiquated academic relics of a bygone era when whites decided what was taught in the class room. That rapidly changed during the Viet Nam era when angry students rioted on college campuses demanding that courses covering women and minorities be added to the syllabus. As cowering college boards hid under their desks, a new era was born as whole departments dedicated to black studies, women's studies, Latino studies sprang up over night. Those boring courses in political science and civics were taken out of the curriculum and dismissed as irrevelant . Where have you been Dr Krugman?? No one really cares about civics anymore.
ConcernedCitizen (Venice, FL)
In the 1950s and 1960s, there were caricature maps of the U.S. showing the northeast and the west coast; designating all of the remaining west of the Hudson and east of the Rocky Mountains as "flyover" or the "great wasteland". We seem to be bringing them back.
Baron95 (Westport, CT)
So, we should be seeing massive migration trends from Red states to Blue states, given that live is so much cruel in Red states and so nice in Blue states.

With the exclusion of California (which has sun, Hollywood, Silicon Valley on its side), what we see is people in droves leaving places like upstate New York and Illinois for Florida, Georgia and Texas.

Have you counted how many congressional seats New York has lost, and how many Texas has gained?

Maybe Americans don't think that Texas is so cruel. For one, Texas does not impose a cruel income tax on its citizens.
Bob (Rhode Island)
Yet more proof that confederate bibles are thumped, not read.
Princeton 2015 (Princeton, NJ)
Krugman goes for the double-play ! In one article, he slams conservatives for both misogyny AND racism ! Next, a rainy day will be our fault.

- Planned Parenthood - "Something terrible has happened to pregnant women in Texas". The issue re Planned Parenthood is NOT about economics or pregnancy generally. Rather, it's about abortion. Personally, I don't have a position on the life v choice controversy. But it's disingenuous for Krugman to ignore the issue. For many people, the killing of an unborn baby is simply immoral and supersedes the choice of the mother. (Yes, a woman has a right to her own body. But there are many aspects of one's own body that are beyond choice - e.g. sale of one's body parts).

- Medicaid - As usual, liberals ignore State and Federal co-sovereignty in our Constitution (see 10th Amendment).
"This should be a no-brainer: If Washington is willing to provide health insurance to many of your state’s residents — and in so doing pump dollars into your state’s economy — why wouldn’t you say yes?" The idea of "Washington willing to provide health insurance in to many of your states residents" is a misnomer. Washington isn't "providing" anything. Via Obamacare, Washington takes your money and then says that if you want it back, you must expand Medicaid. The Supreme Court said that such arm-twisting is coercion and violates the right of States to act in their own citizens best interests. Krugman may want to be like CA. But many of us don't.
FunkyIrishman (Ireland)
When ideology trumps common sense, then the courts ( last resort ) should step in and correct the miscarriage of justice. Unfortunately, the radical right wing Supreme court ruled opposite precedent and for that ideology. This is has allowed republican controlled states to skirt the law ( Row vs. Wade ) any which way they can by women to back alley once again.

What is a no brainer is why would women ever vote republican again, yet they do again and again against their own interests. ( unless of course they have the means to travel elsewhere to get '' the procedure'' )

Or is it bigotry ?
Anna (heartland)
the death surge, as Krugman calls it, may have more to do with increasing obesity mortality rates than with defunding planned parenthood.
blackmamba (IL)
All ugly politics is local. And there is none more ugly and cruel politics than in the black belt on the West and South Sides of Chicago. Mean streets unknown to Chicago Mayor and Clinton protégé and Obama aide Rahm Emanuel. Indeed these streets were not the streets of Mr. Obama's vulnerable marijuana smoking days.
Kenji (NY)
God bless you, Professor Krugman. You are a national treasure. Keep it up!
Ian Maitland (Wayzata)
Predictably, when he runs out of anything to say, Krugman resorts to his nasty habit of smearing his opponents as racists and misogynists -- and his chorus of groupies in the comments section echoes his slurs.

Has Krugman ever stopped to wonder why many people want to defund Planned Parenthood? No, I mean really wondered what makes them tick? And, no, spare me the stuff about "cruelty" and a "substantial infusion of misogyny." That is for a stump speech to the party faithful.

I am asking for the truth. Has it not occurred to Krugman that, far from hating women or the disadvantaged, abortion opponents are motivated by a sincere belief that abortion is murder and that there is only a trivial difference between new born baby and one that is close to being delivered?

Krugman doesn't have to agree. I am asking whether he really thinks that this belief is merely a smokescreen for cruelty and misogyny? If he has not seriously considered the possibility that abortion opponents are motivated by (possibly mistaken) caring and compassion he trashes them, then isn't he displaying classic symptoms of sociopathy?
Sweet Tooth (The Cloud)
Yes and No again, Professor.

You've put the cart before the horse again. The logic for decoding why things are not how they should be is not the piece-meal assessment of why "logical things" are not done. But what the thinking is that motivates irrationality at best and cruelty ( there's another word for that ) at worst.

For those of us who can read it, we cannot bring ourselves to utter it. But think what kind of person does such things. And work back from there.

You're about an inch close, and about a mile off.
tom carney (manhattan Beach)
This situation which impacts every aspect of our social lives including rents, education, and even food purchasing and especially the environments in which the poor are forced to live (Flint Michigan), is driven by the insane notion that some humans are superior to others and are therefore justified in being the "ruling class". This bit of total insanity is at the core of the Ayn Randian oligarchies, Reaganomic fascism and the current infestation of Republican ignorance replacing government in the so called red states.
I am certain that if there were not one person of color in Texas the situation would be exactly the same. Also, these self centered egos who assume they are superior do not see their actions as cruel. They see them selves as knowing better and stopping freeloaders from feeding of of the deserving hard working people is good for them.
Those of us who happen to be have skin of a different shade than the Ruling Elite are easy to see targets and are used to help the lesser whites to have some sense of superiority. At least I'm not black.
I am sure the vast majority of people in the U. S.are not afflicted with this hate poison. But as you point out, The vote is our only hope.
Doug Broome (Vancouver)
American exceptionalism is now manifest in how poorly the poor do in comparison with other wealthy democracies, an inhumanity partially bred in the Democratic party when it abandoned identity politics for class politics. While Martin Luther King spoke of the common interests of the poor the Democrats spoke of the determinative roles of race, sex, ethnicity, sexual orientation and identity.

The great victories over sexism, racism and homophobia were all accomplished in the context of ever-greater class stratification. Breaking glass ceilings left the cement class walls untouched.

In other countries labour leads the left. In the U.S. the liberal elites are rich, cultured, intellectualized. They live in a separate universe to labour to whom the liberal elites are condescending. In the face of the snobbery of the Harvards, the distaste of the Yalies for the mere workers, the ludicrous extremes of identity politics, the Dem-complicit destruction of labour unions, it is understandable that in the U.S. workers support the plutocrats who exploit them rather than professors who condescend to them.

Liberal ignorance of the lives of the working class could very well result in a stunning November surprise.
LRN (Mpls.)
In addition, to add fuel to fire, Obamacare seems to be in its own doldrums, with Aetna and United Healthcare planning to ditch the healthcare exchanges.

Reason? A pharaonic monetary loss of several millions by both the companies. What a pity!

If this latest trend of health plans abandoning the ACA becomes rampant, it might ring the death knell for the ACA program, utterly despised by the GOP. As a sequel, it will be back to ''cover your own fundament'' policy, so adored and acquiesced by the fiscal conservatives constantly, that certain fatalities of the deserving can be accepted as collateral damage. Maybe not.

One only fondly hopes any such present Obamacare system does not lend itself to abuses by the non-deserving, as has been sporadically reported. Whether or not it is authenticated, is another Pandora's box. Conservatives can quote some numbers and liberals some other.

The liberals will, more than likely, be clamoring for some purposeful action, in this unfortunate scenario, coupled with the ultra-conservatives, starting to stonewall them with all their might.

However, a middle ground has to be reached, and a reasonable potpourri of the 2 major principles has to be hammered out. That may seem like asking for too much, but it may not be totally impossible.
Don (St Louis)
Let's not forget the role of gerrymandering and the unequal distribution of power between rural and urban areas. These are dominant structural components of the distribution of political power within the individual states. The result is Republican control of state legislatures and Congress even when Democrats have been successful at winning the national popular vote. Also, a cursory comparison of the number of voters represented by Republican U.S. Senators versus Democratic Senators shows the awesome power wielded by sparsely-populated rural states.
idzach (Houston, TX)
Dr Krugman,

I beg the different with your statement about 19 states are refusing to take free money from the federal government. The Medicaid federal subsidies for the states are only for a 3 years. Subsequently the states have to raise taxes in order to recover the cost. 19 states are 38% of the Union. Not a small number of none compliance states. As we can see from the insurance companies dropout, the cost is much higher than anyone cared to admit prior to the implementation of the ACA. It was well known that the cost of the new insured persons will be very high, but the administration either preferred to bury the head in the sand, or deceive the American public.
William LeGro (Los Angeles)
Two crucial words: "civics lesson"

Who gets civics lessons anymore? Those were phased out of public schools long ago. I think we're seeing the results in public ignorance about our nation, democracy, constitution, and responsibilities as citizens to the nation and each other. I learned all this stuff in ninth grade, and it has really stuck with me. It doesn't take much to teach people about such basic things, and yet we're not doing it. With predictable consequences.
John MD (NJ)
It's all been well explained before. No need to wonder at this behavior. read
Hedges and Sacco "Days of destruction, Days of Revolt" and know that it is the poor and powerless now. Soon it will be YOU the oligarchs and their right wing minion politicians come after.
Mylan and Epipen are just an example.
Laura Ipsum (Midwest)
I think "States of Cruelty" would be a nice companion piece to "Where the Death Penalty Still Lives." I've often thought that the same people who are protesting outside Planned Parenthood begging women to spare the lives of the unborn should be first in line to provide for those babies when their mothers are not able to care for them. Instead, many of these children come into the world unwanted and unloved, their story already scripted before their lives have even begun. Mired in poverty, neglect, and abuse, they try to find their way within a system that ignores them once they go from being a twinkle in their mother's eye to a thorn in society's side. Some of them commit violent crimes, even heinous ones, and are then condemned to death (though really they were condemned at birth). Then the same people who wept for the precious children can't get the needle in the adult's arm fast enough.
jstevend (Mission Viejo, CA)
The other issue about state and local elections are the past reports about the substantial effort by the political right wing to win there, far more diligent and organized about this than the left. As a result, the report has been that over-all political power in the U.S. can be argued to be about evenly divided 50/50.

Gerrymandering and the 'Karl Rove' strategy (same thing?) seem largely responsible for much of the right's power.
sj (eugene)

Prof. Krugman:
what do you suppose the economic-benefit that results from this on-going "experiment" in lives-disrupted within and without the state of texas is?

or,
are the results an overall economic-loss for the majority,
while the few benefits accrue only to the Elites?

how does this advantage of transfering-up work?

then:
why do the citizens continue to reelect the individuals who establish and reinforce the political structures that perpetuate this downward spiral?

what is there in this process that pretends to make these voters' lives better in any way?

why does the republican't party hate texans and texas so much?

in the end,
before we are all dead in a Keynesian sense,
this foundation-of-cards will surely cause a systemic and catastrophic failure.

how do non-texans buttress themselves against such a force?
Michael Kubara (Cochrane Alberta)
"...it’s all about economics, that small government and free markets are the key to prosperity."

Small government + mega corporations = Corporatism (corporation rule).

"Free markets" = free from government regulation = corporate autonomy (independence to do whatever they like).

The myth is that "The Economy" is a reality transcending politics--it's like Astronomy or Religion--with laws of its own. But the religion is that it transcends politics.

"The Economy" and its corporations are conceptually--logically--impossible without government. They are creations of property, tax and labor law including laws about limited liability, capital gains and union busting--as well as Free Trade agreements.

Investors collectively create corporations as "legal persons" but if labor tries it, it's "anti-free market".

Religions are corporations too--marketing god story mythology (there are thousands of them); sometimes controlling governments (theocracy).

Freedom of religion is another variation on "free [from government] marketing." And so each religious corporation competes for market share against the others pushing whatever god story that sells.

What sells depends on the whims and prejudices of consumers--so in Texas, religions are thinly disguised pushers of racism--hatred sells--even while the god story preaches loving neighbors. In Texas, evidently, "neighbor" is color coded.
jstevend (Mission Viejo, CA)
"...the economic case for being cruel to the unfortunate..." Wow. There's an unfortunate statement. One that got away? Can't change what's already published.
Fred Gatlin (Kansas)
This commentary is on target. I live In Kansas and Governor is the worst in America by two polls. He has almost destroyed state government. Before he was Governor he was United States Senator. That should take breath away.
mjohns (Bay Area CA)
The argument most consistent with actual Republican governance in recent decades is that they enjoy making the lives of those unable to defend themselves miserable while shortening those lives in any way possible. They pick on everyone poor, focusing on disadvantaged groups who are disproportionately poor, including single women, children, and minorities.

By destroying unions, Republicans have created a new group unable to defend themselves. Now Republicans are gleefully working to make the lives of working-class men over 40 miserable by denying medical care, addicting them to alcohol, tobacco, and painkillers, while destroying their economic opportunities. Fox News and talk radio shows present this group with such a depressing and angering world view that their core listeners often use their own guns to end their depression. Otherwise this newly targeted group uses the pain-killing drugs, tobacco and alcohol provided by major funders of Fox and the Republican party to accomplish the same life-shortening over additional time.

No other explanation works as well to illustrate why Republicans have the policy and practices they advocate, or why they ignore all evidence that their policies generate more, not less, misery. Perhaps the party leadership is getting exactly what it wants to get: sadistic pleasure from inflicting misery on the defenseless. All accomplished with "plausible deniability" of course.
Benjamin Greco (Belleville)
Both sides of the political spectrum have fallen into the nasty habit of demonizing people they disagree with. This column is a good example.
I don't agree with Texas pols and think we need to do much more on the state and national level to help the poor survive, lift themselves out of poverty and thrive. But I don't want to categorize people I disagree with as cruel, irresponsible, racist or misogynistic anymore and we won't get anywhere until both sides stop it and stop questioning each other's motives.
Steve Bolger (New York City)
I categorize people who can't adhere to the oaths of public office they swear to as the wost form of liars drawing breath.

English does not get much plainer than "Congress shall make no law".
These people are thieves of illegitimate power.
Deus02 (Toronto)
Every time one reads columns like this, no matter what happens going forward and who is elected President, it is quite clear the Republicans ultimate goals of divide and conquer in their jurisdictions and throughout a good portion of the country, sadly, has been an enormous success. It is obvious far too many Americans choose to remain in ignorance of the issues and the picture at the head of the column just confirms it. How America deals with that for the moment anyway, is proving to be a mystery and is something that is gradually getting worse.

Sorry, but so-called American innovation and the idea that things will all eventually work out on its own is not in the cards, it is going to take a LOT more than that.
Harley Bartlett (USA)
In the desire for a Liberal agenda overall, I appreciate the need for an opposition party that can and will challenge policies that can potentially become weighted and therefore unbalanced.

It's as though the Republican party decided to only way to win the national debate is by preemptively blowing themselves up.

We all need something/someone to keep us questioning our assumptions but there is a stark difference between channeled opposition and obdurate obstruction. As with a sailboat, one moves the country forward the other sinks it. Republicans, and especially tea-partiers, are obviously deeply committed to the sinking option. Never mind that they drown as well.

What any nation needs is informed debate. What we get here in America, is screamers with ear-plugs who can't/won't accept that they have lost an argument, flailing hopelessly back to (fabricated) contentions that have been proven wrong—over and over again (Planned Parenthood). Or "investigations" that have proven fruitless—over and over again (Bengazi).

In the absence of anything to bring to the table, they turn the table over and ransack the house.

Surely, among those who desire conservatism as a principle of governance, there are some (enough?) who can rise above the mean-spirited, greedy, cravenly hypocritical, and blatantly stupid fools who have hijacked the devolving Republican party now swirling the drain. . . and form a new party.

Call it the Reformation Party and try to live up to the name.
Dan Coleman (San Francisco)
If I read you right, you're saying that if the Republican Party digs in its heels and commits to obstruction, to the point where it destroys its own effectiveness, ceases to be a viable opposition, and shrinks to permanent super-minority status, that's a bad thing. Time will tell, but here in California it appears to be a prerequisite for progress rather than a harbinger of doom.
mkm (nyc)
Word of the day "Cruel" - the sort of sophistry Mr. Krugman is practicing here is beneath or should be beneath the NYT.
Kathy (San Francisco)
"Cruel" is not misleading in the least. What do you call denying access to LEGAL abortion care followed by denial of assistance to the families once the children are born? To me, such actions are the very definition of cruelty.
Harley Bartlett (USA)
mkm: Let me guess. You are among those who decry "political correctness" as a means of avoiding truth through the use of euphemisms?

My dictionary defines cruel as : "willfully causing pain or suffering to others, or feeling no concern about it".

Just what about this word is offensive or off the mark for you in this context? His whole article supports the use of the appropriate word. Read it again without the attitude.
Marc LaPine (Cottage Grove, OR)
In the south, including Texas, the bible belt, fundamentalist movement, whatever you want to call it, uses religion as a foundation for their dismissal of the poor and needy, yet their own religion professes to help those who cannot help themselves. Southern "religious" whites believe when god made man 'in his own image' it was a white man. We know in all the "cradles of civilization" we learned in school, all inhabitants were anything but white. In northern Africa where Jesus was born, inhabitants were arabic (brown skinned). Jesus was arabic, spoke the Aramaic language, was brown skinned, brown eyed, black haired and most likely supported a black beard, as did most men in his time. OMG, point that out to conservatives. The picture accompanying the article is populated by only the cruel white folk. Shame on them. Think globally act locally, and don't leave intelligence behind.
Heysus (Mt. Vernon)
This is a cruel country. Every man/woman for themselves, unless you are wealthy. Nearly every country in the world is willing to assist the "have nots" except the USA, which is supposedly the wealthiest country in the world. To me this says, "I made it on your back and I'm not sharing one cent with you". Greed and selfishness seem to exist hand in hand. We should all be ashamed.
Steve Bolger (New York City)
The wealthy are just as subject to getting conned and fleeced as everyone else in this national orgasm of masochism.
Kyle Reising (Watkinsville, GA)
Most of the nice people showing their support and faces in the accompanying photograph think defunding Planned Parenthood is a blow against abortionists. They have been told any of the people going to Planned Parenthood can just as easily stop by the local emergency room to receive health care where an abortion isn't an option, and they believed. They will also more than likely claim not to have a prejudiced bone in their bodies; they are serving their god doing his will.

I suspect the GOP took in this subset of fine moral values when Nixon cut a deal with the freshly minted Republican Strom Thumond and his band of Dixiecrats in 1968. There has always been room set aside under the GOP Big Tent of moral outrage for any bloc of voters angry and upset over policies designed to enslave the lesser forms of humanity to democrat government dependency.

Segregationists were not being mean to people of color they were merely looking out for them while keeping them away from the white women. They knew what O J Simpson was capable of long before O J was born, and that is a proud heritage worth defending. Brown babies dying of neglect and parental malfeasance is just proof of god's infinite wisdom. Every right thinking person knows Obamacare is just liberal revenge taken out on true patriots for their tough love. It's the best explanation I can conceive for their attraction to Donald Trump.
theod (tucson)
Recent Republican Admins. have proved, if you look at their actions (their words are so much warm carbon dioxide), that they love government expenditures that accrue to themselves and their pals. And they like reducing their own taxes while raising them in a variety of euphemistic ways on others. Look at their egregious budget deficits. Look at privatization schemes for prisons, national security and DOD functions, for example.
LT (New York, NY)
Keep the populace ignorant by underfunding education, censoring the schools' curricula, feeding them religious and right-wing dogma, as well as keeping the defacto racial segregation going in the name of "states rights" and voila! -- you continue to control the people.

For many people in the South and several mid-western states, the Civil War never ended. Anything championed by Yankees is always a threat to their heritage.
Michael McHale (Buffalo)
So Mr.Krugman has his shorts in a bunch because there is insufficient government funding to support the slaughter of preborn babies, a disproportionate number of whom are minorities? And he has the temerity to accuse Republicans of bigotry.
BCasero (Baltimore)
Interesting. Professor Krugman writes an article about Red States denying needy people health care and you view that as a stance promoting abortion. That interpretation certainly says more about you than the good Professor.
Deirdre Diamint (Randolph, NJ)
If you want to address poverty and maternal death you must have an honest discussion on free access to long term birth control and women's health

Pregnancy should not be something that happens to you it should be planned

The fastest ticket to poverty is an unplanned pregnancy with an uncommitted partner and a mother with few job skills or financial stability
Lewis Waldman (La Jolla, CA)
We've finally found those Death Panels that Sarah Palin kept talking about.

They are the Republican legislatures, in many cases with Republican governors, who refuse to take that Medicaid expansion.

They have blood on their hands, a whole lot of blood. And, these are the same people who claim to hold dearly to Christian beliefs in a false self-righteous religiosity that smacks of hypocrisy and immorality. They are evil.
Been There (U.S. Courts)
Professor Krugman probably sets the bar far too high hoping for U.S. citizens to pay attention to more elections than the presidency. (Many do not even vote in the presidential election and most do not even bother to vote in the primaries.)

America would be a better place if a majority of citizens merely read the front page of a newspaper, any newspaper.
Ray Evans Harrell (New York City)
The last line was correct. You miss one thing however. As Religions become more openly political and clannish against those who are not of their group, societies lose their moral center. As a result it becomes a willing partner in the game of science vs. religion rather than maintaining a base that even Kublai Khan with his religious tolerance understood better than America. Instead of religion as an exploration of the human moral center and its relation to that which can never be understood but seems conscious, we get various versions of worship of images limited by the minds of the worshiper. That's the religion Dyson and the others go after. But Dyson is "religious" in his science as you are religious in your economics. The great Christian Theologian Paul Tillich said "Faith was what you were most Ultimately Concerned with in your life" I agree. Now, if that concern is only the limits of your provincialism then it's profane and usually immoral, but not always if the subject of your concern happens to be so frightening that you behave. " Ultimate Concern" with that which is Ultimate is long term thinking. Practicing it in your religion carries over to the rest of your life and doesn't give you negative externalities as an option to simply put under cost effectiveness or productivity. Every religion has a profane side that is short term and the root of its failure to deal with the other social domains and slip into immorality.
Ivan Goldman (Los Angeles)
'Most Americans are, I believe, far more generous than the politicians leading many of our states.'

Alas, both studies & anecdotal evidence show that a majority of voters in the reddest of red states are in fact quite comfortable with punishing the poor, especially poor women, even unto death.
Grove (Santa Barbara, Ca)
While I believe that misogyny and race figure into the red state phenomenon, it seems to me that the overarching motivation is a combination of pure GREED and selfishness.
The Republicans are in it for the money, and they truly believe that money is only meant for them, and the don't care how it affects the country or it's people.
Grove (Santa Barbara, Ca)
Make no mistake, they would sell their grandmother for a dime.
While they might be racist and misogynistic, they are equal opportunity when it comes to increasing their own bank accounts. No one is safe.
Ian Maitland (Wayzata)
I notice that Paul Krugman slyly tries to "explain away" Texas's employment growth success story by giving all the credit to Mother Nature. He says "And it’s true that Texas has long led the nation in employment growth. But there are other reasons for that growth, especially energy and cheap housing."

Obviously he hasn't read today's Wall Street Journal. Texas's energy bounty is due more to sound public policy and human ingenuity than it does to nature. It is not just that Texas led the fracking revolution, either.

"Which State Is a Big Renewable Energy Pioneer?," the article asks. The answer: Texas. "On a blustery February night, the Texas electricity market hit a milestone. Nearly half the power flowing onto the grid came from wind turbines...."

Is it asking too much for Krugman to give credit where it is due? That would include former Texas Gov. George W. Bush too. We've seen the future, and it sure isn't the blue states.
Keen Observer (NM)
You are so wrong. But keeping your fantasies if they make you feel better.
Bob Tube (Los Angeles)
I would argue that another reason the cruelty toward the poor goes on is religious. There is (supposedly) a difference between the deserving poor and the undeserving poor. The deserving poor are "like us" but they've fallen on a spell of bad luck and they need a helping hand to get back on their feet. Louisianans flooded by torrential rains this month fall into this category. The "undeserving poor" are, well, not like us. Their low morals, poor work ethic, lack of ambition, etc. mark them as sinners, unworthy of God's blessings or ours. You can tell God's "elect" because God has blessed them with wealth. Similarly, you can tell the sinners pretty easily by their poverty. God has not blessed them, so why should we help them?
David Ohman (Denver)
There are two fundamental reasons for the cruelty factors in Texas and other bastions of right-wing conservatism.

First, there is the ultra-conservative embrace of the thrice-failed trickle-down, "free" market theories of economic support of the rich while keeping a boot on the necks of the poor. They hold this economic version of natural selection as economic Darwinism. There is, of course, another embrace of the anti-empathy, anti-compassion author, Ayn Rand, the Soviet ex-pat who hates everyone and equates "liberal" policies with the former goverment she left behind. What a pant load!!!!

Second, the forces of ultra-conservative organized religion (pick one) have managed to politicize their faith to the point of attempting to remove Thomas Jefferson's "seperation of church and state" from our system of fairness. And here is the irony and hypocrisy of their demands to remove funding from Planned Parenthood: the lack of compassion and empathy runs counter to the teachings of Jesus Christ. Yet, they promote and vote for political candidates at every level, from the President of the United States down to a local judge or bookkeeper, who will kick the poor, the sick, and the elderly to the curb "to teach them a lesson."
So when conservatives blast liberals for progressive policies that help those groups, they are essentially blasting the very religious figures they supposedly adore and worship. They can't have it both ways. So they lie.
mark (ct)
And this legislative cruelty in Texas surprises you because . . . ? Consider that depriving the socio-economically disadvantaged of the food and healthcare they require is a terrific way to motivate their emigration to other States, while simultaneously redirecting those resources to off-setting tax cuts for a rich few and other boondoggles. And yet, most of the Republican-led jurisdictions that engage in such institutionalized bigotry remain "net takers" on federal programs. it's almost invariably the more generous, slightly higher taxes jurisdictions that carry the excess burden precipitated by Texas's despicable war on the poor and otherwise disenfranchised. Let these dying States secede -- as they so often insist they wish to do -- and let's see how long they survive the sovereignty they demand. I give Texas a month.
Steve Bolger (New York City)
Yes, driving to poor to other states is a perfect example of the form of interstate competition Congress is constitutionally empowered to quash out of existence.
John Smith (Cherry Hill NJ)
VOTE In states that refuse federal medicaid dollars. Otherwise you're letting policies be dictated by GOP extremist ideologues. Female mortality has surged in TX which has deliberately cut as deeply as possible into services from the Planned Parenthood health clinics that mostly provide medical care for women with low incomes, who are being punished because Planned Parenthood performs some abortions. That constitutes guilt by association and discrimination against women who urgently need the vital services provided by Planned Parenthood. I find it repugnant that TX prides itself on depriving the largest number of potential Medicaid recipients in order not to get returns on federal tax dollars paid by residents of the state from health care providers. So the ideologues are punishing women because they oppose federal policies. Still, the misogyny of TX is a violation of the civil rights of women. What can I say but, Annie Get Your Gun! But I oppose gun violence. I even oppose using guns as theatrical entertainment even in musicals. The weapons used in music should be the cannons in the 1812 Overture by Tchaikovsky, in my opinion. The situation in TX is further evidence that the GOP's policies tilting the game toward the 1% at the expense of the 99% is regressive and destructive. It deprives residents of the state of their rights to pursue Life, Liberty and Happiness. It also singles out ethnic minorities as targets for deprivation of medical care; more women die in TX.
Critical thinker (CA)
While I agree with PK that Republication governors are doing a terrible job in their states, I think this piece may be viewed as a distraction from a much bigger problem:

The unjustified and cruel hike in the prices of drugs and medical procedures.

The drug industry has become a major public health hazard:

Much has been written about the drug epidemic that is taking place right and is the result Lily who pushed Oxy better than any drug empire could.

But the fact that the drug industry patents (by and large) publicly funded research to bar people from life saving drugs unless the pay exuberant bills and thus condone many many people to death should be viewed as a crime against humanity. The people heading the drug companies and their lobbyists should stand for trial in the Hague Tribunal.
Joe Bastrimovich (National Park, NJ)
Just one quick point about Texas' "employment growth." Texas, like many red states, throws oodles of taxpayer subsidies at businesses to lure them there. Many companies move there strictly for the government handouts, not because of any particular advantage of being in Texas. How these supposed "free market" advocates in Texas explain away such market-distorting practices is completely beyond me.
stu freeman (brooklyn)
I'll say it one more time: Admit Puerto Rico to the Union. And kick Texas out.
Lori Guarnera (Saratoga My)
Amen!
Keen Observer (NM)
And NY is doing such a good job?
Al Rodbell (Californai)
Fewer doctors to treat the working and poverty groups is being exacerbated by a movement mostly under the public's radar. It is dominated by one company, MDVIP, that under the guise of wellness and more time with patient for preventive care, imposes a fee of around $1500 dollars per patient per year. This is attractive to doctors in areas with mixed income patients as they can cut their numbers of patients in half while increasing income.

This is growing even though Medicare now provides payment for "Annual Wellness Visit" that doctors can have a nurse or outside service perform, and the patient really does not even have to agree to it. Greed is a powerful incentive, and the G.P. who is only making a couple hundred thousand for some difficult work can look at those who take in multiples of this for a lot less aggravation and ignore the public health consequences.

When doctors are in the boutique medicine business, there are a lot fewer for the average guy.

AlRodbell.com
Robert (Out West)
That's called a "capitation fee," there's nothing inherently wrong with it, and what you're describing isn't "boutique medicine."
William (Alhambra, CA)
Surely race and misogyny are causes. But both California and Texas have a large non-white population and a large female population. Perhaps self-sorting is a factor. California has been losing to internal emigration while Texas has been gaining from internal immigration. Those who chose to remain in California are more simply more mellow about race, gender, and overall diversity than those who move to Texas. The simple lack of race or gender-based animus contributes to societal health.
Jsbliv (San Diego)
Texas is such a great state. It's too bad the hearts and minds of its residents have been largely taken over by the reactionary politics of those still fighting the Civil War--excuse me, the War of Northern Aggression.
Jon Asher (Glorieta, NM)
The last paragraph of Mr. Krugman's op-ed holds the key to solving this problem -- getting the disenfranchised and marginalized to vote for their own benefit. Voting - in large numbers - is the only way to change situations like that in Texas, where campaign lies, actual voter intimidation and more keep draconian laws in place. Outright lies combined with a cleverly edited video have severely damaged Planned Parenthood, yet despite those lies being exposed the constant re-telling of those lies seems to have convinced a large number of people that they're true. Only a dedicated, well-funded get-out-the-vote effort is going to change the status quo in the Lone Star State where, despite their claims to the contrary, socially it remains 1950.
Sleater (New York)
One way that people all over the country could address the Republican domination of places like Texas is to support voter registration drives, to elect Congresspeople who will uphold the Voting Rights Act of 1965 and subsequent renewals, and to support organizations that battle attempts to remove working-class and poor voters of all races, as well as students, many of whom are white, from the voting rolls. There is a reason that the complexion of state legislatures shifted after Reconstruction and again after the extended voting rights battles of the 1950s and 1960s. The right to vote should be enshrined in the US Constitution, but it isn't; it's an ongoing challenge and everyone who cares about the issues that Professor Krugman is describing should be supporting, in ways small and large, American's right and access to voting in municipal, state, and federal elections.
Susan Anderson (Boston)
Yes indeedy:

Fetuses are more important than life itself.

They haven't got personalities to dislike yet, needs, things like that ...
Susan Anderson (Boston)
Don't forget coathanger abortions, pre-Roe v. Wade, were common.
p wilkinson (zacatecas, mexico)
As a rational person I find the anti-abortionists impossible to understand. These are people who apparently hate blacks, immigrants, poor people - so why do they want more of them? Planned Parenthood funds and facilitates contraception which ostensibly leads to fewer minorities and fewer people on Medicaid. What is the problem with that?
Steve Bolger (New York City)
These fools are just acting out a scam that promises better life after death for making life miserable.
Medusa (Cleveland, OH)
I'd like to know what TX did with the money that was taken away from Planned Parenthood. Where did it go? What was it used for? Are there alternatives health care services for women that received the money?
NYHUGUENOT (Charlotte, NC)
The funds have gone to over 500 other medical clinics which actually provide services Planned Parenthood does not provide such as mammography.
Stephen Shearon (Murfreesboro, Tennessee)
Race is likely a significant part of the reason former Confederate states limit assistance to the poor more than former non-Confederate states do, but race alone doesn't explain this behavior completely.

I suggest we look beyond that to the broader culture. Those same former Confederate states contain many descendants of the Scots and Scots-Irish, and persons in those cultures have a different idea of freedom and value a different sort of relationship to the state and to each other.

David Hackett Fisher, of course, was one of those to discuss this. See his book, Albion's Seed.
Mhairi (California)
I would disagree with this entirely, actually, as a Scottish American (and a true one at that - spent around half my life in the US, and half my life in Scotland, and hold dual British American citizenship). I suggest you look towards Scotland currently, where we have the NHS, free college tuition, and a host of other state funded programs designed in part to help those in lower socioeconomic brackets. I would argue that those of particularly Scots descent would, in fact, be nore likely to help the poor.
blockhead (Madison, WI)
The Scots-Irish were actually English who immigrated from what is now Northern England. In any event, these largely Presbyterian 17th and 18th century people have nothing in common with today's Scots.
NYHUGUENOT (Charlotte, NC)
California is hardly a center of Scots and Scots-Irish emigration. To immerse oneself most is to live in North and South Carolina where the majority of Presbyterian churches can be found. Not only the extremely Liberal PCUSA but the much more Conservative PCA, OPC, Bible and EPC. Almost all the members of the ARP live within 50 miles of Charlotte. The Conservatives have held to the Westminster Standards both in Confession and Catechism and are conservative because of them. Though I was raised Dutch Reformed I am as at home with the Presbyterians as the Dutch churches.
will w (CT)
How can New Englanders possibly change Texas minds? Why not write about something more substantive like why capitalism is destroying the free world and what we can do about it before we all go up in flames?
loveman0 (SF)
in another article today, we learn of Republicans NOT supporting Trump. Only a handful are from the South, or red-state country. Racists all until the end. Why is there a paucity of Democrat representatives from places like Texas?
Know Nothing (AK)
Your words, "irresponsible, cruel or both" might well apply to the decisions of the highest court and to several of its members, specifically.
danxueli (northampton, ma)
The column did well until the last paragraph, whereby Mr. Krugman partially refuted himself, unnecessarily. He got it right the first time. "The people" / voters too often get a pass from columnists. Everything is blamed on 'politicians'. In fact, most politicians are doing the peoples bidding. This is the case in Texas. The voters are NOT "far more generous than the politicians". As Mr. Krugman noted , "voters in local elections don't like the idea of helping neighbors who don't look like them"; or for that matter who don't go to the same church, etc.
Chris Hutcheson (Dunwoody, GA)
Texas - where science and facts go to die
Naomi (New England)
With the maternal mortality rate in Texas, a woman could claim her abortion is simply self-defense. Isn't Texas in favor of self-defense, or is that only when it involves firearms?
NYHUGUENOT (Charlotte, NC)
Aiding in raising that maternal mortality rate is the number of illegals who do not go for prenatal care because they are illegal.
duroneptx (texas)
"So the economic case for being cruel to the unfortunate has lost whatever slight credibility it may once have had. Yet the cruelty goes on. Why?"
My answer: The Republicans and the DINOs.
Vote them all out this Fall. Move towards electing people like Bernie Sanders and stop listening to Tea Party Republicans.
Let's all bring America into the 21st century by ridding this great country of this political plague of racist do-nothings.
a.p.b. (california)
Let's try to be fair: a very reasonable reason that many states did not accept the gambit of free money for Medicaid was that the free money was going to end, but the customers would still be there. There was a time limit on how long the Feds would ante up more than they do for the rest of Medicaid, and the states would be and will be left holding the bag.

As for the California experiment, being a retired person in California, I can tell you that there has not been "dramatic success in holding down costs." Oh, you meant the money spent directly by the state on health care? Because the rest of us, who have to pay for this "holding down costs" by spending more money, actually have to pay a lot more in taxes and cost of living, but no one is helping me to get more retirement income. On the contrary, what little I saved is being confiscated by the Federal Reserve, in the form of interest rates less than inflation.
Steve Bolger (New York City)
Yep, the Federal Reserve Bank hasn't even got the guts to tell Congress that it cannot make up for incompetent fiscal policy by Congress by any tool of monetary policy. We are governed by people who are insulated from the consequences of their own bad judgment.

Depositors should run the Federal Reserve Bank, not bankers.
NYHUGUENOT (Charlotte, NC)
"Depositors should run the Federal Reserve Bank, not bankers."

Better yet the Federal Reserve should be shut down. We've done it before and survived even with Lincoln's Greenbacks. We went almost 70 years without the blood sucking national bank controlling our currency and inflation rate.
N.B. (Raymond)
Bear in mind Mitt Romney is so handsome women couldn't resist him and voted for him as the guv on of a liberal state .He reminds me of Taylor swift's wildest dream song so darn handsome whereas Donald is not so handsome any more and doesn't he support funding of planned parenthood but not so handsome seducer Mitt Romney
https://www.youtube.com/watch?v=2k7d7gRY1xc
Who am I to judge I being the most handsomest man that ever walked this earth.I yes I know how to use the I as Mitt Romney did until Hurricane Sandy greeted the people.
Tuna (Milky Way)
Doc, don't waste your breath. I'm sure these folks either see the rise in mortality rates for pregnant women as due to something else - for instance, the breakdown of the family (which, btw, has its own set of causes) - or they simply don't care as long as "babies" are saved.
David (Southington,CT)
Excellent point which should be stated much more often.
camed1 (Dallas TX)
I assume the sociopath in the White House you refer to is Hillary Clinton?
BCasero (Baltimore)
Thank you camed1 from Texas, for proving the good Professor's point.
Bill Benton (SF CA)
The Founders intended House districts to be competitive. The combination of Blue voters in big cities and re-districting by the party in power leads to un-representative House of Representatives. In 2/3 of the states the Red party is a distinct minority, yet the House delegations are 2/3 Red.

The Supreme Court is responsible for fixing this. They are smart people, so the reason for not fixing it is politics. The Senate and Presidents share the responsibility for putting conservative idiots like O'Connell and Scalia on the court. (They both voted to put the un-elected G W Bush in power.)

California does re-districting by a panel of non-partisan judges. This is better than letting the party that is temporarily in power in the state house gerrymander themselves into permanency. California also has one big primary. The top two become the general election candidates, whatever party they are from. This reduces the power of the extremists. Other states should do the same.

To see what else we need go to YouTube watch Comedy Party Platform (2 min 9 sec). Invite me to speak. Thanks. [email protected]
Steve Bolger (New York City)
Abortion politics has virtually aborted the United States Supreme Court.
NYHUGUENOT (Charlotte, NC)
You won't believe this but a majority of people outside the West and South couldn't care less about California. If the big earthquake finally comes and California floated away or flipped over we really wouldn't care less than we do now.
emm305 (SC)
If you live in a Red state like mine, you now that state legislative & governors races have been totally nationalized into anti-Obama races, along with the Congressional races, starting in 2010. State issue are barely mentioned.
So, when Democrats don't show up at the polls for state races (and, in midterms), it has a disastrous affect on the state.
If you think Paul LePage is an outlier, there are usually several just like him in Red state legislatures.

What needs to happen is these Christian Republicans need to be constantly called out on how hypocritical they are in relation to Jesus' teachings about the poor.
Steve Bolger (New York City)
People who are living for a better afterlife make this life Hell for everyone else.
Paul Wortman (East Setauket, NY)
The mortality rate for a pregnant woman is 17 times higher if forced to give birth than to be allowed the Constitutional right to an abortion. Red states like Texas and their Governor, Greg Abbott, who called his opponent, Abortion Barbie, are clearly misogynistic murderers. This brutal denial of vital, life-saving health care to those most in need goes beyond cruelty to criminality. So called Christian conservatives and their political enablers are, in reality, pro-death, in allowing women their legal right to save their lives.
Tom Walsh (Clinton, MA)
Texas can give the sick, welfare users, paroled convicts one way bus tickets to California, Encouragement to use the tickets can be executed - Problems Solved! (its been done before).
Keen Observer (NM)
How about one-way tickets for the California crony capitalists who've found Texas such fertile territory? I'd pay for that.
Ed (Dallas, TX)
No Democrat has won a statewide election in Texas since 1994 when Ann Richards was elected governor. Ironically, her daughter is president of Planned Parenthood. It's no coincidence that women in Texas are dying from childbirth in greater numbers.
cheddarcheese (oregon)
My conservative Evangelical in-laws "liked" a rant by a family member who concluded that the government is totally inept and incompetent because the IRS got his tax calculation wrong. "As Reagan said, government is the problem...We are becoming a nation totally dependent on Uncle Sam for our future. This nation was founded by dedicated men and women who desired to be free and independent. Let's keep it that way."

There is no fact, argument, or scripture that they will listen to. This is their belief, period. And they will vote that way.

I hear these opinions from my conservative friends all the time. How can we change such closed-minded opinions?
George Lakoff has some ideas: https://georgelakoff.com/2016/03/02/why-trump/
just Robert (Colorado)
In Texas as in other states ruled by anti abortion people hypocrisy reigns supreme. If they truly believed in the rights of unborn children anti abortion forces would support Medicaid for all women who need help in their pregnancies and this is especially so for the poor or near poor. Instead they rail against helping this class of people resulting in pregnancies that fail or the birth of children who needed help before birth. The supposedly Christian elements who stand against Medicaid in their states need to examine what they can do for the children they say they demand be born.
pcrudy (right here now)
I get it now.

It's about race when blacks don't get money for abortions, but not about race when e.g Clinton calls blacks 'super predators' and her husband funds law enforcement with 100's of millions of dollars so they can throw a disproportionate number of blacks into prison?

Why not simply be 'color blind' on these issues and simply argue that if one acts responsibly you won't need Planned Parenthood and you won't get sent to prison?
Steve Bolger (New York City)
The war on cannabis is really a war on liberals. Random drug testing is a fact of life for all federal bureaucrats, and no other drug remains detectable after use for as long as cannabis.
WZ (Los Angeles)
Why won't you need Planned Parenthood? Birth control, pre-natal care, women's health care generally ... Planned Parenthood provides a lot of services other than abortion.
PH (Near NYC)
The 110 Republicans on the front page with 'new-found poitical religion' and won't vote for Trump...They are responsible for this and not Trump. He hasn't held an office (luckily). If Trump becomes the excuse to recuse "REAL" GOP/TP folk from their "Shining Kansas on a Hill" dream, I think I will be sick.
Jeff McDougal (Atlanta)
The only way to dilute the influence of the politically active lunatic fringe is to stop having so many elections. All elections, local, state, and federal, should align with the presidential cycle.
M. B. E. (California)
Look on the bright side. With losses from maternal and infant mortality plus gunshots (http://www.cdc.gov/nchs/pressroom/states/texas.htm), Texans may be able to keep the population down without resorting to contraception.

Hard on poor folks, but -- cheer up! -- good luck for the rest of us. They may succeed by killing enough of themselves to reduce state population and thus lose Congressional seats. One blot on that optimistic scenario: promise rings have been found just as ineffective in preventing pregnancy as spitting in a frog's mouth.
Socrates (Downtown Verona, NJ)
States of cruelty, misery, poverty, ignorance and 'Christianity'.....owned, operated and managed (almost exclusively) by the Republican Party.

Using data from the Organisation for Economic Co-operation and Development (OECD) quality of life study, the ten most miserable places to live in America are:

10). Georgia (10th most miserable)
9). New Mexico
8). Louisiana
7). South Carolina
6). Oklahoma
5). Tennessee
4). West Virginia
3). Arkansas
2). Alabama (the Runner-up !)
1). Mississippi (the most miserable)

Nine of these ten states voted for Mitt Romney in 2012.

New Mexico is the lone Obama state on the list.

FROM: http://www.politicususa.com/2014/10/08/study-finds-majority-worst-states...

http://247wallst.com/special-report/2014/10/07/the-10-states-with-the-wo...

Grand Old Poverty, Punishment, Pillage & Plunder 2016

Nice people.
Mark Lebow (Milwaukee, WI)
To Republicans, federal money is still taxpayers' money, and should be returned to the taxpayers as soon as possible. But if there is a military program they want funded or a war that needs escalating, then it goes back to being free money, because they say we need those things. Free for me, but wasting other people's money for you.
Pragmatist (Austin, TX)
From my position in Texas, I don't think racism is a cause of the choice to not expand Medicaid in Texas. It is a combination of ideology and loud/well-organized, anti-abortion forces. Texans are skeptical about federal programs/big government and tend to not want to become reliant on them. Of course, they also have disenfranchised many of the state's voters to insure it is a relatively small number who drive this issue.

The ideology of anti-democratic responses (making sure Obama has no successes) is a great part of it. The anti-abortion movement is also concerned that federal entry into healthcare will eventually lead to a federal abortion mandate (which it should). Texas is full of illogical responses like many states.

The real question in my mind is why have national GOP leaders (this is a uniquely Republican position to cut of their nose to spite their face) encouraged this response instead of acting like statesmen to expand healthcare to all? And why haven't voters punished them for it?
L (TN)
Abortion has divided this nation along lines, federal and state, that would normally be blurred by good intentions on both sides. To be pro-choice is evil. End of discussion, end of compromise. This intransigence has carried over into governance, hence the inability of Congress to get anything done, and into every aspect of American civic life. Unfortunately for the religious right, evil can infiltrate even the most noble of human endeavors, corrupting those who claim the highest ground and resulting in atrocities. Only governance chock full of checks and balances, as ours is so enabled, can limit that corruption by preventing coercion of one group by another. I hope as a nation we are not fool enough to alter a formula that while not foolproof - slavery or the treatment of native Americans for example - is better than most others. Secular governance works exactly because it refuses to provide divine cover for human manipulations in periods of disagreement, as it once did for kings. Let's keep it that way, at the federal and state levels.
Steve Bolger (New York City)
The biggest evil of all is claiming to know what God thinks. These people all take the name of God in vain. They deserve to be reviled for it.
Al (Davis)
I am all in favor of letting this State level experiment play out. Texans are fond of advertising themselves as "a whole nuther country". Let's have a well designed experiment set up to test this idea of red vs blue governance. Yes it probably won't happen as that would be tantamount to using the poor as lab rats, rats that don't vote of course.
Joe From Boston (Massachusetts)
Can those of us in the rich BlUE states stop underwriting those in the poor RED states?

We pay more than one dollar in federal taxes for every dollar we get back, and RED states in general pay less than one dollar for every federal tax dollar that they gat back.

Talk about "income redistribution."

Since conservatives are against income redistribution, how about we hold them to their principles, and quit subsidizing them.

Works for me.
Ray (Texas)
As usual, Krugman skirts the argument about Planned Parenthood. People that oppose abortion are not misogynists; they believe that abortion kills a living human being. Based on that belief, they seek to protect the innocent life of the baby. I can understand that not everyone thinks of an unborn baby as a human life, but that doesn't mean those who do are not motivated by sincere compassion. This is the same spirit that inspired the civil rights and anti-death penalty movement; protection of the defenseless.

In regards to low insurance coverage in regards to Texas, that's simple; we have a huge population that comes from cultures where private health insurance is a foreign concept. Thus, they simply don't understand/trust the idea of paying for a service they may not need in the future. Extending Medicaid simply reinforces this notion. That's why ObamaCare has always been a ridiculous solution to this problem.
Robert O'Keefe (Bullhead City, AZ)
If you oppose abortion, you should support Planned Parenthood and wish for its expansion. Its support of birth control programs over the years has prevented many thousands of abortions.
Steve Bolger (New York City)
You people believe children are God's punishment for sex. You believe you can't get to Heaven unless you make other people miserable in life.
Keen Observer (NM)
As someone who worked in health care in Texas, I have to call you out on the "don't want to pay for something they may not need" notion. The EDs in Texas, particularly rural Texas, are full of GOP- voting decriers of big government and its programs. They choose to spend their money to big trucks, beer and cigarettes rather than health insurance when it's available. They are massive consumers of health care resources yet stiff hospitals for their care, and expect the rest of us to pick up the tab. Even when they're told they qualify for local, state or federal programs than enable hospitals to get reimbursement for their care, they refuse. And hospitals can't do anything about it. It's the "keep your government hands off my Medicare" ideation, and it's been going on for a long time. And don't fool yourselves. The women in this demographic have abortions and use PP; they just don't advertise it.
Shelly (Asheville, NC)
I was impressed by Paul Krugman's comment that American voters do not pay enough attention to state and local politics. This truthful observation has led to what I consider a political disaster in my my home state of North Carolina. In 2012, the GOP establishment here succeeded in putting the final touches in what I would regard as a political revolution. Through gerrymandering combined with voter apathy, the Republicans created a kind of strangle hold on North Carolina government when they elected a governor and, worse yet, brought about large, veto-proof majorities in both houses of the legislature--this in a state where registered Democratic voters slightly out numbered Republicans.

Even those outside of North Carolina who follow politics know that the GOP in this state has not only given us the disgusting HB2 bathroom law, but has refused to accept federal funds for medicaid, has passed legislation aimed at restricting minority voting, and has enacted one of the most regressive tax systems in the country, where the rich pay less and the rest of us pay more in higher sales taxes.

During this political season there are signs that North Carolina voters are waking up. Our lamentable Governor Pat McCrory is trailing in the polls and there is a great deal of unhappiness with the performance of our out-of-touch legislature. Maybe a counter revolution is in the making in the Tar Heel state.
Gary Waldman (Florida)
Your second paragraph, Mr. Krugman, is of vital importance. The vast majority of laws that have a direct consequence on our daily lives are made at the state level. Our votes in off-year elections are essential. Voting for president is important, of course, but not nearly as consequential to our lives as voting for state reps, state senators and governor.

Yet I would venture to say that a huge percentage of Americans have no idea who their state reps are.
njglea (Seattle)
It sickens me to see so many women blindly wanting to defund Planned Parenthood. They must be victims of the ridiculous "religious" idea that women are less than human and not capable of making their own decisions about their bodies and lives. Those women are welcome to their own ideas but they are not welcome to force them on the rest of us. Don't use family planning, contraception or abortion if you don't want to. It's your CHOICE. Stop trying to legislate the bodies of others. It is UNCONSTITUTIONAL and socially unconscionable.
roger (white plains)
The red states tend to receive more from the federal government than the blue states, and yet they are the first to complain about contributing anything to the common good. In these states, perhaps, there is not such thing as the "common good." Only individuals. We in the North should stop funding them, except that it would only exacerbate the misery of these who need help.
FJP (Philadelphia, PA)
"Most Americans are, I believe, far more generous than the politicians leading many of our states. The problem is that too many of us don’t vote . . . realize how much cruelty is being carried out in our name."

I wish I agreed with you. I really, really do. I used to. I don't any more. There is a whole lot of meanness and selfishness out there. Just look at the photo accompanying the story. A whole sea of white middle class privilege that doesn't care if poorer, browner and blacker women and kids die. The cruelty doesn't just happen and the politicians agitating to defund PP, repeal Obamacare, make sure everyone has a gun and uses it, etc., etc. didn't just pop out of the ground one day. They are in office because people want them there. This is reality.
Phillip Ruland (Newport Beach, CA.)
As usual, Paul Krugman sees only what he wants to see. In this Obama era of defining economic success down to a 1% growth nub, saying California's healthcare exchange is successful is a akin to saying the Titanic got the better of the iceberg. Quality hospitals and doctors are, for the most part, unavailable on the California exchange due to MediCal level reimbursement. And now with heavy losses (due to heavy compliance and anti-selection rules), the carriers, save Kaiser, are doing their best to exit the exchange. Of course it didn't have to be like this. Obama might have listened to a few people across the aisle in writing the ACA law, and made it comprehensible, straightforward and reasonable for all parties. Instead we got a hugely complicated and costly health care bill rammed down our throats. Even in Krugman Demo heaven (California) it is an unmitigated disaster. I know, I deal in it everyday. To be sure, the Ivory Tower guys like Krugman at the NY Times will find some statistic telling us what a success it all is and attributing any failure to the GOP. Par for the course...
Bruce Olson (Houston)
They say Texas people are among the friendliest in the nation and proud of their strong traditions and heritage.

Truer words could not be spoken.

However, it is only skin deep.
Ludwig (New York)
It is actually a fiction that a fetus is "part of" a woman's body. There is absolutely no scientific basis for that belief.

Unfortunately, the people who oppose abortion most strenuously are people whose acquaintance with science is even less than that of NYT readers.

If you deny Darwin and believe that the earth is 6000 years old and that there is no such thing as global warming, then you have pretty much discredited yourself - scientifically speaking.

But just because the fetus has a bad lawyer does not mean it deserves to die.

The fetus has its own DNA, derived both from the father and the mother, and in a few weeks it has a beating heart. It is most manifestly NOT a part of the woman's body, merely inside it.

Does that mean that a pregnant woman has NO rights?

Of course she does, we are all entitled to arrange our lives in an intelligent way and that includes the ability to use contraceptives and have reasonable access to other reproductive means.

But her rights are not UNLIMITED. They have to be balanced with the rights of the fetus, and for that matter the rights of the father.
Steve Bolger (New York City)
There is no right to enslave women by impregnating them.
Urizen (California)
"California...shows how it’s supposed to work...the result has been dramatic success in holding down costs and reducing the number of uninsured."

Any report on ACA that's attempting to cast an upbeat spin, must equate having health insurance with having access to affordable health care. Recent polling showed that 39% of Californians with health insurance are worried about being able to afford routine medical bills.
http://kff.org/uninsured/

Of course, single payer would have addressed the medical cost issue much better than ACA and would have ended the uninsured problem but Krugman, tireless champion of the status quo, has referred to single payer as "politically impossible", even referring to Sanders' single payer proposal as akin to belief in unicorns.

The term, "politically impossible" is a euphemism for: congressional Republicans will shoot it down, but most Democrats would shoot it down as well, and Obama wouldn't even include a "public plan" in ACA. Krugman resorts to the euphemism because he's fully aligned with the corporatist/centrists who now control the Democratic party.

With every column, Krugman's tacit message shines through: all policy must stay within the corporate consensus. On health care, that consensus says: all health care dollars must travel through us first, and they've seen to it that 20% of our health care dollar becomes theirs.
Anne (Montana)
Yes. Local politics matter. It would be interesting if national tv covered some of these campaigns.
Electroman70 (Houston, TX)
Integrating that the picture for the article show white people protesting against Planned Parenthood. Trump supporters as well? I wonder if the people they perceive to use Planned Parenthood services are largely 'ethnic', poor, or illegal.
offshell (Chicago)
You missed one, a big one. Texas doesn't have cheap housing, unless you're comparing to NY or CA. But it does give massive tax breaks or even direct payments to businesses to expand in the state, i.e. good ole boy bribery on the public's dime.
Nfahr (TUCSON, AZ)
For once I believe that Trump is doing some good! Now, at last, cruelty against poor people, people without recourse, is out in the open. It has been hidden for too many years.
kellymac (New York City)
I lived in Texas for many years until a few months ago. The rhetoric you hear there is simultaneous hand wringing about abortion and "baby killers" while deploring how poor people have too many kids. They aren't interested in actual women's health or the health of those poor children when they come into the world.

And yes, there's misogyny there too - women using birth control? "I don't want to pay for you to be a slut." I wish I had a nickel for every time I heard thing when I advocated for expansion of family planning.
Steve Bolger (New York City)
People who hold simultaneous mutually contradictoery beliefs are schizophrenic, and most of those are paranoid too.
DP (atlanta)
It's a mistake to view everything through a racial lens - it's not always about race, sometimes it's about religion, sometimes it's about cost, sometimes it's about resentment - in this case towards the ACA and a desire to see it fail, which it may well in any number of states because it was a misguided mess from the beginning and we needed single payer or Medicare for all.

Opposition to abortion and to Planned Parenthood has been growing nationwide and is primarily behind Texas' funding cut off, not race. The religious right is driven by its own fierce anger and its desire to implement all sorts of dangerous laws. Texas' defunding of Planned Parenthood is an example. Those fetal "right to life laws" are even scarier.
ChesBay (Maryland)
Right-wing, ultra-conservative, anti-choice groups rage about the "sanctity" of life, but approve of the deaths attributed to unwanted pregnancy. They also like to execute people. They have no idea about the "Right to Life." They are mindless killers.
Dudley McGarity (Atlanta, GA)
If you Blue Staters think we are so cruel, why do you keep moving here? Oh, that's right, for our healthy economies, nice weather, affordable housing, and low crime rates. How about we make a deal -- if you move here, don't bore us with stories about how you used to do things up north. If you can't do that, just pack up your stuff and move on back to Chicago.
NS (New York)
Why then, are you reading a blue state newspaper if you don't want to be bored with those stories?
Xenia (Las Cruces, New Mexico, USA)
I don't think it's about race, actually. I think it's more feeling you shouldn't "have to pay for" anybody else, whatever their skin color. It seems to me that a large number of Americans have a very limited "in-group," consisting of themselves, their immediate family, and possibly their coreligionists. They don't seem themselves as part of a larger community of all Americans or even all citizens of a particular state. Combine that with contempt for anyone worse off than you ... and well, this is what we get.
hen3ry (New York)
Xenia, what most people miss is that there is good to paying for other people to have access to decent health care that they need. There is a societal good to seeing to every child's receiving an appropriate and decent education. There is also good in trying to have a minimum standard for housing and other things. What is the good? To try and ensure that our basic needs are met and to avoid such inequalities that can and often do destabilize a country. We have some prime examples in the past and in the present of just how much of a powder keg a country can be when its citizens perceive one group as having much more than everyone else or of most citizens having no chance to have a better life because the majority of life is controlled by a very small minority. The other part that people forget is that having wealth doesn't equal honesty, intelligence, goodness, or the ability to be a leader. It's what you do with what you have that counts.
Steve Bruns (Summerland)
Solipsism. Like Republican lawmakers suddenly "getting" gay rights when one of their progeny turns out to be gay, nothing is a problem until it happens to them. Lather, rinse, repeat. Too bad we don't have enough time to let tham all experience some hardship and thereby gain a bit of empathy.
Howard (Boston)
Due to the actions of Republican politicians thousands of Americans are dead.
The Republicans in charge of Texas are mass murderers.
doug hill (norman, oklahoma)
Republicans here in Oklahoma hate President Obama so much they can't think clearly. Not expanding Medicaid here means that many of our small town hospitals are teetering on the brink of insolvency. But our GOP leaders would rather see that than submit to the President's perceived tyranny.
Eroom (Indianapolis)
Does the majority really hate the President that much......or is the loud voices of the "haters" are the only ones that are heard while voices that disagree tend to keep quiet due to the hassles likely to ensue at the hands of the haters?
Steve Bolger (New York City)
Pacifying gun brandishing psychopaths is all our politicians can do.
Ben Alcala (San Antonio TX)
"The point is that America would become a better place if more of us started paying attention to politics beyond the presidential race."

Well Dr. K I have only one thing to say to this: DUH!

From personal experience a committed Hispanic socialist does not stand a chance when the state he lives in is overrun by barely-literate borderline-racist White people voting GOP even though it goes against their economic interests:

http://userctl.com/BlueVsRed/001.png

It does free me up to vote my conscience, so I don't have to vote for the corrupt war-mongering elderly White woman this time around:

http://userctl.com/BlueVsRed/061.png

The big problem is that with Hillary Clinton's nomination the Democratic Party is no longer the party of the little people but of the rich and their corporations.

Move the national Democratic Party HARD TO THE LEFT and the GOP will have to scramble because they would be playing defense instead of offense like they have been since Reagan.

It sickens me to see "thought leaders" like you excusing Hillary as "flawed" but not damaged and her lies as "fibs" just because she supposedly is somehow "better" than "The Donald".

I would LOVE to see your investment portfolio, I am willing to bet that you have a lot in bonds so as such you are willing to tolerate another four to eight years of gridlock.

We little people can't really stand any more gridlock so you do us, and by extension this country, a great disservice:

http://userctl.com/BlueVsRed/036.png
Naomi (New England)
Ben, do you honestly believe the entire country is secretly just dying for a move hard left, if only the Democratic leadership could stick to it?

You are as delusional as Trump, and you're blaming Clinton for living in the present reality. Do you know how FDR got popular consensus for his leftward move? By allowing states to exclude people of color from the program.

There are still too many people in this country who would rather stay in poverty than share prosperity with black people. Hard left would LOSE the election, and losers get nothing in our winner-take-all system. I'm sad we are that way, but we have to base political strategy on the actual electorate, not one that may someday exist. On the bright side, Clinton's primary successes in the south may come in handy this election!
Ian Maitland (Wayzata)
Don't they teach in kindergarten that post hoc is not propter hoc?

Of course, Krugman knows this, but he can't control himself. He's no fool, so we are left with only one explanation -- he is a charlatan.

It's not just elementary logic that Krugman has sinned against. There is the question of his sources. To paraphrase the Bible, by their sources ye shall know them. Well, as in this case, Krugman has increasingly outsourced his research to advocacy groups and organizations and propagandists. Is it asking to much for him to support some of his most outlandish claims with citations to peer-reviewed research? Goodness knows, that is a low enough standard that Krugman should still be able to cherry-pick his results.
Knorrfleat Wringbladt (Midwest)
Simply stating that correlation is not causation is pretty thin soup. However I would expect that from a number of your arguments. Your support of unregulated capitalism to the exclusion of the "common good" is one of the leading causes of business greed that results in 1% of the population owning more than 50% of assets. Following your ethical system for business leads to medieval serfdom.
Is there an endowed chair of "Esurient Sociopathic Oligarchs" at the Carlson school?
Ian Maitland (Wayzata)
Knorrfleat:

Thanks for adding "esurient" to my vocab.
You say that it is "thin soup" to point out that correlation does not mean causation. On the contrary, it is about a fundamental fallacy. It all goes to show that Krugman thinks he is above the rules. It means, for example, that you can't trust any factual claim he makes unless you verify it for yourself. And that goes for his rants about how America is becoming an oligarchy.
lastcard jb (westport ct)
Ok, best article i have read all week, the heck with everything else, this lays it out in Un-PC terms : https://thecontrarianblogger.wordpress.com/2016/08/24/the-morons-case-fo...
Social Worker (Stony Brook University)
there are many other clinics to go to for prenatal care ??
Facts Matter (US)
Thanks to right-wing media, there is a widespread notion that the government "funds" Planned Parenthood in the sense of allocating certain funds to simply give to Planned Parenthood. This is simply false.

Planned Parenthood receives money from the government only through PAYMENT FOR SERVICES RENDERED to recipients under certain government benefit programs.

Planned Parenthood is merely one of thousands upon thousands of entities qualified to receive insurance reimbursement from such programs, notably Medicare and Medicaid.

Another example of such an entity is the medical practice of the family doctor who takes care of your grandma through Medicare payments.

The government is no more "funding" Planned Parenthood that it is "funding" that family doctor.

Abortion, which accounts for only 3% of the healthcare delivered by Planned Parenthood, is excluded from services covered by Medicaid and Medicare.

Despite the best efforts of Roger Ailes and his imitators, facts still matter -- even in Texas.
H Prough (TN)
I'm sorry to say...facts don't matter when you're trying to discuss them with someone clutching a bible in one hand and a gun in the other. At least, that's been my experience.
John Townsend (Mexico)
The GOP voted down the Fair Pay Act relegating women to earning 75% what men are paid for the same work. The GOP regularly denies women the services they need to care for themselves and their families from Planned Parenthood to FMLA to SNAP, to paid sick leave. The GOP supports TRAP laws to cut off access to legal and safe contraception services. Both Trump and Pence support these policies.
Cheekos (South Florida)
Consider that the House's proposed bill, short-changing the Zika battle, included a poison pill to defend Planned Parenthood, which provides family planning to many poor women on Medicaid. Many of the same states have not accepted Extended Medicaid and teach only abstinence in sex education. Lastly, the GOP denies global warming, which WHO believes makes the spread of the Zika Area larger, and also accelerates the life cycle of the Aedes aegypti mosquito.

Whose side is the Republican Party on when it comes to combatting the Zika virus?

https://thetruthoncommonsense.com
Jasr (NH)
"Consider that the House's proposed bill, short-changing the Zika battle, included a poison pill to defend Planned Parenthood, which provides family planning to many poor women on Medicaid."

An apt example. Not only do Republicans short change an effort to combat a potential epidemic for political gain, but they combat poor women's ability to control their own fertility. It is a perfect storm of oppression: 1) eliminate effective planning for the poor, 2) hamstring efforts to reduce transmission (and develop a vaccine for) a dangerous virus that is known to cause birth defects that affect humans for life, guaranteeing that some poor women will be saddled with the care of severely disabled children, making it almost impossible to escape dire poverty.

"Cruelty" doesn't cover it.
Bob (Rhode Island)
I'm just waiting for the inevitable war between Sunni texans and Shiite taxans to start.
I mean take away the denim and those ridiculous cowboy hats and texans are indistinguishable from any jihhadist in the Middle East.
And with such generational hatred toward everything that's different texans are going to eventually turn on each other.
Call it what you want but it's comin'.
When you hate everyone you see eventually you'll pass a mirror and begin to hate yourself.
Let's hope that happens sooner rather than later.
scott k. (secaucus, nj)
Why are politicians who get the BEST health insurance in the world, being asked to decide whether EVERYONE should have the same?
Bob (Rhode Island)
You know what?
Texas IS like a whole other country...and that country is Syria.
And like Syria texas too treats women like cattle.
John LeBaron (MA)
Dr. Krugman writes, "Most Americans are ... far more generous than the politicians leading many of our states." No argument here, but then giving table scraps to a dog would be more generous than the likes of Greg Abbott, Sam Brownback, Rick Scott or Pat McCrory, to name but a few. The genorosity bar in the Planned Parenthood destroying, Medicaid-denying states is really, really low.

OK Bowser, beg! Beg! Good dog. Good dog!

www.endthemadnessnow.org
brupic (nara/greensville)
if they're far more generous, why are they electing whom they elect?
Buoy Duncan (Dunedin, Florida)
I've always found it interesting that conservatives rail against a potentially monstrous and intrusive Federal government when local government can have you thrown out of your house at 2:00AM for a building code violation and homeowner associations have tried to confiscate homes that didn't use regulation garbage cans. It was not the Federal government that cited me for having grass over eight inches tall . For government that disrespects our unspoken rules about decency, look locally
A.G. Alias (St Louis, MO)
"America would become a better place if more of us started paying attention to politics beyond the presidential race." Yes, but unfortunately Republicans are far better at mobilizing voters, making the situation far worse than it would otherwise be.

After president Obama was elected, "We want to take the country BACK [from the BLACK 'SOCIALIST' or 'MUSLIM']" message spread widely in the rural white God-fearing, church going, conscientious communities. They were also led to believe they'd be quite successful in that endeavor.

Meanwhile the passive Democrats, especially the minorities kept savoring the wonderful achievement of electing a black president, which they never expected would happen in their life & as usual didn't vote in midterm elections.

If at all Bernie's army ever going to be successful, their primary objective ought to be to register the maximum number of minority voters & mobilize them. Convince them of the peril of not voting in midterm elections. In a decade or 2 there would be substantial improvements.

In midterm elections get as many progressive measures in the ballots as possible, like a California-model progressive state income tax - top state income tax rate in CA is >13%, in MO it is only 6%, but believe it or not, a majority of Missourians pay at higher rate in state income tax than Californians do!
Robert Crosman (Berkeley, CA)
The people in the picture above the column, mostly women, believe that abortion is murder - which is a defensible position, at least once the fetus is viable. What is hard to understand is why they don't exert their energies to help women prevent unwanted pregnancies, through better sex education and access to contraception, and to facilitate adoption of unwanted babies, which are in huge demand. The conclusion one is forced to draw is that they want to punish unmarried and poor women who engage in sex, which is a far different agenda from the prevention of the murder of unborn children.
John Townsend (Mexico)
Both Gov Perry and Sen Cruz of Texas set the example of remarkably crass politics. Their state is ranked first for the number of people with no healthcare coverage at all ... fully a third of its population ... a condition which they deliberately precipitated by refusing provisions of the ACA
L’Osservatore (Fair Verona where we lay our scene)
Hey, everybody! Did you know that, by definition, anyone not buying in to the government supporting the profitable abortion industry is therefore cruel?

Yes! They are not only ra-a-a-a-a-acist, mean, ignorant, crazy, nihilist, populist, religious, patriotic, AND don't drive fast enough in cars too nice for them, but are now cruel as well?

What would we ever do without a former economist keeping us ahead of the trends like this? Thanks, Gramps!
Keep posting (NY)
I appreciate comments like these because I suspect they have the unintended effect of driving the young and undecided toward the decency of Democratic liberalism.
fouroaks (Battle Creek, MI)
Well, 'O' I disagree with you about the 'patriot' part, but for the rest, your mirror seems to have it nailed.
ACW (New Jersey)
'The problem is that too many of us don’t vote in state and local elections'
I've lost count of the many, many comments i've posted over the past several years pointing this out ... . Thank you for waking up, Rip van Krugman.
Ego alert (NYC)
ACW --

If only Paul Krugman had more time to read your comments!

You're not the only one who has lost count of your posted comments. Perhaps it's time to abandon the comment boards and mail personal letters to New York Times columnists?
ACW (New Jersey)
Ego alert. Sigh. I'm not complaining specifically about Krugman not hving time to read my comments personally. I am complaining about his utter obtuseness in suddenly figuring out 2 + 2 equals 4.
I am far from the only one who has been saying this all along that although the left has bleated the slogan 'think globally, act locally', in practice 'liberals or progressives or whatever they're calling themselves this week' have patted themselves on the back for voting for Obama, big whoop, while ignoring the lower-office races where their votes might actually make a difference. And that the right figured this out long ago and have been taking over your school boards, town councils, county freeholders, state legislatures. And then you wake up one morning and wonder why your schools are teaching 'intelligent design', oil tankers are running through your backyard, and your community garden has been sold to a developer for luxury high-rises. But hey, you were one of 60M votes for Obama!
And it might do Krugman good to read a few of his critics, rather than relyiing on his echo chamber.
nb (hartford)
Does anyone know why the Democrats have neglected working at the state and local level in many localities? Are they out of focus, clueless, or outnumbered? Do the Dems need better leadership?
Maybe Will Rogers was right about belonging to a disorganized party.
JP (California)
Time to move to Texas.
Ellen (Chicago)
It seems that the state of Texas has shown the rest of the country what happens when access to women's health care is restricted especially to poor women. The state of Colorado provided quite another experiment in women's health. They gave women and teenage girls access to long term contraceptives. This resulted in a 40% reduction in teen pregnancies and a 42% reduction in abortions.

Colorado's Effort Against Teenage Pregnancies Is a Startling Success ...
www.nytimes.com/.../colorados-push-against-teenage-pregnanci...
The New York Times
Jul 5, 2015 - A program to offer long-acting birth control, like free IUDs and implants ... a difference that advocates say gives young women time to finish their ...
LAllen (Broomfield, Colo.)
Yes, Colorado's program of providing long-term birth control for free was a raging success. It should be noted and noted and noted again that the state's republicans killed this program as soon as they could, which was about 5 minutes after they retook the state senate in 2015. Reasons given were ideological and fiscal.
Gerard (PA)
Stop paying for preventative women's health care at a national, cost-effective supplier!
[ amended protest placard ]
DTB (Greensboro, NC)
Why should the public fund a group which maintains a political advocacy PAC?
Brian (New York)
There is no medical supplier in any segment of society that does not maintain a political advocacy PAC. All physicians are members of the AMA, all hospitals are members of both state and federal versions of the Hospital Association (in NY it is known as NYHA) and every type of specialty provider, from pharma to medical equipment to home care agencies to nursing homes have their own lobbying groups. Even the health insurance plans do. To act as if Planned Parenthood should simply stand there and allow Congress to hurt the patients that they are trying to serve without opening their mouths or utilizing the same strategies that every other entity in America uses is ridiculous.
Mr Bill (Rego Park, Queens, NY)
(1) Because PPFA and the PPFA Action Fund do not share funding and operate independently of one another.
(2) Because PPFA's activities reduce public expenditures on health care.
(3) Because it is in the public interest to save lives of members of the public.

Any further questions?
Jasr (NH)
"Why should the public fund a group which maintains a political advocacy PAC?"

The need is for the public to fund primary care and family planning services for women and families who can't afford them.

Not the political advocacy PAC.
Charlotte (Florence MA)
Paul, You are absolutely right. If i you care at all, vote in local elections, please!
It takes a village.
Mr Bill (Rego Park, Queens, NY)
"Pro-life" = Killing pregnant women. "Orwellian" doesn't begin to do it justice. Maybe the term "womanslaughter" would.
sdw (Cleveland)
Political parties often get trapped by catch phrases or slogans which they have created to rally supporters, and Republicans are much more susceptible to such traps than are Democrats.

Republicans use single-word rallying cries like “Benghazi” to play upon the anger of the party faithful, even where the facts do not really support what an average conservative believes. Remember “Acorn” which hasn’t existed for several years? Some right-wingers still mention it.

In Texas, the dismal and tragic record of a third-world death rate for pregnant women can be traced, in part, to the catch phrase, “Planned Parenthood.” The phony videos were discredited long ago, but the G.O.P. still relies on the phrase, and Texas women suffer.
Doug Terry (Maryland)
JOB GROWTH IN TEXAS: no unions to speak of, local and state governments that will do the bidding of corporate power and, very important, big houses on comfortable, lawn covered lots at half or less the price of the east and west. You can even get a pool in the back on a strong middle class income.

Other factors: Not too much worry about worker safety issues. Lots of space to dump industrial wastes, much less concern about being caught violating standards.

Texas is a punishment oriented society. This comes from the lingering influence of the frontier days, which only ended a little more than 100 yrs. ago. You work hard or you don't get anything. Touch anything that doesn't belong to you, judges will do the max to put you away. Low social benefits for the poor? They want the workers pliable and ready to work hard for low pay. If they are paid not to work, then why would they bother?

Until very recently, prisons were seen as an economic growth industry to bring jobs to small towns. Give people no assistance to survive, let them commit crimes and then make money locking them up. It costs much more to punish people than to help lift them up, but who's counting?

In the governmental and social senses, Texas is a mean place. The people who back those attitudes are what is generally called the working economic class. Those who don't have all that much themselves are firmly in support of these get tough, stay tough policies, even when they impact their own lives in negative ways.
Doug Terry (Maryland)
Adding a couple of points. On the job growth issue, many of the "Texas jobs" come from luring, stealing, corporations from other states. A great deal are in the defense industries (federal taxes) and the cyclical, up and down of the oil business, which regularly goes boom and bust. If you offer corporations a low tax, low regulatory environment with lower wages generally, which one isn't going to take it?

In personal relations, Texans are generally much more friendly and welcoming than other regions. Visitors notice this immediately. The friendliness can be surface or superficial, but the public kindness is most welcome anyway. Just don't cross a Texan** unless you want to be eating a bowl of fire ants for breakfast. Many believe in rough justice all around.

**What does it take to cross a Texan? Anything you do that he doesn't like or appears to push back against his choices.
Donna Gray (Louisa, Va)
It's no surprise that Mr. Krugman ignored examples of real cruelty from the left. For example, after liberals sued to obtain donor lists during the California Gay Marriage Proposition campaign, even the NY Times covered firings of some individuals, and boycotts of companies associated with them. This was for merely donating to a political cause. There was no claim of discrimination, only that hey expressed the 'wrong' opinion.
rs (california)
Ahh, yes, the conservatives' demand that liberals tolerate -- no, embrace-- their intolerance.
Eroom (Indianapolis)
False equivalency!
kswonderland (KS)
Can you give any actual cases, i.e. time, places, dates, people, etc?
Gary (Oslo)
Republicans love America, but Americans? Not so much.
Nancy Rockford (Illinois)
The Republican Death Panels in action.
mgaudet (Louisiana)
I don't think that it is just about race. It is more about Republicans just not wanting to help the little guy.
Eroom (Indianapolis)
Especially if he or she is black!
JWL (Vail, Co)
Seems to me the rejection of the ACA by red states is associated with their view of every man for himself. Of course, if this philosophy had held with the U.S.founders, there would never have been a reason to come together as a country. We would be a loose confederation of colonies, without a common military, without interstate highways, without a federal government, courts, education, healthcare. In other words, we would lack infrastructure and we would be weak.
Every state that turns down federal money to help their economic underclass, is rejecting help that affects all it's citizens. Whether planned parenthood or Medicaid, they will have more sick people to care for, draining their coffers, and the taxpayers end up paying those bills.
Carl Ian Schwartz (Paterson, New Jersey)
"Every man for himself." "Jenem das Seine"--"To Each His Own"--was the motto over the gate to Buchenwald.
MLB (Cambridge)
So the economic case for being cruel to the unfortunate has lost whatever slight credibility it may once have had. Yet the cruelty goes on. Why?

There are many reasons including the corporate takeover of the Democratic Party over the last 35 years, which help suppressed real public policy debate between an America that embraced true equality of opportunity or an America that focused on maximizing corporate and unrelentingly slashing taxes for the 1% while cutting back on LBJ type programs. The voter apathy you speak about in your op-ed is a directly linked that the suppression of real public policy debate by so-called "progressives who get things done." (You know, the candidate you endorsed while she was running against Bernie Sanders.) While I will vote for Clinton this November to prevent Trump from moving into the White House, I and many others will work to refocus the Democratic Party on bringing back a "government of the people, by the people, and FOR THE PEOPLE."
Woof (NY)
Mr. Krugman, a trade economist, does not read the literature on Social Science and Medicine. He should . Here is one of the most cited papers from the field

" The impact of public spending on health - does money matter ?

Abstract

We use cross-national data to examine the impact of both public spending on health and non-health factors (economic, educational, cultural) in determining child (under-5) and infant mortality. There are two striking findings. First, the impact of public spending on health is quite small, with a coefficient that is typically both numerically small and statistically insignificant at conventional levels. "

"whereas health spending is not a powerful determinant of mortality, 95% of cross-national variation in mortality can be explained by a country’s income per capita, inequality of income distribution, extent of female education, level of ethnic fragmentation, and predominant religion."
Deon Filmer, Lant Pritchett

(Social Science & Medicine. 49, Issue 10, 1999, 1309–132)
Andrea Hawkins (Houston)
Is this citation almost 20 years old? Typical cherry-picking of data.
I finally got it also! (South Jersey)
Paul, you are correct about the Red States of Cruelty. The overweighted effect of the right wing conservative 'small government' movement on the middle and lower income classes across the bible belt and south is reprehensible. Fortunately, the federal appellate courts and the SCOTUS has started to call out these states governments for what they have become once the republicans take control of their legislatures; bigots, racists, and cruel haters who's actions are nothing more that unconstitutional efforts to leave behind vast majorities of their populations, without the social nets that have propelled this country forward from a dismal past for the last 40 years through LBJ's Great Society, though disenfranchisement, though not expanding medicare, medicaid and or expansion of the Affordable Care Act. Add the salt and pepper spice of denying family planning services to the impoverished who cant afford to have raise or feed a child in a world of reduced healthcare options, welfare options, educational options, housing options, and you have a perfect storm equal to that of the youth of the Middle East! No hope! What is the result??? Oh, you got it; the next generation of bigots, and haters who will vote for .......... The great White Hope? Trump!! WIll he deliver? Surely not....... His rising tide will not raise the ships let alone the hopes this country need to be raised!!! We lived through 30 years of this empty talk!!! The Gingrich Revolution must be declared DOA.
Penningtonia (princeton)
While I agree, I believe that you left out the religious component. Evangelical Christianity is mean-spiritedness personified. They are no different from the Taliban
PAN (NC)
The GOP has a "RED Stain" on their hands, and it is not from the color of their state. They are now extending their cruelty to the Zika virus and the poor who may benefit from Planned Parenthood services. The GOP, with Trump as their new leader, has a fetish for cruelty.

The GOP does not need an economical case for cruelty - just look at Guantanamo Bay; it may as well be another Red State - 51st US State of cruelty - founded (as it currently exists) by Republicans.

For those who can afford it - Live Long And Prosper ... More.
James T ONeill (Hillsboro)
In a nutshell, what the conservative politicians in states like Texas are saying" your health and therefor your life does not mean a tinker's damn to us". End of story!! (but by the way we can afford to spend $ 60 million on high school football stadiums)
Kai Melling (Saarbrücken)
Ah excuse me, but I can't think of a more cruel, hateful and unfortunate act than killing your own child.
Daniel (Miami Beach)
By "killing your own child", I'm sure you mean having an abortion.

You may believe that life begins at conception, and you have a good, scientific basis for that belief (but not a religious one; there is nothing I'm aware of in the Bible about abortion).

There are others, myself included, that do not believe life begins at conception. About 25% of pregnancies end spontaneously, but nobody (at least nobody I ever heard of) would think about having a funeral in such a case. I have a very good, scientific basis to not believe that life begins at conception, primarily that a zygote, and even a fetus up to a point, cannot survive biologically independent of the mother. So, that zygote/fetus, in my view, is not a "human", and terminating a pregnancy is not murder. It is simply a decision that a person can make about their own body. We can agree to disagree about that, and both be considered reasonable people.

However, when you insist on referring to such a decision as "killing your own child", when you consider it, and communicate it as, murder, some among you will clearly see that killing anyone that provides such services, or assists in providing such services, is justified.
Steve Bolger (New York City)
The US really has cultivated a mob of ignoramuses who believe all their own troubles result from God's alleged wrath over legal abortion.
Jed (New York, N.Y.)
20 years ago, I talked with an affluent Republican woman in south Florida about abortion. She was conservative, but completely pro-choice? Why? She succinctly stated: when I was growing up the lack of access to abortion services meant death by sepsis for young women. Restrict access and death rates will rise again. So, it's a simple equation.
Daveindiego (San Diego)
How long does the Kansas experiment need to fail before the people of Kansas accept the facts?
doug hill (norman, oklahoma)
In recent Kansas elections moderates made gains over Tea Party Republicans, so there are signs of hope there.
Ned Roberts (Truckee)
A more nuanced view - one less critical of those "cruel" people who resent government welfare - is found here:

http://www.motherjones.com/politics/2016/08/trump-white-blue-collar-supp...
JSD (New York, NY)
While I am generally on the same page as Professor Krugman, this statement shows breathtaking naivety on his part:

"Most Americans are, I believe, far more generous than the politicians leading many of our states."
confetti (MD)
Kiberals are optimistic, our principles still tethered to the Perfectibility of Man doctrine. We even get hung up on tolerating intolerance. We try to prove that mean bigoted bullies are that way because they've been economically wounded. It's sometimes fatuous and hopeless and absurd, but when all's said and done it's the best way to fly - just affirming best hopes and rolling with disillusioning punches.
And keeping one's horse tied to a tree.
JSD (New York, NY)
Well said, confetti. However, I would distinguish between our aspirational philosophy and the reality that we must face in November, 2016.

I would love to indulge the fantasy that at heart the people voting over and over to defund their fellow citizens are simply being misled by politicians secretly beholden to special interests. If we could only elucidate a better way and take away the economic pressures leading them to the GOP, they would be happy to follow their generous nature to a more enlightened politic.

Unfortunately, it's just not true. People are voting the way they do for a reason and the South has voiced a consistent message since the Civil Rights Era. They are so committed to keeping down minorities, they will vote over and over to keep themselves in poverty, to vote for anything that may give them a step up or a path out of squalor. They seem resolved to accept any economic injustice, just as long as it doesn't raise up you-know-who to the same level.

As liberals, we need to face the hard truth that certain voters just are not operating on the basis of good faith or thoughts about what is best for the country. Once, we can accept that, we can start to deal with the problem effectively (i.e., as a matter of brute power) rather than continuing to yell into the wind at voters who will never never never accept a paradigm of equality.
Eroom (Indianapolis)
As a resident of Indiana, I can attest to the fact that local action can make a big difference. Before being tapped as Trump's running mate, our arch-concervative Governor, Mike Pence was headed for defeat in his reelection bid. I can also attest to the fact, however, that a 50-State strategy on the part of national Democrats can make a big difference as well. In 2008 Indiana went "blue" in the Presidential race for the first time since 1964. Then in 2010 Democratic national leaders promptly went back to the failed "targeted states formula," writing Indiana off as hopeless and hanging us out to dry. As a result, the increasingly radical Republican Party was able to overwhelm the state House and Senate races and gain a "supermajority." In these circumstances, voters remained largly uninformed regarding the actual issues the GOP intended to pursue and Democrats couldn't afford to get their messages out. We can do a lot locally....but this wave of right-wing extremism at the state and local level will never change unless national party leaders stop writing us off and dare to tell the truth.....that the Donald Trump phenenomona is not an aberration but rather a daily reality in the so-called "red states" where people like Trump have ruled for years and only fear electoral challenges from further to the right!!
confetti (MD)
This is really crucial. We more and more have two Americas, with large swathes of the country mistreating the citizenry in really atrocious ways. Then again, access to info is denied to no one nowadays - citizens get exactly what they vote for. Change that.
Andrea Hawkins (Houston)
Yes, the Democratic establishment didn't seem to like Howard Dean's 50 State approach even after it was quite successful. I've always wondered why that was the case. Makes as much sense as the cruelty of the Republican states being discussed here.
Mr Magoo 5 (NC)
Krugman,
It's time (NY Times) to stop telling us what you think you know. That fact is you cannot legislate morality.

Thomas Jefferson said. “Indeed I tremble for my country when I reflect that God is just. But it is impossible to be temperate and to pursue this subject through the various considerations of policy, of morals, of history natural and civil. We must be contented to hope they will force their way into every one’s mind.” (1781 Notes on the State of Virginia, Query 18)
Sudhindra (New Jersey)
I tremble for any country that brings god out to government. God is just. God is great. God willing. Gawd!
Eroom (Indianapolis)
So you think Krugman is advocating the legislation of morality and Republicans and their Evangelical allies are not?!?!?!
Mr Magoo 5 (NC)
Eroom,
So, you think you know what I think. You think you know what is my religious beliefs and political party.

What presented by me lead you to that conclusion? Like Krugman, you need to give just the facts and not what you think you know.
Alexander Bain (Los Angeles)
Between Zika and the Texas Legislature, pregnant women are in a tough place. And both pestilences are getting worse. Texas children will bear the brunt of this.
jprfrog (New York NY)
It has been evident for a long time that underneath all of the spurious "reasoning" and moralizing about who deserves help and who does not, there is an underlying theme: a desire to inflict pain. Trump personifies this; when he describes his "plan" to uproot and deport 11 million people he seems to be enjoying himself, practically salivating at the thought of the misery he is planning to create. And his crowds eat it up --- the cheers in response to his outrages have the sound of the lynch mob baying for blood.

Anyone who has engaged in conversation with a fundamentalist has also encountered this phenomenon: when they warn you that unless you embrace Jesus that you will burn forever, they almost seem to be savoring the prospect. Saint Augustine put it so: "They who shall enter into [the] joy [of the Lord] shall know what is going on outside in the outer darkness. . .The saints'. . . knowledge, which shall be great, shall keep them acquainted. . .with the eternal sufferings of the lost.” The theme was a favorite of Jonathan Edwards as well.

It seems that all too many of our "Christians" can't wait for the afterlife in order to watch the unworthy (e.g. the poor) being tortured...they want to speed up the process right here on Earth.
hen3ry (New York)
"It seems that all too many of our "Christians" can't wait for the afterlife in order to watch the unworthy (e.g. the poor) being tortured...they want to speed up the process right here on Earth. " jprfrog, it's one of things a friend of mine points out to me when I say I don't understand people. He says that many evangelicals believe that the current world doesn't matter. It's the hereafter that counts so nothing needs to be protected, fixed, or prevented. Funny, non-Christian that I am, I always thought that the main idea of Christianity was charity, good works, and helping others to have decent lives, and not executing others, forcing women to have children they can't support, and punishing the poor.
Andrea Hawkins (Houston)
They think this way because they focus only on one of Paul's letters that the only thing needed to be saved to declare Jesus your "personal" savior and you are born again. They conveniently ignore Jesus's actual teachings. This wholly a construct if evangelicals. You will not find this in Roman Catholicism or Mainline Protestant religions. How surprised will they be when instead of the Pearly Gates, they experience the Gates of Hell.
Radx28 (New York)
Republican policy is a silent, but effective killer of "others" who don't meet Republican standards as humans.
Joanne (Canada)
The irony of this is striking, isn't it? It's precisely what they accuse pro-choice people of doing to the unborn that they feel perfectly righteous in doing to others so long as they are outside of the mother's womb. You cannot be pro-life and deny support to the children you are clearly responsible for having been brought into the world. Either put your money where your mouth is and give help to the poor, as the Jesus you claim to follow demanded, or acknowledge that you worship money and are in fact not pro-life but are rather pro-birth and believe children are God's punishment on women for having sex. They focus so much on abortion that they don't see the motives behind it for pro-choice women like myself: I believe that children are a blessing to those ready and able to care for them, and I want to support women in that endeavour. If providing abortion now allows them to love and care for children 10 years from now(or never, if that is their choice), then everyone is better off. If conservatives shouted about the rights of underprivileged people they've never met as loudly as they do about the rights of unborn children they have never met, suffering for all in the United States would be a distant memory.
Bruce Joffe (Piedmont, CA)
So, why don't poor folk in red states know that their government leaders are depriving them of better health care?
confetti (MD)
What nice liberals hate to say is that they love their hatreds more than they love their health.
mikecody (Buffalo NY)
As an economist, I am sure that you have taken many courses on statistics. Given those courses, and the oft repeated mantra "Correlation is not causality", I find your statement "the death surge does coincide with the state’s defunding of Planned Parenthood" to be, at best, misleading.
Mary C. (NJ)
Nonetheless, it was the appallingly high death rates of pregnant women (from self-induced and back alley abortions) that "caused" SCOTUS to decide Roe v. Wade as it did. And from the mid-1970s the mortality rate of pregnant women has plummeted--an extraordinary coincidence? No cause-effect involved?--really?
Dodgers (New York)
Are you being misleading when you claim to be an economist?

Krugman's statement is clearly not saying that one thing caused the other. He is using "coincide" as a synonym for "correlate."
Haim (New York City)
So, the researchers who actually know something about the subject "are careful to say that it can't be attributed to any one cause," and our Nobel Prize-winning opinionater knows that the first rule of statistics is: correlation is not causation.

And yet, Paul Krugman goes ahead and implies causation.

And that is why I have not been able to read past the first paragraph of Krugman's essays, for a long time.
Brian (NY)
Too bad. You're missing a lot. BTW, as usual, Prof. Krugman does not,in this article say the surge in deaths is caused by the closing of the clinics. He leaves it to us to make the determination.
Thanny (NJ)
It's not about race.

It's even more stupid (yes, stupid) to say it's about misogyny. Just have a look at that picture above the column. What sex are the majority of people in it?

This is the kind of nonsense that turns moderates towards the disaster that is Trump.
Sudhindra (New Jersey)
Many women are complict in putting women down. This is a well known phenomenon. The women in the picture are either misled by religion or motivated by racism or merely accessories to misogyny.
A trumper needs no excuse beyond the above.
florida IT (florida)
Florida's Rick Scott is part of the problem. He slashed mosquito control budgets and is now whining that the federal government isn't doing enough for Zika failing to mention the republican requirement to defund Planned Parenthood with the Zika funding. He doesn't want the poor to have access to birth control and health care support and if pregnant they must carry fully to term everytime regardless of health issues but cruelly they also slash support for needy families.
Jose (Arizona)
I'm amazed at the ignorance of many Americans. They don't vote, and when the Presidential election comes along they complain of the poor choices they have. Then they think voting third party will change the system, when all along its because they don't vote.
mdalrymple4 (iowa)
I will never understand why people continue to vote for the party that deprives poor people of rights - the republican party. it is time for all women in Texas (and other confederacy states) to vote out these horrible sick republican politicians.
RJ (Londonderry, NH)
Hey, they can have all the "rights" they want - long as it doesn't take my tax dollars to provide them.
Andrea Hawkins (Houston)
Every one of your "rights" requires my tax dollars. I am more than happy to withhold them from you - no right to bear arms, no right free speech...I can go on.
mdalrymple4 (iowa)
I seem to have no choice but to pay for your wars even though I am peace loving.
blueberryintomatosoup (Houston, TX)
Let's remember that Republicans so despise Obama that they vowed, on inauguration day, to obstruct anything the president did. The cruelty, by the right wing, towards those less fortunate was already a given. Add that to the hate for Obama, and we have Republican controlled states trying to score political points with no concern for the impact their actions have on the poor and on the health care systems they depend on.
Any time I encounter someone who would have benefited from the expanded Medicaid, I let them know why Medicaid was not expanded in Texas. A few of those people are very much against the president and the ACA. I let them come to their own conclusions about the effects of not voting or voting against their own interests.
Brian (New York)
Unfortunately, while "one sociopath in the White House can ruin your whole day" 248 sociopaths in the House and 54 sociopaths in the Senate can ruin your whole life. All of these men and women, predominantly white, wealthy and oddly not all male, make daily decisions that negatively impact women across the spectrum in ways that remove options for care and that can truly devastate the life of the individual woman. I am always amazed that the women of America stand idly by as their rights are removed and their lives are controlled by the idiotic decisions of our House and Senate. I ask myself almost daily: When will they stand up? When will they vote for themselves? When will they take control and end this madness?

I fear that the answer is: Not too soon.
Diana (Centennial, Colorado)
One thing that should be pointed out is that the religious right plays a part in controlling a portion of what goes on in the Red States. It is they who lead the fight to end a woman's right to choose, no matter the cause nor reason, even in the case of rape or incest (which has been incorporated into the Republican Platform). Unless and until separation of Church and State is enforced, this saga will continue.
In the Red States, the draconian laws denying access to abortion have been focused on misogynistic control of women, cloaked in the pretense of protecting women's health. Thank goodness some of these laws are being struck down. However make no mistake about it, if Trump wins the White House and Republicans maintain control of Congress, a right wing Supreme Court Justice will be chosen, and then all bets are off concerning what happens not only to women's rights, but Obamacare, and civil rights in general.
This election will determine the course of history in this country. Will we maintain what so many have fought for in terms of social programs, women's rights, and civil rights, or will we slide into a fascist state, with a leader who hasn't the temperament nor qualifications required to be President? This time next year a newly elected President will be well into his or her first term in office. That thought keeps me awake at nights.
I agree with Dr. Krugman, we need to change the balance of power from the bottom up if we are to progress as a country.
Mountain Dragonfly (Candler NC)
However, the sacrosanct adulation of the Second Amendment, with its misinterpretation, under a Trump/GOP supported SCOTUS, will become the paramount governing rule and we will continue to kill each other off while making sure that every microbe's life is protected.

Government starts at the grass roots, despite its direction being led by those at the top of the power pyramid, and I doubt that many of us could even say who is on the ballot for local positions of power. Bernie Sanders promoted the idea that everyone needs to participate in order for us to truly be "We the People". But we seem to choose to be slaves to ignorance.
cjpgh25 (S.t Louis, MO)
In my Catholic Church I disagree with anyone, patron, pastor, or Pope, who suggests that any belief on any issue should be contained in the law of the land. The Constitution provides the greatest example for all religious rights in the world, and we are free to believe in the morals of our faith. Do not allow any person of any faith any reason to think that a moral position of their belief can do anything to the constitution that would improve it.
Support your morals within the confines of your
religion by the Constitution as written.
Maryellen Simcoe (Baltimore md)
I think we also need to remember that we face a choice like this in every election, not just this one, although the choice is unusually pointed this year. We also have to vote in every election, democrats are particularly remiss in this. We are not just protecting the poor, or women, we also have to remember the environment and civil rights. For profit prisons, for profit medicine, for profit education, we Americans need to fight to prevent ourselves from becoming just another commodity.
AC (USA)
Political correctness is popular with the right, so I'll say it, 'family values' 'christian' Republicans not only don't care if the poor or people who don't look like them die, many will eagerly vote for a candidate who will virtually guarantee it.
John Townsend (Mexico)
It´s disconcerting the number of GOP women who turn a blind eye to the GOP´s extremist assault on women.

GOP congresswoman McMorris Rodgers for example voted against the Fair Pay Act insisting that women do get paid equally, and sees no problem with overturning roe vs wade taking away a woman´s right to choose or dismantling planned parenthood entirely, supports the personhood law essentially abolishing abortion entirely, and banning the pill through constitutional amendment.
Wcdessert Girl (Queens, NY)
Democrats honestly have only themselves to blame as well as some Republicans who find themselves saddled with candidates who do not truly represent their interests. We don't turn out in force for elections at the local and state level. The 2014 elections had the worse voter turnout in 70 years. Especially here in NY, which had a race for governor and 27 house races. In CA and Texas, the two other largest states along with NY, less than a third of eligible voters voted.

What does this say about an sad lack of understanding on the part of the average person of who democracy truly works and the responsibility we all have to vote for city council, aldermen, borough president, and every other elected position through the presidency? People come out for national elections, but POTUS has far less direct impact on your every day life than the governor, senators, and representatives of your state, and the mayor, city council, borough president, where you live. We can't expect one person to come along every 4-8 years and make everything all better. Especially when foreign and international interests and security issues are often at the forefront and dominate the President's focus.
John Townsend (Mexico)
When it comes to abortion what any politician, church, or civic authority has to say about it will not alter my view, my rights and my actions ... that there be only two people involved: the doctor/nurse practitioner and the woman. Period. These religious zealots who insist on unfettered conception regardless of conditions and circumstances invariably and routinely ignore the fate of the unwanted child committed to a life bound in shallows and miseries absent vital necessities.
Anna (heartland)
John, I agree with you. The only 2 people involved are the woman and the doctor. Not the American taxpayer whose beliefs don't believe in abortion. They don't want to pay for some one's abortion.
I support a woman's right to do whatever she wants with her body- I don't want to pay for her abortion.
She can do that herself.
This is the issue.
Why should I be forced to go against my beliefs?
Because you say so?
John Townsend (Mexico)
By the same token, who pays for the plight of unwanted children
abandoned by the system?
Ross W. Johnson (Anaheim)
Fewer regulations and less government oversight have not helped states such as Alabama or Mississippi. They remain poor and undereducated notwithstanding their position as case studies as paradigms of limited government. Moreover, the GOP has been consumed by its Southern Strategy: The tail is now wagging the dog. The demons of racism and xenophobia that the Republican Party intended to manipulate have now turned on their master and may destroy it altogether. The "party" in the Republican Party is over. The chickens have come home to roost!
Ken L (Atlanta)
I don't think it's race. I think it derives from the Republican political philosophy, which can be summed up as "Everyone for themselves." Those who have somehow managed to thrive don't believe they owe the same chance to their fellow person. I don't think all Republicans think this way, but their leaders do, and therein lies the problem.

Democrats, on the other hand subscribe to the "We're all in this together" philosophy, which means they'll lend a hand to help pull their neighbor up and along. That doesn't mean pure socialism, where everyone is guaranteed the same income, job, etc. But it does mean removing the barriers facing the less-fortunate who just want a chance at a healthy life, a good education, and a good job.
hen3ry (New York)
And we are all in this together. Microsoft wouldn't be what it is without customers. Our elected officials wouldn't be in office except for our votes putting them there. None of us would be where we are if we hadn't had help from someone along the way to adulthood. Sometimes the help is positive and sometimes it's negative. One hopes that the positive outweighs the negative whether it's personal assistance or government or private.

The best things any country can do for its citizens is to provide them with assistance when they need it without discriminating against certain classes or ethnicities, to provide a decent education, and, in today's world, access to the health care that is needed no matter what the cause of the need is. Government can also help people find jobs, retrain for new ones, and provide programs when the economy is not working like it did during the Great Depression. Refusing to allow people their dignity is more damaging than asking them to do what may need doing for a fair wage.
Sleater (New York)
Except Republicans do like to help rich people. A lot. Look at a far more liberal state, New Jersey, where the Republican governor has repeatedly attacked unions, the poor, etc., but has also gone out of his way to use tax dollars and his discretion to help the wealthy, including casino owners like Donald Trump in Atlantic City, mall builders in the Meadowlands, the company that runs halfway houses all over the state (the New York Times covered this four years ago, but it got no real media traction), and a major airlines at Newark Airport, which allegedly created special flights to South Carolina for one of his advisors in return. Race, class, gender, religion, etc. all are factors. But all over the US, the Republicans always favor the wealthy and powerful, in part because they tend to be their backers and puppetmasters.
Ellen Hershey (Bay Area, CA)
I think it's a stew of racism, religious fundamentalism (the kind that says my religion is better than yours, therefore I'm right to impose my views about abortion on you), misogyny, and political philosophy that says every man/woman for himself/herself.
PhntsticPeg (NYC Tristate)
"A large part of the answer, surely, is the usual one: It’s about race."

I think your being way too generous about everyday Americans. They've been brainwashed into thinking that helping their neighbors is akin to a sin against God. They assume minorities get more of some ethereal help than they do, even when they don't and the proof of that is provided.

When the market crashed and I saw White folks whining about how they had to "struggle" without cell phones and other perks they were use to having I just laughed. Yeah, your really struggling now. Oh? you have to use food stamps now too? But I thought you were against that "free handout".

They were until they had no choice. Then they were glad that at least their was "something". The hypocrisy is thick and memories are short.

White America is so use to denying a large swath of its population the same services it feels entitled to that they don't even see the problem, until it affects them deeply. Then they holler like their dying.

That is why you see Trump winning - folks may be struggling due to the policies they once supported but they will always point fingers about specks on minorities instead of looking in the mirror and taking that log out of their own eye.

We need to stop pretending and call it what it is...we are a selfish and greedy country and only by laws can we force Americans to do what is right. We've lost our moral compass more than a few generations ago.
Mark Thomason (Clawson, Mich)
The ugliest political behavior I ever encountered was the most local. Nobody behaves worse than the Boards of Condominium and Community Associations. Many other attorneys shared their views on this, each seemed more outraged than the last.

It is a matter of numbers. There are so many more positions, every one an opportunity for some marginal character to act out on ego or as crazy-uncle political ideas. They do this nearly out of sight except of their victims, because there are too many at too low a level to attract attention to what they do.

The only checks on them were their own attorneys warning them off what would surely lose to a challenge, and the challenge itself when a disgusted judge puts a stop to it.

City, county, commission, Board, they are when crazy-uncle gets actual power. They are where extremism goes near unchecked. It is democracy at its worst, with most who could vote not even knowing what they've done. Who knows who they voted for on the Road Commission, or even who won?

This is the level at which the Parties matter the most. They are no longer effective checks on who runs with their names. In fact, they are not effective at that today all the way up the ladder.

The cure is new Parties. this is or should be their role, to pick a selection of good people to run in their name.
Objective Opinion (NYC)
Mr. Krugman, who's a liberal, has politicized this issue; we have 19 states, led by Republican governors who are opposing Medicaid expansion. Mr. Krugman says the states are 'cruel'. He leverages your 'feelings' in this article with the mortality rate of women; trying desperately to find a correlation.
The States who have refused Medicaid understand the expenses associated with the program, which costs will convert from federal to state over several years. Medicaid currently makes up the largest percentage of many states' budgets' - there's a legitimate concern the costs will be unsustainable in the future. Mr. Krugman, why don't you write about Medicaid fraud - the GAO last year said some $60 billion of American taxpayer money was lost to Medicaid fraud, abuse and improper payments. Let's fix the system before we continue pouring more funds into it.
Tell the entire truth Mr. Krugman, not what you want the readers to believe.
Steve Bolger (New York City)
Congress has all the power it needs to end unequal protection of the law by applying the commerce clause to all forms of competition between states.

Americans need to stop electing people who do nothing but sell them out in Congress.
kwb (Cumming, GA)
I'll not dispute that defunding Planned Parenthood in Texas is unfortunate, it seems to me that Krugman jumps to readily to his conclusion about cruelty a d how "something terrible has happened to pregnant women in Texas."

The NYT article on he references, the Huffington Post article from which it derives, and the medical journal paper that was the original reference are all careful to state that there's no one cause for the 1 year spike. But Krugman, as is his wont, is happy to blow the report up to the level of a national tragedy while equating coincidence with causation, He also states that the mortality has doubled in recent years, something that's untrue as the increase was reported for a single year.

According to state statistics, there were 3770000 live births in Texas in 2011, so the 148 deaths represent one in 2550, and the increase as one in 4960.

Krugman has his point of view, but it can be useful to put actual statistics in front of his readers.
Patrick Hunter (Carbondale, CO)
James Gilligan's book, "Why Some Politicians Are More Dangerous Than Others" compares the political party in power with the rate of suicides and homicides. Under Democratic control those rates go down, conversely under Republican control rates go up. Dr. Krugman states that the death rate for mothers in Texas has increased and that outcome follows the trend.

Republican governors, for strictly political reasons, are denying better health care to their citizens. People are dying for lack of timely care. How is that not a crime?

Stepping back, it shouldn't have to be the Federal government that is back-stopping services such as housing, health care, unemployment coverage, disability, money for food and education. Local communities and state governments should take care of their own. Democratically controlled states lead the nation in all of the factors that improve quality of life for ALL of their citizens. Republican states, especially in the deep south, rank at the bottom of quality of life criteria.

"Cruelty" is a human trait we ought not to encourage. Like racism and fear it is one of the very effective tools of right-wing politics. It is insidious.

The slogan "Make America Great Again" is offensive on many levels, not the least of which is that the Republican Party intends to do exactly the opposite. Don't take my word for it, take a look at their Party Platform.
JC (Washington, DC)
What you decline to mention, Mr. Krugman, is that most of these cruel policies derive from nothing more complicated than the Republicans' overwhelming focus on forcing the failure of anything our current President does. Whether it's Medicaid money or funds to ease the recession, Republican governors have simply said "No, thanks," leaving millions of their citizens in sickness and need. Much of the time, those suffering most have only themselves to blame, failing to vote in local elections. And Democrats are particularly culpable: You can't complain about the loss of Planned Parenthood and other benefits if you didn't vote for your local representatives.
Jeff M (CT)
Prof. Krugman seems to think this is only a problem in states like Texas. It is certainly worse in states like Texas, but look at the national numbers. In 1990, maternal mortality in the US was 12 per 100000 births. That's the same as Slovenia, close to Germany (11), worse than Canada (7), much worse than Greece (5). Now look at 2015. The US has gotten WORSE, it's 14. Slovenia is 9. Canada is still 7. Germany is 6, Greece is 3. A women in the US is twice as likely to die in childbirth as one in Canada, and almost 5 times as likely as one in Greece. What a great country we live in.
lastcard jb (westport ct)
Hey Jeff, perhaps you should go back to school, it is a problem in statse like Texas which are PART of the US and skew the results for the country accordingly. If you fix the state you fix the country - duh. Why is that not obvious?
russ (St. Paul)
I want to second Krugman's point that the general populace is kinder than the politicians who wind up in office.
Why that discrepancy occurs is a good question and here, too, I think Krugman has (for years) been on target. The GOP plays the race card beautifully, and cruelly, but not necessarily because they are themselves racists.
They do it because it gets the racists to the polls; once elected they can carry out the economic directives of their paymasters, of whom the Kochs and Adelsons are just the poster boys.
What the wealthy want is low taxes on income (it's only about half of what it was when Reagan took office) and a castrated government that can't regulate their business and can't hire enough IRS auditors to untangle their tax avoidance shenanigans.
Face it folks, IRS agents are your friend, IF there are enough of them. When the GOP decimates the IRS ranks, that staff can only check simple returns from the little guys, like you and me.
Follow the money - it's advice that will hardly ever lead you astray.
salvatore spizzirri (long island)
the gop, by doing what it does to get racists to vote is , in it self, racist.
Keith (USA)
Christians have long known that women are particularly prone to evil. Certainly there is nothing more evil than killing God's most blessed gift, your and your man's baby. Scriptures on these points are clear and irrefutable. So is the penalty. Clearly there is nothing wicked or cruel in visiting God's wrath on harlots and hussies. I imagine these states of so called cruelty are populated by the righteous who believe in the purity of the Bible and honor the will of an all-powerful God who calls his wrath upon the wicked. I see no mystery here. What puzzles me is why in a Christian nation and these God fearing states there are no legal sanctions against the men (fathers, brothers and husbands) who allow the women under their care to disobey God so brazenly. Is not what's good for the goose good for the gander? Freedom! And Jesus!!
James Jordan (Falls Church, VA)
Perfect title for this topic.

Voters have allowed the Constitutional Rights of States to be used to abuse our basic human rights. There is a proven solution to these abuses to our well-being, which is guaranteed in the Constitution. The proven solution is the political expression of the majority of the voters, regardless of party affiliation, vote for candidates who favor a government that will continue to make America a fair society that protects the basic human rights of all people.

The shorthand for reversing the bad trend that this column highlights is: in November there should be a "wave" election in which the current majority party, the GOP, the Republicans, the T-Party, should be replaced with candidates who will pledge to eliminate these abuses.

It makes sense in terms of the national economy to do better in health, education, and income, the three fundamental areas of human rights, our common welfare, and the nation's economic health. As Professor Krugman well knows, study after study that compares these three factors on a national or international basis shows very clearly that these three interdependent factors are crucial to economic success.

Of the big three, health is clearly the biggest factor in the nation's economic performance, this is the conclusion of our most recognized economists. We would be absolutely stupid to continue with the Medicaid abuses of many States including my own Virginia imposed by a GOP majority in the State legislature.
Wezilsnout (Indian Lake NY)
Dr. Krugman's observation about the basic generosity of Americans would probably find agreement among the very people who avidly support Trump. They see themselves as supporting traditional American values: work, religion, being good neighbors, et al. They believe that they are the real Americans and the rest of us are stealing their heritage and their country. This mantra allows them to support candidates and policies that result in discrimination against minority groups and anyone who does not appear to them to be living up to those "values". Their thinking becomes distorted as they struggle to rationalize their support for an obvious racist.
In an NPR interview this morning, one of these Trump supporters told the interviewer that he believed in traditional American values like "common sense". He then insisted that it is common sense to "build a wall"! Dr. Krugman, it's time to start thinking of how we are to remain a viable society AFTER Hillary becomes president. She is going to run into obstacles that dwarf Mitch McConnell's stonewalling of the Obama administration.
NM (NY)
Thank you for this reminder of why we need a strong Federal government - it is a safeguard for our citizens in the face of petty, irresponsible state governance.
LMCA (NYC)
Hard to believe that it was a Texan Democrat, LBJ, that enacted with Congressional approval Great Society programs, such as Medicare, Medicaid, etc. His words were prescient about the Republican lumped proletariat: "If you can convince the lowest white man that he’s better than the best colored man, he won’t notice you’re picking his pocket. Hell, give him somebody to look down on, and he’ll even empty his pockets for you."

And that has been Republican strategy ever since. Convince people through faux religiosity and ship jobs overseas to make a bigger margins but convince those poor whites that it's the lazy brownies' fault.

These people truly have no conscience.
Steve Bannister (Salt Lake City)
You must call out sociopathy when you see it. Individual Republicans can be unwitting sociopaths, but if their party engages in sociopathy, as in Texas and other non-Medicare expanding states, they are personally stained.
democritic (Boston, MA)
I find myself grimacing whenever I hear a politician end his/her speech with "...and God bless America!"
This country is so blessed (indeed, we are the richest country in the world). If there is a God, he/she/it must be utterly horrified at how we treat the worst-off among us and refuse to share those blessings.
N.B. (Raymond)
bear in mind the pagan is joining with the Christian and the religious Jew. And they are eager to give to Orthodox Islam more converts because it is all about gaining power and control over all the people. If Vladmire Putin could gain 98% approval rating they believe they should be able to muster at least 49% of the people and old balls and weirdos will vote green or libertarian and the head of Medusa (Hillary) would be put on a pike figure of speech.
Roger Cohen is frightening today
You can’t have observed Farage over the past couple of years and not think Trump may well win in November. That’s Britain’s lesson to America. There is too much smug Hillary-has-it sentiment swilling around.

Farage proved pollsters wrong. He proved commentators wrong. He made a mockery of President Obama and others who urged Britain to remain in Europe. He delivered something as unthinkable as Trump’s rise to the Republican nomination:
Glassyeyed (Indiana)
Out here in red-state-land it's definitely about race, but there's also a lot of ignorance and distrust involved.

Most of the conservatives I talk to either are completely unaware of the Kansas/California comparison or simply don't believe the results. They are completely convinced that tax cuts create jobs, that budget deficits are by definition bad, and that all deficits are caused by giving away free stuff to lazy slackers who refuse to work.

Anything that conflicts with those beliefs must be liberal lies, and liberal lies are properly met with rage and politically incorrect speech which purports to describe the lazy slackers and the lying lib's.
elizabeth (chesterfield, va)
At some point the US needs to join the modern world and get rid of States Rights. It is criminal that a citizen in someplace like Texas cannot get the same benefits/rights that a citizen in New York or California is 'entitled' to.

It is also beyond imagining that so many blue collar Americans consistently vote against their own best interests.
Marian (New York, NY)

"one sociopath in the White House can ruin your whole day"

Indeed. That is why this election will turn, ultimately, not on race but on which psychopath is more nightmare-inducing.

Trump sounds like a racist. But it is the Archie-Bunker vernacular sort of racism, likely the result of spending too many of his formative years in Queens. It is a defect of ear, not heart.

Then there are n/a "sins of the father…"

Nonetheless, rental discrimination and racist phraseology are small ball in ClintonWorld.

When deconstructing reflexive black support for the Clintons, Randall Robinson asked: "For God in heaven, what for?" Hillary's: "superpredators"/"Firewall"/"drag & drop," virulent, insidious, dehumanizing racism, vote-stealing & vote-denial disguised as voting rights. The NAACP suing the Clintons for intimidating blacks at the polls. The Clinton crime bill. Indeed, Rwanda.

Some argue that blacks were against the '94 crime bill and blame its passage on the "selective hearing" of whites. "Selective hearing" sure sounds like "black lives do not matter." How else can one possibly explain Rwanda?

"Be Careful…Genocide finding could commit USG to do something"
nsarchive.gwu.edu/NSAEBB/NSAEBB53/

"There is such a thing as a lesser evil & Hillary is not it"—Michelle Alexander (The Nation: "Why HC Doesn’t Deserve Black Vote")

The determinative nightmares will be induced not by cries of racism but by the ease with which one of the candidates lets people die.
lastcard jb (westport ct)
Marian - what? Have you been so brainwashed that you can't see what is in front of you? read this and have a nice day :https://thecontrarianblogger.wordpress.com/2016/08/24/the-morons-case-fo...
Marian (New York, NY)
lastcard jb — You seem to be missing my point, which is this:

We already know HC is unfit to be pres. If her name were Hillary Schmo, she wouldn't pass an FBI background check for an entry-level spot. She would be in slammer—minimum.

She is w-o accomplishment—many failures, tho—despite having been at or near seat of power for 25 yrs. Reflect!

We know Trump is an unfit candidate, but we can only guess as to his fitness to be prez. I would rather take my chances with an unknown than go w/ certain debacle.

Her mess: Libya, Syria, Benghazi, Yemen, Honduras, Russia reset, 2 irrational, nuke-proliferating, legacy-driven deals w/ insane, apocalyptic signatories, 400k+ deaths of innocents, incalculable future deaths, unleashing of al Qaeda/ISIS, destabilization of 4 continents, Armageddon pope, generals & King Abdullah call WWIII.

When evaluating HC, one must not confuse policy w/ character, cold-blooded w/ dispassionate, calculating w/ wise, wonky w/ competent or smart, corruption w/ success & failure w/ experience.

Review her decades in/about the WH. Her abuse of women/power, her corruption, her calculated failure to protect national security. Her fascistic impulses—beware!—they flourish when she holds power. Rwanda…

All this as HC continues to sell out this country, amass more money/power. Nonstop. And if you think Chelsea on Clinton Inc Board isn't a bridge to the cash, I have another bridge to sell you.

This isn't about politics. It's about our children.
Pdxtran (Minneapolis)
The reaction of the rank-and-file Republican to ideas such as universal health care or free tuition at state colleges is,"I'm not going to give more free stuff to some (insert racial or social class epithet) who's spent his whole life on welfare while I have to work for a living."

Never mind that it is not possible to spend one's whole life on welfare. Never mind that single-payer health care and free tuition would apply to the speaker as well as those he despises and would make his own life easier.

It's about keeping those "others," whether they be another race or another social case, down.
Michael Roush (Wake Forest, North Carolina)
I couldn't help but notice the number of women in the picture accompanying this article who are participating in throwing their sisters under the bus.

Way to go girls.
Pete (Fort Lauderdale)
Pat Buchanan was once quoted to say that he would rather have 100 school board members than one senator. Democrats need a huge refocus campaign, and maybe even an Alec counterpart with public outreach.
John Quixote (NY NY)
Defunding Planned Parenthood is another one of those Orwellian newspeak phrases that rallies the lemmings. Oh for a society where voters at the local level looked at facts and real lives instead of the koched-up foxic waste talking points that numb our impulse to help our neighbors.The GOP think tanks might have missed it, but voters of conscience respect candidates who can think for themselves and take a human stand on education and health care.
Suzanne (Indiana)
Cruel indeed. Not funding healthcare means those that need it and can't afford it will at some point die off. Talk about death panels! The GOP used to be the party of fiscal restraint and problem solving without just throwing somebody else's money at it. No longer. Now, it's every nasty CEO's dream come true. Just get rid of the people that aren't helping the organization. Problem solved!
Dean H Hewitt (Tampa, FL)
I don't think it's about race. I think it's about profit. Look at what Kentucky is doing with their healthcare. Finding ways to allow private corps make money off government systems is what is happening. If they feel they can't do it, then they just give the money as tax cuts. They have sold highways to get a profit for private entities. This is why I'll never vote for a Republican, ever. I see Ds as maybe over doing programs and efforts, while the Rs will always under do support and always look for a way to scam the people.
Tom (Ohio)
Any of you whose opinions differ from mine are racists and misogynists, and must be crushed. If only Americans weren't mostly morons, they would vote more (for my party, naturally, despite a lot of history that says that might not be true) and life would be grand for all.

With a message like that, how can the Democratic Party fail?
You're unintentionally funny (US)
That is precisely the message that Donald Trump is currently trying to falsely attribute to Hillary Clinton. Trump's "explainers" have been all over TV for a week parroting Trump's smear.

Sounds like you got the memo.
Bob (Rhode Island)
We'll keep cutting taxes fer the rich because solvent blue states will continue to pay our red state bills for us the way they always have.

The republic strategy in a nutshell.
Greg Hooper (Calgary)
Yup. Just a difference of opinion, by which non-whites and women are systematically shafted.
Bob Laughlin (Denver)
I have a suspicion that a lot of the "I won't vote for her because we need to shake things up" crowd are probably among those missing in action back in 2010. People don't show up for the mid-terms, or their local elections, and then wonder why nothing is getting done.
These pages are starting to detail the lack of knowledge about the basic working principles of our government and our Nation and that is a good start. There has to be a way, any way, to show the uninformed that the country they profess to love so much is special only because of the government they profess to hate. And that taxation is not theft.
Dick Weed (NC)
Look at all those white folks that don't want to help black folks at all or want them to be a majority that are probably mainly protesting because they think planned parenthood provides free abortions to black folks that they have to pay for. But if black folks did start having a lot of babies then these anti-abortion folks will be complaining and moaning about how much welfare for these kids is costing them. It's such a catch 22 for them.
Mystified (Oklahoma)
Black folks aren't the only poor people utilizing Planned Parenthood and Medicaid. There are a considerable amount of poor white folks out there too!
Tom Connor (Chicopee)
It's neo-slavery. Poor red state whites worship the white aristocracy with corporate welfare and low wages as payment for being told that they are superior and being robbed by the slothful, mooching, undeserving non-white poor. Poor whites are then appointed as overseers over poor non-whites by enforcing a state of political abandonment, neighborhood apartheid and mass incarceration. Four hundred plus years of slave holders, slave drivers and slaves. The American paradigm is sick to the core.
Mike (Ohio)
Krugman buries the lead again: Voters need to be just as engaged in elections for state officials including governors, state representatives, Secretaries of State and judges. Democrats need to maintain their 50 state strategy (pioneered by the Obama campaign in 2008 and 2012) because a "rising tide of blue" in like Texas, Kansas, Arizona, etc, is the only way to bring "enlightenment" to those low information voters.
MB Barden (NYC)
The left's failure to show up for state and local elections has led to Republican dominance. The problem isn't Republicans. The problems is we don't show up. Bernie Sanders, whom I supported, is determined to do something about this. The country needs him to succeed, but I am skeptical he will.
Liberalnlovinit (United States)
Notice in the photo that there are no lower income women protesting - that's because a lot of lower income women depend upon Planned Parenthood for basic health care needs.

But the upper income people in the photo wouldn't know - or care - about that.
Glen (Texas)
Here in Texas, the taproot of the misogyny described by Krugman is religion, and not the one that forces women to dress like Ewoks. Christianity of the fundamentalist strain is predominant here and, abetted by Catholic dogma and of course persistent racism, the result is the attitude of it's every man for himself, not women and children first.
JCM1953 (Missouri)
There's also a big emphasis in Texas and most of the South on your ancestry, "who you came from." Lots of So-And-So The Thirds who want to tell you just how many So-And-Sos in their family were Big Men in their little dirtburg towns. In fact, the emphasis on religious sectarianism and family names rivals . . . the Middle East and Islam.
Moderate (PA)
Red state Americans are not generous. Public policy proves that.

In addition, when it comes to "giving", the group that gives the most to charities (as a percentage of income) is the lowest 20% of wage earners.

Red state Americans are not generous. Public policy in regard to people who are less fortunate is the expression of that. No amount of leadership could overcome a truly generous electorate.

Wake up. There are two Americas. One that spouts Christian ideals and lets people die from hunger, want and disease (red state) and one that embraces secularism and actually prevents want, hunger and disease (blue state.)
beverlybrewster (san anselmo, CA)
Christians from denominations which ordain women as clergy, like mine, the Presbyterian Church (USA), are working hard feeding the hungry and caring for the sick and those in need in blue states and red.
Lee Elliott (Rochester)
A lot of politicians in red America have learned that as long as they promise their constituents easy access to guns and hard access to abortions, then worry about being reelected is a thing of the past.
John Q (N.Y., N.Y.)
For the mortality rates of pregnant women to rise because free federal Medicaid benefits are unavailable goes beyond ignorance.

Our Republican lawmakers in 19 states are insane.
NI (Westchester, NY)
My only advice to Texans - move to other civilized states. There are at least 40 of them in our Country.
Klee (Philadelphia)
A lot of these problems exist because of the destructive belief in states rights and federalism which have been the bane of our democracy since the Articles of Confederation were were hammer out and then codified by the 10th amendment of the Constitution.
ZipDon (Texas)
Those of us who live in Texas have seen first-hand the way the Texas "Teanderthal" government Republicans, led by Gov. Greg Abbott, have jeopardized the health of women and teens. Some of the actions denying health care have led to death and permanent disability. Yet, the Republicans in control of the legislature continue to pander to the "dumb, stupid and proud-of-it" Texas Tea Party and Southern Baptists who are directly responsible for these deaths and disabilities. "Hook 'em."
HRM (Virginia)
Mr. Krugman spends a lot of verbiage tying maternal deaths to the loss of Planned Parenthood. But what was the mortality caused by. In Texas, in the past, illegal abortions were the number one reason. It does impact poor women the most. White women could always have an abortion in a hospital. It was termed incomplete miscarriage or abnormal bleeding. There are also pills that can be taken to abort a pregnancy. Doctors can prescribe them and if needed step in if the abortion is incomplete, So Krugman missed his chance to show who and why the deaths are happening. This was contributed to the Opinion Page. That is what it is, an opinion. But if he really cared, he would have searched for who and why and shared that with us.
Clark Landrum (Near the swamp.)
It's a wonder that the Republican Party even manages to exist let alone control a majority of states. Their leaders are total incompetents like Dubya and Trump. They apparently are masters of the art of propaganda. One of their most annoying ploys has been to convince a lot of religious dimwits that God is a Republican.
Jose (Arizona)
Gerrymandering.
Susan H (SC)
For almost 50 years I helped two poor children in third world countries through the Christian Children's Fund (now Child Fund). In 2008, with the downturn in this country I switched one of those sponsorships to the US. So where is the child I help? Texas. The other is in West Africa.
Mary C. (NJ)
Yes, "It's about race," but not in a simple way. Some states with high Latino populations have expanded Medicaid by accepting federal dollars: New York, California, and Arizona for example. But states like Texas and North and South Carolina, Louisiana, Georgia, Alabama have rejected expansion with federal money. The result is a worse impact on African Americans than on Hispanics, worse for the elderly and single female parents than for families that have one worker earning below-poverty wages.

"Moral" opposition to abortion is only a pretext. Most women who seek abortions already have children at home whom they struggle to support. With health insurance, a woman has some freedom to choose to bring an unplanned pregnancy to term. Depriving her of both the means to support another child and of abortion keeps her family in dire poverty and anxiety. Keeping the poor poor is clearly the goal of assaults on Planned Parenthood and of states' refusals to expand Medicaid. Keeping workers so desperate that they will work long hours at half poverty-level wages and still not qualify in some states for public assistance or subsidized health insurance is the goal. Limiting workers' freedom by keeping them dependent on subsistence wages is the goal. Can they now even remember freedom well enough to want to vote to regain it?
Mike BoMa (Virginia)
Yes, it's race and class, but also right wing evangelical religion. Please, practice your own version of religion but don't co-opt the power of government to force it on the rest of us. This has been a growing and malignant movement that the GOP, and perhaps others, simply have to stop.
vulcanalex (Tennessee)
"But why are states like Texas so dead-set against helping the unfortunate, even if the feds are willing to pick up the tab?" There is a simple answer here, we already spend way more of our scarce resources on public health care. We don't want to spend any more, and of course the Feds are not mandated to always pick up the tab. Pretty simple we can fund our schools or provide unlimited free health care fo more people, easy choice.
Mary C. (NJ)
One way to try--futilely--to justify cruelty is to spin out a false dichotomy, an "either-or" informal fallacy of logic: Tennessee can support free public school education, or we can provide "unlimited free" health care, but not both. What your state and others like Texas are asked to do is to accept federal subsidies to provide health insurance to many who cannot now afford medical care, and it is fully possible for your state to do that without shutting down its school system! Tennessee comes in very low in national rankings of money spent on education--currently 44th on the Rutgers study?

Adequately funding both education and health care is not only a matter of generosity; it recognizes and responds to a basic human right.
KB (Texas)
The picture of this article is an excellent evidence of the conclusion of the article. The whole GOP agenda is based on racism and now they confirmed it by nominating Trump as their Presidential candidate. Texas surprises me most as over time it will become a Blue State till GOP is playing their racist policies without any change - it looks like a hari-kari. Medicaid expansion of Obama care is no brainier.
Godfrey (Nairobi, Kenya)
Cruelty is one thing but what is so maddening is that Congress still continues to allocate a massive procurement budget to the US military, even when they say that they do not need the equipment. Just buy! they are told. (http://www.military.com/daily-news/2015/01/28/pentagon-tells-congress-to...

These are human lives they are completely refusing to help. But they prefer to spend on machines that are not wanted or needed.

I really don't get it.
Don (New York)
Ultimately the problem is there is a portion of the US who can't rationalize reality with ideology. Texas is a great example of politicians spoon feeding this ideology of State's rights and fighting the big bad Federal government. Texans like to flaunt their employment record as proof of their independence, but the aside from the energy sector, the military and weapons industry make up almost one quarter of their economy. They can't rationalize the fact that that is Federal money, tax payer money from the rest of the country.

Similarly, you see this over and over again in disaster States like Louisiana. Every election cycle you see the bile and vitriol about the big bad Fed, how taxes are bad. Yet, in the past decades we've seen increasing power of coastal storms, States like Louisiana are collecting billions in Federal recovery funds, year after year after year. It has become common place that the media hasn't really covered the fact that billions released to Louisiana so early in the season.

Healthcare is just another blip in the long list of denials. They continually vote against their best interests. They ignore history, when holier than thou politicians and wealthy families were able to get abortions (girls were sent away to "convalescent resorts") and pre-natal healthcare, while leaving the poor to die. They stand in denial until they're the ones in need, and then they blame others for their own ideological failures.
reader (Maryland)
RE the Texas job growth due to energy, the Wall Street Journal reports today that it is by far the leader among states in green energy (particularly solar, wind) and cheap electricity. Also today the New York Times reports that Hillary has problems convincing coal miners that they can have a better (and healthier) future.

Res State logic is not a renewable resource.
Jude Smith (Chicago)
Has anyone considered that the reason why members of minority groups have preferred to be served by government programs, including working for the government, is because there is less a chance of discrimination in those programs, in those environment that in the private sector where there is a long history of gouging price-points and blatant discrimination based on race, age, etc.? I'm just saying. A public option and shoring up the rest of the law are the two next best steps forward with healthcare in America.
Bob (Rhode Island)
I'd be far more apt to swallow your proud southern independence crap if solvent blue states didn't have to pay bills for the proud insolvent southern red states.
85% of red states are debtor states who rely on real blue states to pay their lazy confederate bills for them.

End The Confederate Gravy Train Today!!!
Paul (Greensboro, NC)
In relation to this "States of Cruelty" story, I can't clear another NYT story out of my head about Mylan Pharmaceuticals just launching a generic version of their EpiPen ONLY after national public criticism of their $600 price gouging for their brand EpiPen. See:
Callousness and cruelty is on the rise in good old America. I saw signs of Mylan corporate callousness in 2014 when a Mylan Pharmaceuticals security guard in Greensboro told me to send a letter to their website, after I asked a simple question about Mylan as a local citizen. I wrote my letter, but I never heard from Mylan. What were they hiding in 2014, and what significant facts continue to be hidden from most Americans now?
Alces Hill (New Hampshire)
In Vermont, the Democratic Governor tried and failed to implement a single-payer system, and that Governor (Peter Shumlin) is not running for reelection. Health care reform is the #1 issue in Vermont's upcoming election, which may well elect a moderate Republican Governor who thinks the state should simply switch over to the federal health care exchange, or possibly a regional collaboration. It's really hard to see how race drives Governor Shumlin's failure, and Vermont is by far the most progressive state in the country. If the ACA is failing in Vermont, then pointing the California and vilifying Red People in Red States doesn't cut it.
Daniel A. Greenbum (New York, NY)
A big part of the problems are Democrats. They have to vote in local elections. Town councils, state legislatures and mayors, governors and other local officials have much more impact on people than the president. Whether in Presidential election years or off years Democrats have to go to the polls and throw out the those who oppose healthcare for all and for women and much more.
ted (portland)
"Not wanting to help neighbors that don't look like them". Cute Paul, but how about people doing something to help themselves and not expect other people to pay for there problems. In Catholic Italy and Germany, actually throughout Europe except for the new arrivals the birthrate has been dropping for decades and for a very good reason people can't afford families when confronted with the new globalized world that saw the loss of millions of their jobs. So those perennially horrible Germans did the right thing and quit having children they couldn't care for, little did they imagine ten years ago they would be asked to care for everyone else's from a Middle East conflict and globalized world not of their making. My hats off to them, it's a lot more than the American hedge funders are doing, to busy worried about oil futures and currency swaps. To them war and turmoil are money.
Yuri Asian (Bay Area)
Ted,

The average family size drops dramatically when women have access to education and jobs. When a country enjoys prosperity -- not poverty -- birthrates fall. Because fertility rates in Germany fell, there was a shortage of workers, which is why the German government brought in large numbers of Turks and Syrians decades ago to assemble VWs, Mercedes and BMWs. Germany recognizes its economic dominance depends on having a productive and young workforce. The government's willingness to absorb the recent wave of Syrian refugees is as much a pragmatic economic decision based on future workforce needs as it is humanitarian.

China is the best example of population reduction through economic and educational opportunities for women. Most major Chinese cities have suspended the draconian one child policy because rising income levels and empowered women have reduced China's fertility rate to below population replacement.

I agree generally with your sentiments regarding self-reliance. Except the reason too many people are in difficult circumstances is what's been done to them intentionally by greed, exploitation or bigotry. Unfortunately for the human race not everyone has the same starting line or fancy running shoes to reach the finish line: a decent chance to live with a modicum of security, dignity and meaningful freedom.
ted (portland)
Yuri: Agreed, but then what is the point of generations of people working for a better society, examples abound from Northern Europe to fifties America if they must then share the fruits of their labor or lose them entirely to globalization. People should be staying home and making their own countries great. Good examples are India and the Americas where the opposite is true, the less than fortunate as you point out don't get a fair shake because for sometimes centuries a ruling caste has been allowed to exploit the masses. We had an American revolution to counter this to which only the French came to our aide, perhaps the time is long overdue to dispense with the oligarchies in India or Mexico. It's not good enough to make a pile in your country and then leave for places not yet destroyed by desecrating the environment and using your own people to enrich yourself. We are however on the same page Yuri everyone should get a descent chance at life. I feel you are a bit disparaging of the Germans, Germans are still job sharing hours Yuri so all may continue to work, they don't need the headcount believe me, or better yet take a stroll through the beautiful German towns there are still many looking to replace the jobs replaced by the clever fellows in Silicon Valley and New York, they are the only ones who are standing tall in these terrible times. The worlds wealthy are conspicuously absent.
Yuri Asian (Bay Area)
Ted,

I admire the Germans for their pragmatism and humanity. Their farsighted workforce policy has positioned them for the future as other industrial powers -- China and Japan -- are hostile to immigration and as a result, in a single generation, their future has turned cloudy with a rapidly aging population and expanding pension costs depleting national retirement funds supported by a shrinking active workforce.

China is facing a huge retirement bill for its military with the largest standing army in the world. Their decision to cut troop strength and reduce military spending is directly related to its shrinking population of young people and expanding ranks of retirees. This is exacerbated by a rigid national retirement policy set at 60 for men and 55 to 65 for women.

America was lucky to benefit from the tragic circumstances in other countries that resulted in earlier and even current waves of immigration. The single best feature -- and strength -- of America is its rich diversity. However, the difficulty of finding community for immigrants in recent years is motivating many to return home when they retire.

Regarding extreme wealth -- it's a form of morbid obesity that's unhealthy for everyone, including the wealthy.
Debbie (Central New York)
There are several separate nations within the USA. E Pluribus Unum is a nice thought, but in many ways, just a thought. Education correlates with better health, planned pregnancy and better economic outcomes. Colorado provided free contraception and high school graduation rates increased, unplanned pregnancy decreased and abortion decreased. Certainly, rapes can result in pregnancy and even Ron Paul suggested that a dose of hormones in the ER constitutes appropriate early pregnancy prevention. I am stunned day after day in the "red state" neighborhoods of the "blue state" in which I live by the divisiveness, lack of empathy, and historical ignorance of people who want to forget that pre-Civil War, half of our nation's economy rested on unpaid slave labor, that our early hale and hearty settlers settled on land that belonged to others and that "income inequality" refers to the span between highest and lowest and is not a term employed by liberals to ensure that independent street corner poets be paid the same wage as heart surgeons. Those in my community who seek to defund Planned Parenthood are the same folks who don't want to pay for the children once they're born and who, like many, are unaware of the reality that between 1950 and 1970, 1.5-2.5 million babies were born to and taken from their mostly Caucasian mothers during what many mothers refer to as the Baby Scoop Era. People see what they want to see and cruelty abides because of it.
MRO (Virginia)
The countries with the lowest abortion rates follow the Planned Parenthood model - reduce demand for abortions through education, healthcare and contraception.

Those countries that follow the egregiously misnamed "pro-life" model only drive abortions underground and drive up maternal and infant mortality rates by destroying the quality of care.

Criminalization of abortion does not overall save lives. A substantial portion of pregnancies end naturally and the ability of forensic medicine to tell the difference between a natural miscarriage and an intentional abortion is extremely inadequate. Also, the best treatment for a failed pregnancy often involves completing the termination under medical supervision. Criminalization makes this impossible.

The only effective way to reduce abortion is by reducing demand. Reducing supply is just a despicable, cruel hoax that must stop.

When I look at the people in this photo I am reminded that witch burners thought they were saving children's lives, too. These people are all about ego, bloodlust and naked arrogance, not about saving lives.
Sid (Kansas)
Right wing extremist deology kills women and children and families and communities. Fanaticism exploited by the right is a pernicious force in American life that with its polarizing, other blaming intrudes upon the democratic process of negotiation and seeking common ground making dysfunctional an American democracy and converting us into a third world country with the profoundly disadvantaged growing more numerous. The wealthy wash their hands of responsibility knowing that by preaching fundamentalism they exculpate themselves from any responsibility for the commonweal and keep their taxes low and their politicians under control. We are losing America the land of the home of the free for whom our sons and daughters died to preserve the greatest experiment in equality in the history of the world. 'Wake up America!"
Fourteen (Boston)
“Ideology always paves the way toward atrocity.” (Terence McKenna)
RevWayne (the Dorf, PA)
The Death Panels Sarah Palin spoke of to frighten voters is, sadly, in many states her own GOP. But, there is an ongoing emotional issue that affects many voters. In two sentences Dr. Krugman sums up the conflicting views and reaction of many Americans. The “opposition to these programs is concentrated in states where voters in local elections don’t like the idea of helping neighbors who don’t look like them.” A few sentences later we are assured that “most Americans are, I believe, far more generous than the politicians leading many of our states.” Mixed emotions that would be easily remedied with a national health insurance.

Too often the poor with “no voice” are attacked and trampled upon while serious debate over funds spent on unwanted military equipment or large farm subsidies or … are neglected. As has been called for by so many, America needs to join the Industrialized countries and offer a single-payer health care system.
Bemused Observer (Eastham, MA)
My former wife grew up in Kilgore, TX, where her father, a Cherokee Indian, worked in the oil fields in the 50's. He was struck by a crane on the job and completely paralyzed. Her mother applied for welfare, workman's compensation, food and church assistance, etc., to no avail. She told me she would get home from high school, look in the empty refrigerator, drink a glass of water, and vomit. She eventually got a part-time job in a local restaurant along with her mother making 60 cents per hour. She immediately moved to New York City after graduating from high school.
P.S. Texas has not changed.
Jeff Atkinson (Gainesville, GA)
Local/state politics is perceived among liberals, especially young ones, as involving little issues and unworthy of their attention, an attitude not shared by conservatives, especially older ones, who appreciate power wherever it's to be had.
Bob (Rhode Island)
...but don't have the slightest clue on how to use it.
JH (JC)
These same local governments are trying to infuse profit motive into all public agencies. Just came across information related to Fortune 500 companies partnering with local politicians - all "small-government types" - to privatize foster homes, stealing benefits rightfully belonging to orphans. Meanwhile, public corporations receive subsidies for getting involved where they don't belong, morally speaking and otherwise. Like the Professor says, voters must do their due diligence in all elections, not just every four years.
blueberryintomatosoup (Houston, TX)
In Texas, privatizing many of the functions of the state agency that handles Medicaid and SNAP is a disaster. From my vantage point, hostile "customer service" has increased, and the amount of money they must be wasting just on unnecessary multiple mailings, and obscure and confusing language in the mailings (which prompt people to call for clarification), must be staggering. It makes me wonder if the company handling all that gets paid for each mailing and phone call, while the state keeps cutting what Medicaid covers.
hen3ry (New York)
Americans are cruel. That's the only way to explain why we refuse to allow women control over their bodies and reproductive lives. It's the only way to explain why we elect people who try to legislate into existence laws that allow business owners to preemptively discriminate against customers who look like they may be part of the LGBTQ community by refusing to sell to them. It's why we allow the death penalty and why we refuse to consider that rehabilitating criminals could be more cost effective than letting them rot.

We refuse to allow all our citizens access to health care they need unless they are rich. We do not fund education in a way that benefits those who need a good education most. We allow businesses to endanger their employees. We tell people that they deserve to be poor because they are lazy, stupid, or just plain don't deserve a decent life. We do everything but help. We punish the handicapped, the sick, the elderly, the poor, the middle and working classes by refusing to help them when they need it yet we help out corporations and the very rich when they say they need it.

Every citizen should be able to live a decent life, have a job, have access to the medical care they need, enough food, and decent shelter. If we are the richest country on the planet providing this should be no problem. And yes, we can do it if we close up enough tax loopholes and stop giving welfare to corporations and the ultra rich.
NJB (Seattle)
Some Americans are cruel, or at least callous. But don't forget the many who agree with PK in this piece and want to forge a different America from the Texas and Kansas models.
Kevin (philly)
"Americans are, I believe, far more generous than the politicians leading their states"

Which good and generous people put these cruel bigots and misogynists into office then? What decent, kind people supported Trump all the way to the nomination? No, America is filled with, by and large, a petty, inexcusably ignorant people with only pockets of true human decency. This country has a rotten, racist core that has never been excised. Americans are content as long as their tiny bubble is undisturbed; all other concerns are immaterial and worthy of nothing more than an indignant tweet.
Susan Anderson (Boston)
Universal health care is so obviously a public good that shows the US of A in a negative light compared to every other civilized country in the world. (Though the current Brits are trying to loot theirs, like stupid white men everywhere (see Michael Moore's book of that title.)

However, my progressive friends, we need political progress to achieve this. That means getting the best candidates you can into office, not taking your toys and going home.

It continues to baffle me that it is somehow Hillary's fault, when she tried really hard, and learned the hard way, that the US political process won't tolerate such obvious public benefits.

The only way to overcome it is to begin shifting the goalposts away from the far right negativity that is handicapping all of us. Incrementalism is lousy, but the alternative is worse.
ted (portland)
Ms. Anderson were you referring to Sir Phillip Greene who recently looted the fifteen thousand British Pensioners of their life saving? Not quite sure he is the atypical "stupid white man" you are so condescending towards. He's actually Jewish and currently domiciled on one of his yachts and his wifey is holed up in Monaco, more favorable taxes, less likely hood of extradition. These stupid old white men you refer too are the old blokes that built England and helped to save Europe although I'm sure they ask themselves why they bothered sometimes. Old white men arent the problem, part of it maybe, but look further South towards say the Middle East, that's where the problems seem to emanate from.
Q (Florida)
"It continues to baffle me that it is somehow Hillary's fault, when she tried really hard, and learned the hard way, that the US political process won't tolerate such obvious public benefits"
She tried really hard and learned the hard way how to become an excellent liar.
Integrity and honesty are important and with all that hard work she managed to cultivate neither.
John Townsend (Mexico)
It's noteworthy to look at the 2012 election from the point view of GOP voter appeal. He won 24 states:

- 9 of the 11 Confederate states
- 8 of the 10 states with the lowest population density
- 0 of the 10 best educated states (based on percent of population with a college degree, median household income and percent of population below the federal poverty line)
- 9 of the 10 least educated states
- 1 of the 10 healthiest states
- 9 of the 10 least healthy states
- 10 of the 10 weakest gun control states
- 0 of the 10 strongest gun control states
- 9 of the 10 largest net recipients ("takers") of federal money states.

There's more at work here than simply the need to "reach out to minorities".
There's the glaring issue of grappling with a low-information electorate that naively votes against its own self-interest.
Michael (Boston)
Except that the main reason for voting against their own economic self-interest is interests in other areas. Sometimes it is hating gays. Sometimes it is loving guns, and sometimes it is racism. None of these are 'good' reasons in the mind of this elitist East-coast liberal, but they aren't simply ignorance, and we need to recognize this.
Andrea Hawkins (Houston)
As noted, these same states are the ones that most overtly see recipients as only being those who are considered "the other".
John Townsend (Mexico)
IMHO ignorance and "hating gays, loving guns, and racism" is synonymous.
Steve Shackley (Albuquerque, NM)
The problem is absolutely that Democrats don't vote. In the last mid-term election in New Mexico, the fewest Democrats voted in 60 years and we have the first Republican controlled House in the state legislature in 60 years. Democrats essentially voted them into the state House. And what did they immediately do? The drafted bills to de-fund Planned Parenthood, make abortion illegal, tax cuts for the rich and essentially the Republican wish list. The Democratically controlled Senate deep-sixed all of them, although out Republican Governor welcomed them all. If Democrats don't come to realize that their voting behavior si causative, it's all over.
karen (bay area)
The RNC has a very active propaganda arm-- Fox News-- and is active in getting people to vote in non-presidential elections. I am not suggesting that the DNC build a propaganda machine, but some voter education and registration and get out the vote couldn't hurt. Otherwise people like me-- a majority of the population in a powerful economic state like CA-- get the shaft, as all the power abdicates to the GOP, thanks to low dem voter turn-out in smaller states.
Steve Shackley (Albuquerque, NM)
It's difficult to be a liberal thinker, where the world is a gray area, to get fired up without the racism and hate as part of our personalities. I lived in the Bay Area for 23 years, and just rarely saw the hate I do more often in New Mexico, especially in the southern rural part of the state. I grew up in San Diego, and it was pretty red, but now purple. Albuquerque is 80% Democratic, Santa Fe and Taos more so, so it's more like California.
N.B. (Raymond)
Every single state discourages voting .Imagine if all the poor voted instead of the arm twisting to never cast a vote and remain disconnected that every single state practices.
We would become a social democracy instead of becoming Trump's darlings and you are either with him or against him just like our George Bush before him who ALWAYS used a telepromter
ACM (Austin, TX)
More proof that we have incredibly callous and cruel people holding public office in Texas: here's what Don Zimmerman, a city council member in Austin, told a group of schoolchildren and their parents who had come to petition the council for continued funding of after school programs:

As the Austin Chronicle reported this week, Zimmerman gave a "sanctimonious lecture to citizens testifying to Council on the proposed city budget. Having told mostly Hispanic schoolchildren and their parent to aspire not to 'live off others'...Zimmerman responded to subsequent criticism by describing the same citizens as 'greedy and selfish.' ... He dismisses schoolchildren supporting their schools as freeloaders, but when Council considers spending he likes - suburban highways, homestead exemptions, public safety - he doesn't accuse supporting witnesses of 'living off others' or tell them to 'do something useful.' He's been particularly attentive to the demands of suburbanites in currently unincorporated areas who wish to continue enjoying the benefits of Austin prosperity without having to share the costs with the rest of us. ... The result? You and I are helping to pay for (his) water rates for the next decade or so."

This is the kind of nasty person we are talking about. "This man is aggressively critical of anyone who disagrees with him," but "throws a tantrum when criticism is directed at him," wrote the paper.

We must stop electing this kind of selfish person to office!
Squidge Bailey (Brooklyn, NY)
Why have states with right-wing governments refused the ACA Medicaid expansion? And why, generally, have these states done nothing to aid the poor?

Allow me to offer that this story teaches us something about the cruelty with which the bourgeois state constitutes an industrial reserve army, the economic underclass that serves to suppress wages, without which capitalism cannot function. It is not enough that this pool of reserve workers be poor -- poorly housed, poorly fed, and poorly educated. What we have learned is that the logic of capitalism prefers that they be sick, as well. Perhaps It is only by threatening their physical well-being that the requisite degree of desperation may be instilled in this class of worker such that they are willing to take a job at minimum wage.
Bob (Rhode Island)
They are afraid the black guy might get some of the credit.
Freedom Furgle (WV)
I often wonder why cruelty plays so well on the right, with everyone from fiscal conservatives to evangelicals espousing the need for "tough love" to solve the nation's ills. I'm sure the reasons are complex and varied, but I can't help but think the main reason is ignorance; far too many people confuse cruelty with strength - the classic leader's trait. They accuse those of us who take a stand for the little guy of being weak-kneed, bleeding-heart, wishy-washy liberals, never realizing what courage and strength it takes to stand up for the oppressed in an atmosphere of violent, belligerent hatred.
The problem with this is that the cure is education. Something the right has done their best to kill in the cradle.
pixilated (New York, NY)
I find it strange that the party of "personal responsibility" and the "freedom of the individual" is filled with people who spend a great deal of their time trying to interfere with other people's personal lives, most often to deprive them of opportunities they have been offered by a power greater than state governments, the federal government, which represents the entire nation. When you add Christianity and its basic tenets of charity, forgiveness, humility and loving thy neighbor as oneself, it's even more of a head scratcher.
Pat (Blacksburg, VA)
I find it distressing but not puzzling: it's about 'freedom for people like me' and 'I built this myself (taking my big profit for my lavish life-style while my hard-working employees had to rely on food stamps)". All too common. Luckily, that also is not the attitude of most people I know -- but I hang out with liberals.
Sarah (Arlington, VA)
Americans on the right and arch right of the political spectrum always accuse Europe to one big nest of 'socialist welfare states', if not even outright pinko.

The governments of these countries actually have a social conscience by providing strong safety nets to the less fortunate among them, which of course includes universal healthcare.

Otto von Bismarck, the Iron Chancellor of Germany, started healthcare, accident insurance and social security retirement insurance in the mid 1880s for blue collar workers, a concept that was later followed by other countries in Europe.

In the eyes of our dear Republicans and their base, that Bismarck must have been one super socialist, having turned the German Kaiserreich into a pinko heaven.
Mr Magoo 5 (NC)
Sarah
Under the German civil code states not to have any excessive (harmful) deleterious effects on the neighbors. The German courts every year review thousands of “neighbor cases”, because it is impossible to define "What is “Excessive”. It is impossible to make a civil law that will make people moral and loving towards one another.

We are not born as bigots and racists, but raised in a culture and home environment, which wallows in hate towards anything that does not fit into the belief system we were raised. Paul missed the mark here totally, but that is not his job. His job is to get people to read his opinion and he is good at what he does.
Sarah (Arlington, VA)
What does a German civil code that has to do with housing laws to do with my comment? Nil, nada, rien, nichts zero....

And no, Prof. Krugman didn't miss the mark at all. He rightfully points out the cruelty how far too many states treat their less fortunate by not providing Medicaid and closing Planned Parenthood clinics, the ones that work mostly with the poor.
CA (key west, Fla & wash twp, NJ)
Good column but the issue is why do so many Americans distrust Government to do together what we cannot do alone. That said the cacophony from the right have fed this distrust of Government. Including in this reality is both the Legislative Branch and the Judicial Branch of the Government, unlike the Executive Branch most of the individuals serve for life. This has created and atmosphere that has become very partisan, the result is the party "line" over the establishment of good Government of and for the people. So we have come full circle many Americans distrust Government and fail to vote in too many elections, they fear nothing changes.
Desmond (Halifax, Nova Scotia)
This speaks to Krugman's point, if people only pay attention to politics at the federal level, they may well come to that opinion without realizing how much damage is being done at the state level, the result of an election in which they may not even have voted.
GiGi (Montana)
A different moral calculus is at work in states like Texas. These are people who believe no woman who can't afford to raise a child should have one, but it goes further than that: she shouldn't have sex either. Abstinence is the only acceptable birth control.

You can rail all you want against these values but it's what the people of Texas want. These are higher values for them than compassion. Suffering, even death, is fit "punishment" for being poor.

I don't know how to change this set of values. Churches could do it but won't. But one thing won't help: calling these values racist. They aren't. Texans practice equal opportunity moral condemnation of all the poor.
Steve Shackley (Albuquerque, NM)
Well, Hillary is only 6 points behind Trump in Texas (our neighboring state of NM is 20 points ahead for Hillary). My point is that even Texas may shift at some point in the future. Or they could just leave, and Texans if they wanted to come a pollute our state would have to have a passport, and couldn't buy up all the real estate.
Marv Richardson (Minneapolis, USA)
I confess to being a serious fan of Dr. Krugman. Yet, in line with @Gigi's comment, I agree that he calls out racism when the simpler explanation of [perceived] economic takers explains the behavior. Ironic for an economist of Dr. Krugman's stature. That said, I'm still going to read every column and expect to agree with 90% of them.
Andrea Hawkins (Houston)
Actually, Texans focus their cruelty on poor people of color. It's just that every once in a while a poor white person is collateral damage.
Amy Mollberg (Blanco, Tx)
Mr. Krugman is so right about Texas. The state that claims to be concerned about the unborn seems to care little about the mothers or their children once they are born. It is also true that Texas is at the bottom of the list of state funding for education. Our leaders spend our tax $ trying to prevent the federal government from improving the quality of life here (funding for children, healthcare, environmental quality, right to vote.) It is not shocking that Texas tracks with third world nations when it comes to maternal mortality. Our state leaders are cruel and inhuman to the less fortunate residents of Texas and do not care to spend resources to improve their quality of life.
DR (upstate NY)
I recently re-watched the John Wayne movie "Red River" after many decades. The scene where Wayne simply shoots the representatives of an absentee Mexican landowner, saying in effect "He has too much land, I need/want it" --then says prayers as the victims are buried--pretty much sums up Texas history. A place with this kind of history cannot psychologically afford mercy to its victims; it would have to question its entire excuse for being.
Ed Bloom (Columbia, SC)
Paul,

I believe the Democrats are paying for their fixation on the presidency and congress at the expense of the various statehouses. We on the left complain about gerrymandering, but it has come about as an important Republican strategy because of we haven't been as interested in state elections where it is instituted.
karen (bay area)
Pity CA-- we get out and vote democratic and we are doing fine-- but then we get stuck with national policies that go against our values and interests because the red states don't get out and vote. Frankly I think the GOP is on some level OK with not winning the presidency-- they can block any progress by controlling the two houses and blame the president (democrat) for everything that is wrong. In the whole wide world!
Fred (Leonardtown, MD)
State or federal funding for Planned Parenthood cannot be acceptable to anyone who is pro choice because the use of tax revenue to perform abortions makes every tax payer an active participant in every abortion.
Accounting tricks don't make it not so.
reality check (US)
Every member of a unified political entity – – a town, the state, a nation – – inevitably pays taxes to support initiatives with which he or she may not agree.

For example, my taxes pay for the imposition of capital punishment, for war-making based on fraudulent premises, for corporate welfare, and for many other initiatives I find repugnant.

Similarly, you may conclude that some portion of your tax money supports initiatives not to your liking.

This is reality. The alternative to accepting it is to locate an unclaimed island for yourself.
lawyer (NY)
You are promulgating the rightwing-generated misconception that the government somehow "funds" or allocates donations to Planned Parenthood.

This is not the case.

Like thousands upon thousands of other healthcare providers, Planned Parenthood is eligible to receive reimbursement from the government health insurance entities known as Medicaid and Medicare, as well as many state-based insurance programs --

FOR SERVICES RENDERED.

Just like the family doctor who takes care of your grandma on Medicare.

The government is no more "funding" Planned Parenthood that it is "funding" that family doctor.

Abortion, which accounts for only 3% of the healthcare delivered by Planned Parenthood, is an excluded service.

Facts matter.
toom (Germany)
FRED--The Hyde amendment forbids the use of federal monies for abortion. So your comment is totally incorrect.
Vesuviano (Los Angeles, CA)
Good heavens, there are two columns today in this paper - this one and an editorial - that point out in fairly simple terms why California, controlled almost totally by Democrats, is doing so much better than a whole bunch of states that are firmly controlled by Republicans. Something to do with raising taxes on the wealthy to pay for services for the public in one case, and in the other case it's actually believing, as Democrats do, that government exists to provide services that benefit all people.

Wow, I think I remember reading something along those lines in our Constitution of the United States. Maybe we should fly over states like Kansas and drop millions of copies over the state. But could the people in Kansas read them, given that their public schools are so underfunded?

Never mind.
Brent Jeffcoat (Carolina)
Thick-bone, hard-headedness shielded with righteousness. Leaflets can't penetrate the heads of those folks. The sticks and stones of a foundering local economy may get through, but words will never, never do. Anyway, the suffering get their just desserts.
michaelslevinson (St Petersburg, Florida)
I am an independent write-in candidate for president. Those who cry out the loudest against abortion—they are the ones who were aborted in a previous life, and the experience is stamped in their character—they hear the word and freak out.

Every state has a military base. My plan: create abortion clinics on the bases to include state-wide transportation to the clinic for the indigent that may include an overnight stay.

In the event any state tries to interfere and somehow force the clinic to close then the whole base will close, eliminating a couple thousand jobs. The LAN Lord uh pin Heaven decides who is born and who is torn. .

http://michaelslevinson.com
Patrick (Long Island N.Y.)
I measure the economy by the amount of spending by both government and citizens that generates the movement of money and and wealth creation.

We all know two things; the Republicans are conservative and the Democrats are liberal i their spending habits. I would think the movement of money from hand to hand would invigorate the economy. Hiring people frees capital and puts it into circulation, then consumers spend it creating even more jobs and growth.

It doesn't matter to me who spends the money as long as it gets spent to generate economic activity. The Republicans horde money and the Democrats spend.

Every business person knows, you have to spend money to make money.

As for the Republican "Austerity", that goes without saying. As for health care funding and the denial of care for the poor, that would be the signature of the party of death, the Republicans.
Paul Leighty (Seatte, WA.)
The only way to get out of this mess is to dump the Grand Old Pirates at all levels of government.

A serious substantial reinvestment in the country is called for and health care is only one good example of things that need to be fixed in the nation. The Alt-Right is another good example of why we need to send them and their party packing in November.

The one party state of California is showing the way and we here in Washington state are going to follow in November. It will take a concerted effort over several cycles; 2018 & 2020 to rid ourselves of the pestilence of the Grand Old Pirates but it is achievable.
KJ (Tennessee)
I think hard-line religion is as big a factor as race. Here in the south the "in his image" part of creation is white. And there's the idea that god inflicts misery on those he doesn't favor, unless, of course, it's you, in which case your faith is being tested and he'll make it up to you later.

On the flip side, these people are amazingly generous, but they are careful to keep their distance from the folks they help. Mission trips are great because you can visit a few beaches and leave all those pathetic people behind when you go home. Disasters are fine, too. You can send food and your old clothes and feel good about yourself, and not be pressured by ongoing problems like local kids that don't have enough to eat daily, or old people who can't afford medications.

Organizations like Planned Parenthood stand for everything religious nuts hate and fear. You know, they're going to use our money to let a bunch of loose women get rid of innocent babies. If you try to rationalize the good PP does, like disease control, they'll get right back to those loose women. It's a control issue and an acceptable way to hate.
Susan H (SC)
And they don't stop to think about the quality of life of those innocent babies born to women who don't want them or can't afford them. I remember years ago when abortion first became legal someone arguing to me that having to take care of a child was "proper punishment" for women of "loose morals." The thoughtlessness of that remark has stayed with me all these years. And, at least once a week there seems to be an article in the paper about another child beaten to death, left to die in a hot car by a parent who "forgot" to drop them off at daycare, or sexually abused.
Virginia Witmer (Chicago)
Yes! The failure to see beyond one's own "tribe," be it religious or merely social (monied), is at the core of our own and many of the world's problems. We are all in this country and on this planet together. Our continued existence depends on our recognition of, and adjustment of our thinking to, that simple fact.

To those "Christians" trying to impose their views on everyone: "In as much as you have done to the least of these my brothers and sisters, you have done it to me." (With apologies to the King James version, but you get the message.)
Richard Green (San Francisco)
Yeah. I have always found it curious that the Bible-thumping crowd always condemns, as you put it, those "loose women," yet almost never has a word to say about the men fathering those children. Oh, that's right, those God-fearing Christian men have been led astray by all those "loose women." Interesting, since by their own beliefs, there has only been one case of pregnancy without human copulation.
Harold (Winter Park, FL)
A thought on Texas from personal experience. There are islands of sanity in Texas, primarily in Dallas and Austin. Dallas, for example, has the Perot Science museum with a whole floor devoted to evolution, no mention of creationism anywhere. A beautiful place.

But, just a few miles out of these metro areas you find yourself in the wild west with all its primitive culture in full bloom.
Joseph Huben (Upstate NY)
"Conservative" and Christian "morality" have become synonymous. All of the Republicans wear their "Christian" faith as signature emblems of their character. They do so with the collaboration of "Christian" churches and a narrative which neglects the mission of their religion: " ‘Depart from Me, you who are cursed, into the eternal fire prepared for the devil and his angels. For I was hungry and you gave Me nothing to eat, I was thirsty and you gave Me nothing to drink, I was a stranger and you did not take Me in, I was naked and you did not clothe Me, I was sick and in prison and you did not visit Me.’…"
Gerrymandering, perverting religious beliefs, rewarding the rich and punishing the poor are deliberate methods used by Republicans to seize power in the States. This has paved Trump's road to power, but it does not stop there. Paul Ryan, a purported devout Catholic, offers an incentive to the poor by depriving them of food in his budget. "For I was hungry and you gave Me nothing to eat" does not apply to Ryan, nor does the demands of the Pope to feed the hungry, and care for the stranger. Inequality is necessary, greed is needed by Republicanism, victims are necessary, racism, xenophobia, and terror are all necessary incentives to generate enough voters for Republican success. Cruelty is a genuine character trait of Republicans who pretend that their goal is to reward hard work when they only want workers whom they can exploit for example Mexican immigrants.
underhill (ann arbor, michigan)
They have to tell us (loudly) they are christians, because we would never know it by their actions.
manfred marcus (Bolivia)
Exactly right. Unjust treatment of the indigent, the poor, the unemployed, is happening partly because of rotten politicians; but also because we, the public, complacent in our little laissez-faire, do allow it to happen. A reminder: "no chain is stronger than its weakest link"; we are all together in this, or should be, for society's wellbeing. That republicans are mean and nasty beyond measure does represent discrimination, a tribal attitude that will come back to bite us. How can we possibly look in the mirror, and see the monster reflected, and not change for the better? Are we so petty, so small, so Trump-like?
Eddie Lew (NYC)
We seem to be an uneducated, obtuse, myopic people, all in all; every child born in poverty and thwarted to having a decent start in life is a brain drain for our country, and we don't get it. In my opinion, Republicans and their manipulation of the stupid segment of our population is at fault, Mr. Krugman. And I agree, many of the not so stupid don't vote because of selfish, righteous indignation concerning issues and candidates, are not helping.

We are gradually becoming a sad sack of a country (albeit with thousands of nuclear war heads), to be pitied rather than emulated. What other conclusion can one come to? Imagine all the possible scientists, doctors and artists we are sacrificing for our stupid notion that the poor are not worthy or our deep rooted racism? American exceptionalism? We truly are exceptionally obtuse, not to say myopic, with a genius for electing people who don't govern so much as loot.
Charlie (Indiana)
Thank you!

I was one of those left standing at the end of a cotton row in the 50's and had I been black, there is little hope I would have succeeded as well s I did.
dEs JoHnson (Forest Hills)
Yes, all politics is local, and isn't just a thing every four years.

When Trump criticizes immigration policy, actually supporting white supremacy, he fails to see that white immigration brought old habits of the Old World. In the 15 years before 1914, some 15 million people immigrated here (Hobsbawm). Most of those were decent, hardworking Europeans, but they weren't actually schooled in the US Constitution, and they hardly left their biases at Ellis Island. They grew a deep and abiding fealty to their own notion of America.

On the Right, the rebel is revered, even if his actions actually trashed the Constitution. In Reagan’s White House, a complicated plot was hatched and carried out to do business with the terrorist regime of Iran. This involved the swap of arms for hostages and money; it involved lying to Congress about civil rights abuses in Honduras; and involved the Saudi king in setting up a Swiss bank account for illicit funds. Some members of the Ragan administration served time for this, a whole bunch were pardoned by Bush I, and Oliver North had his sentence dropped on a technicality. He still has a show on Fox: War Tales with Oliver North. And Fox preaches the Constitution.

Texas is just part of the problem.
dEs JoHnson (Forest Hills)
The impact of that 15 million newcomers? The population of the USA in 1900 was less than 80 million. Add some for territories that were to become states, yet 15 million was huge injection of opinion and tribal totems and taboos
susaneber (New York)
If only the rich can afford healthcare, won't hospitals have to cut staff? Maybe there will be fewer hospitals, less research, less choice of healthcare providers. This reduction of services would affect even the rich.
I remember thinking, when I heard a doctor complain of the low pay he got from Medicare, that without Medicare he wouldn't even have those patients.
Hugh Robertson (Lafayette, Louisiana)
And indeed Medicare and Medicaid are an important component of the support of our teaching hospitals without which new doctors would not be trained. And on that subject, the AMA continues to lobby for controls on who becomes a doctor making it necessary to be rich or lucky to become one.
dEs JoHnson (Forest Hills)
Good points. But long-term thinking doesn't trouble the rich.
Hapax (Retired in Rural America)
Hospitals do close. A struggling hospital in very rural Scott County, Tennessee recently closed. It was an access point for healthcare for the area. The failure of the state to approve Medicaid expansion hurts healthcare and local economies. Now the scorecard is $2 billion in foregone Medicaid money in Tennessee alone.

As rural hospitals close, not only is the local economy hurt, but also people won't want to move there. Areas without medical services will not attract businesses or even retirees and the depopulation of rural areas feeds the downward economic spiral.
the doctor (allentown, pa)
Texas indeed has its priorities perversely reversed with its war against Planned Parenthood - an invaluable health-care provider especially in rural areas - and abortion clinics while allowing "open carry" on college campuses. That it also cruelly denies Medicaid benefits to the poorest of its poor is a moral outrage. This state is indeed "Lone" but it is certainly no "Star".
Stephen Kurtz (Windsor, ON)
The declaration of independence cites life. liberty and the pursuit of happiness. I guess those Republican legislatures recognize the last two but not the first.
Lake Woebegoner (MN)
I thought I'd peruse Krugman's column today, having eschewed his baloney for the last year. It's still baloney.

Nowhere in his column does he tell us what the surge in mortality is in Texas. Or what doubling has resulted in, numbers-wise.

I can tell you this: the mortality of the unwanted human fetus has remained the same:100%. 50,000,000 unwantrf humankind is a staggering number, unless you, like Krugman and ilk, think the human fetus is a small ring of baloney to be tossed in the unwanted meat pile.

Until we all wake up to what abortion really is: murder, women who don't want their unborn child will find a way to destroy it. What we need is a new organzation, called Pre-Planned Parenthood, an organization that prevents unwanteed pregrancy before it happens when egg is not human, instead of after conception when the zygote is, guess what, human.

The mortality rate of pregnant women is far, far from the mortality rate on unwanted babies-to-be. Humdreds of thousands fewer. Yet, all deaths are avoidable if we had in place a Pre-Planned Parenthood policy to better help women avoid getting pregnant, and providing them all the help they need to carry their child full-term if they do.
Susan Anderson (Boston)
Your argument would work better if you were in favor of supporting mothers and babies after they are born. Perhaps you are one of the many who claim they do, but on further investigation these people are selective in their charity, and only willing to do so in a limited way and/or at some distance.

Otherwise, you are subject to the purity monster that says the unborn are more important than those who have progressed beyond the early stage fetus.

But it does sound like you're in favor of universal access to inexpensive birth control (particularly for men, the main perps in this).

Congratulations!
ktg (oregon)
planned parenthood does provide options and methods to control not becoming pregnant, in fact their intent is just that. The use of abortion is a last measure, not the intent.
Lake Woebegoner (MN)
Susan, my deep regrets for not making it clearer that I do support both mothers and babies after they are born. I contribute to the many charities who support them. I bring them Meals on Wheels if they need them. My wife makes blankets for the newborns.

Yes, more needs to be done to save lives. My belief is that all life is sacred. All.

And yes, I firmly believe the best way to avoid an abortion is to use birth control and have access to it before copulation.
Grey (James Island, SC)
South Carolina governor Nikki Haley recently called a press conference to announce the state's latest big legislative achievement: allowing people from Georgia and North Carolina to open carry their weapons here . What a breakthrough!
This followed the announcement of making it a criminal offense for doctors to perform abortions after 20 weeks even in the case of malformed fetuses unlikely to survive or a mother's life in danger.
This wisdom is part of the Governor's expertise in medicine, in which she turned down Medicaid expansion because South Carolinians are "different" and Medicaid actually endangers people's health in SC. And more guns make people healthier.
Go figure.
underhill (ann arbor, michigan)
too bad the governor and legislature of south carolina will not be charged with murder when this new law, inevitably, leads to the death of a woman. Medical decisions should be made individually, in response to the circumstances, by doctors and patients. The legislature has no business making these decisions by fiat, for everyone. This is pure evil.
Patrick (Long Island N.Y.)
Yup. The Congressional races were overlooked while everyone focused on the Hillary/ Trump popularity contest and fortunately is now be addressed. I believe there is more power vested in the Congress and it deserves a Herculean effort to win by the Democrats. The opportunity for winning was never greater.
trblmkr (NYC)
Are you writing from the future? Can I borrow your machine?
NM (NY)
The hypocrisy is staggering.
The same individuals who want to remove thorough sex ed from schools and access to family planning then want to impose restrictions on abortion, defund medical help for pregnant women, and then take money from food stamp and other social supports. It is a death spiral.
And they dare call themselves "pro-life!"
KarlosTJ (Bostonia)
If Planned Parenthood cannot survive on its own, without government help, then it deserves to die the death of all inept, corrupt, bankrupt businesses.

Of course, if the government stopped engaging in forcible charity - taking my wealth and showering it over its preferred recipients - then you would see more charitable organizations. Like we had, historically, before FDR decided to make you spend your wealth as he wanted.

Krugman cannot recommend that, because it would demonstrate his hatred of freedom. He cannot stand to see Americans spending their money as they choose. Because, well, he simply knows better than everyone else.
Susan Anderson (Boston)
There you have it. Exactly how did you acquire "my" wealth? Is there any chance that you used public services, low-paid labor, unregulated financial markets? Perhaps not, in which case you are exceptional and I compliment you.

That said, we all benefit when family health care and planning is supported in a civilized society. Most employers would benefit from universal health care, removing the burden from smaller employers and preventing markets from enabling greedsters who have recently been jacking up prices of medicine. For example, I recently needed an antibiotic, and it turns out the generic substitute was more than five times what it was a couple of years ago, and the original was many times that. Deregulation hurts all of us.

Eventually, you too will suffer from a degraded environment, though you have closed your mind to the idea that our earth is finite and exploitation is not an infinite resource.
Len Charlap (Princeton, NJ)
Well, Karlos, let's see how the country did when we followed your advice and cut federal spending back to no more tha we were talking in. When we actually paid down the national debt.

The federal government has balanced the budget, eliminated deficits for more than three years in just six periods since 1776, bringing in enough revenue to cover all of its spending during 1817-21, 1823-36, 1852-57, 1867-73, 1880-93, and 1920-30. The debt was paid down 29%. 100%, 59%, 27%, 57%, and 36% respectively. A depression began in 1819, 1837, 1857, 1873, 1893 and 1929.

So when we stopped " taking (your) wealth and showering it over its preferred recipients", everybody suffered.
Richard Miner (NJ)
This argument is one of the few, coming from people who consider themselves conservative, that actually makes some sense. At least it dovetails with their basic notion that government can't do anything right and that private enterprise (and charity) is the only route to bettering lives. But, by arguing such an extreme position they part company with traditional conservatism; Adam Smith and Milton Friedman both would have found them less extreme than I do but extreme none-the-less. I'd ask the writer to re-read Milton Friedman, then consider whether Friedman's view of the relationship between private enterprise and government isn't more balanced than his own.
Jordan Davies (Huntington Vermont)
"So the economic case for being cruel to the unfortunate has lost whatever slight credibility it may once have had. Yet the cruelty goes on. Why?

A large part of the answer, surely, is the usual one: It’s about race. Medicaid expansion disproportionately benefits nonwhite Americans; so does spending on public health more generally. And opposition to these programs is concentrated in states where voters in local elections don’t like the idea of helping neighbors who don’t look like them.

In the specific case of Planned Parenthood, this usual answer is overlaid with other, equally nasty issues, including — or so I’d say — a substantial infusion of misogyny."

A perfect recipe for what is wrong with the Greed Only Party and Texas in general. 19 states still refuse to extend Medicaid to the poor.

From Matthew 26:6-13 - "For ye have the poor with you always, and whensoever ye will ye may do them good: but me ye have not always."

I suppose the religious right haven't read this passage recently.
HL (AZ)
I love the passage you quote. I pay an enormous amount of my wages in Federal taxes. From reading the NY Times, I can see clearly that much of the taxes I pay go to servicing debt and to wars around the world, spying on my fellow citizens, the funding of secret courts, a military that is more than 50% comprised of private contractors or if I may be so bold, mercenaries. We recently destroyed a hospital in Afghanistan, a hospital I helped fund through charitable contributions to Doctors without Borders. We utilized foreign soldiers to provide the targeting. Many of those foreign soldiers armed and trained by the CIA and US military which were also funded by my tax dollars.

These wars are supported by both Democrats and Republicans.

I personally would rather funnel more of my tax dollars to charitable giving to both Doctors without Borders and Planned Parenthood rather than to the whims of my elected officials. It seems to me that both The right and left really enjoy blowing up stuff with my tax dollars.

I don't like quoting scripture when it comes to politics. The irony and hypocrisy of both the left and the right when they resort to scripture should give both pause.
vulcanalex (Tennessee)
No it is about money, not race. Here there are many poor white people.
Susan Anderson (Boston)
It's not about those "precious" unborn babies, is it? Because once those become "ugly" born babies served by "ugly" mothers the concern disappears. "Ugly" is a code word for unspoken hatred towards others, which appear to be so important to hurt that Republicans are willing to hurt many of their own in order to achieve the goal of exclusion. Since many of the voters who approve this nonsense are struggling to get by themselves, it is a puzzle that resentment of these so-called "others" who might be but aren't always different is more important than getting help.

It's partly about the deception. Keeping uninformed voters from getting together with the facts is the intent. But it seems that they themselves are complicit in keeping their minds closed.

Increasingly here at the NYTimes advocates for this kind of ignorance are showing up accusing us of being in a bubble and not caring. But it's not that we don't care, it's that we are baffled by blind stubborn resistance to real self-interest and willingness to inflict and suffer pain on behalf of maintaining anti-human hatreds.

It's certainly not about health care for women.
Lake Woebegoner (MN)
How wonderful it must be to be so elite as being able to judge what constitutes beauty in in unborn baby. You might wonder how it is that Ms. Anderson can label these babies' beauty, never having seen them.

Well, it's very simple. In the mind of a simple, singular focus, beauty is what decide to call it. The synomym for beauty is being wanted. Pulchritude has nothing to do with it. Only acceptance.

If you're wanted, you live. If you're not, you die.
Thomas MacLachlan (Highland Moors, Scotland)
Paul, this is really quite simple. Issues like Planned Parenthood and Medicaid expansion have little to do with race fundamentally. Of course, minorities are hurt the most with the regressive policies seen in the Red states. But when all the chaff is cleared away, the real reason why the Red states behave this way is to further the goals of the oligarchs in power. See, the true foundation for all these side issues is power, not race. Get the electorate to focus on wedge issues like defunding Planned Parenthood, and they won't see how the wealthy at the top are carving the economy up to fit into their bank accounts. This has always been about the power of the most wealthy. And they had to identify villains, so they chose the least powerful, since they could not retaliate against them or even protect themselves from the onslaught. And the voters on the right are ignorant enough to believe in this strategy without realizing that THEY are the ones getting most hurt by it. The continue to vote against their own best self-interests, and end up making inequality ever more pronounced.

There is a strong element of dominionism at work here, too, where the right believes they have the divine authority on their side to take whatever they want, because God loves them more. And He shows that by bestowing wealth upon them. It's selfish poppycock, of course. Self-delusion of the highest order.

This is why it is so imperative to vote the Republicans out of office this fall.
Fort Worth school trustee (Fort Worth)
The infant mortality rate in Texas is a scandal in itself. The refusal of our state to include supplemental Medicaid coverage is bad enough. Even worse is the refusal of our county to include some residents in the eligibility pool for our county health care, a service provided by all other urban counties in Texas. This is why our county is a heavy contributor to the state's already miserable infant mortality rate.

Health care is vital to the ability of parents to adequately prepare their children for education, and it is well known that the family is the major contributor to student performance.

What a waste!
Guapo Rey (BWI)
There may be some method in Red State policy: reduce services to the underserved so that they self-deport to more liberal states, reducing their own state budget pressures. Hopefully, at the same time, maintaining their position as the "takers" in the Fed redistribution of tax revenues.
vulcanalex (Tennessee)
Residents mean illegal aliens? Code words at work.
OldBoatMan (Rochester, MN)
The root cause is the concept of Medicare as a joint state-federal program. The devil in the details is that Medicare is a block grant program. Money for health care is funneled to the states with insufficient restrictions and little, if any, accountability.

Sure, a Republican Congress will resist any effort to hold Texas accountable for its use of medicare funding to create a healthcare system that competes with third-world countries in the mortality rates of pregnant women. And I suspect that an unacceptably high mortality rate among pregnant is not just a Texas problem, but a nationwide issue.

Perhaps one day we will have a Democratic Congress that will use its investigative powers to study issues such as the high mortality rate among pregnant women and issue a well documented report.
MJ Borden (Madison, Wi)
Medicare is a federal program. Medicaid is a joint fed/ state program.
Len Charlap (Princeton, NJ)
OBM, I think you meant Medicaid, not Medicare.
David c (Westfield nj)
My solution is to make voting mandatory. This is every citizen's responsibility in a democracy yet so few partake. Besides forcing interest in national and local politics, it also undermines the impact of special interests since there narrow voting blocs lose power with more voters.
Wayne (Brooklyn, New York)
The Republicans have been too busy passing voter ID laws to impede voting. So it's unlikely we will become like Australia where people are fined for not voting.
vulcanalex (Tennessee)
Just how to you propose to make voting mandatory? And in which elections? Somehow people like you don't understand freedom.
Ariel (New York)
As a Democrat, I vote in ALL the elections, however small, even though it's hard to get to polls with my work schedule. I live in a rural area and find the majority here have twisted, negative ideas about people on welfare. I think social welfare and issues of race and class need to be taught in high schools and the media needs to get better at educating versus selling inflammatory headlines. We are a dumbed-down society that educate ourselves by headlines versus taking the time to really read. Education on these issues needs to start early.
vulcanalex (Tennessee)
Yes indeed those low educated people who just vote for a Democrat, even if they lie, are corrupt, and are not trusted. Those voters.
Jackie (Missouri)
See if you meet the qualifications and can vote by absentee ballot.
HL (AZ)
My big grip with the ACA Paul is while it created a scheme to give people the right to buy insurance for health care and subsidized people who couldn't afford insurance, it didn't require access to quality providers.

The end result is the insurance companies who got all these additional customers for insurance, have reduced access to quality providers.

It seems to me you are making an argument about Conservatives in Texas and other red states who are effectively deny people access to a quality provider like planned parenthood but you have cheerleader the efforts of liberals who passed the ACA denying middle class and subsidized lower class insured people access to quality providers.

You might want to consider that liberals have passed a health care act that provided both universal coverage and universal access. While they greatly expanded universal coverage, they have allowed insurance companies to greatly reduce access to quality providers. States of cruelty are in the eye of the beholder.
Susan Anderson (Boston)
This is a Republican problem too. They have succeeded in getting courts to remove mandates so it is harder and harder to create a pool that helps everyone.

They know that chipping away at the money and requirements side creates hardships for the whole program, and are willing to play the long game, with continuous attacks and challenges.
Len Charlap (Princeton, NJ)
The ACA was not passed by liberals, but by centrists. Liberals supported HR676, a 70 page bill which simply gave an improved Medicare to every man women and child in America.

I have been on Medicare for 13 years. I can tell you that it is far better than any of the 20 or so private plans I suffered under previously. With a few improvements (Dental coverage, better drug coverage, better mental health coverage, etc.) it can be even better.

It would be similar to the system used in Canada today. We pay a total (including taxes) of $8715 per person per year for health care. Canadians pay $4351. If our system were as efficient as Canada's, not only would we have much better health insurance we would save over $1.5 TRILLION each and every year. This money could be better spent elsewhere.
HL (AZ)
Susan,

The Republicans have no answers. That said the Democrats who created and passed the ACA, severely reduced access to quality providers in order to expand coverage. When Mr. Krugman writes a column about the denial of access to a quality provider, there is a finger that needs to be pointed at the ACA which was created by the Democrats.

I'm not making the argument that the Republicans offer any solutions, they clearly don't. I'm just pointing out the irony and hypocrisy of this column. As a progressive, I'm frankly, beside myself that the Democrats have accepted this plutocratic reality that the elites in their leadership have created.
Rufus W. (Nashville)
Sometimes it seems we are just a few short steps from criminalizing the poor and creating Victorian type debtors prisons: We can't seem to get a living minimum wage off the ground, good paying factory jobs are evaporating and moving out of the US, health care access for many is elusive and many who do manage to get insurance are burdened with $5,000.00 deductibles, schools in many areas are understaffed and underfunded- setting up students for a lifetime of hardship, and even if you can make it to college - the average tuition for state universities is staggering (most folks could not easily and quickly come up with an additional $10,000 a year). Things are a mess and neither candidate has really shown any plan as to how to fix it. I am not sure either candidate really cares.
vulcanalex (Tennessee)
Well Gee since most of these issues are properly addressed by states and charities those running for president should not be involved.
Len Charlap (Princeton, NJ)
vulcanalex, if you would read the column, you would see its main point is precisely that some states and charities are doing a terrible job with these issues.
sjs (Bridgeport)
Yes race is a factor and misogyny has an effect (the endless need of men to control women). And don't forget religion. But I think the real reason is social/economical class. Do not ever ever underestimate the hatred and scorn for the poor in this country. I'm not sure why. Is it a loathing caused by fear that that could be them? Or that poor people are a slap in the fact to the American Dream? Or is it some general feeling that poor people should not be poor and its all their own fault? I don't know, but I do know it is very real.
Judith Testa (Illinois)
It seems to me that the religious-based hatred and contempt for the poor can be traced back to Calvinism: that pernicious form of Protestantism that forms the basis of most fundamentalist Christian beliefs. That is the origin of the belief that wealth is a sign of divine favor, and that being poor is a sign that God hates you. A worse perversion of the message offered by Jesus is hard to imagine.
Berne Shaw (Greenwich NY)
Every group can be dealt with in such a way they lose care for others and scapegoat other groups when they have lost something. But those groups who were powerful and dominant and have been cut out of the entitled role i.e. The middle class with the destruction of unions and massive shift to the wealthy have nothing tempering their citizen responsibilities and are susceptible to a return to bigotry racism misogyny xenophobia and worse.
Nan Socolow (West Palm Beach, FL)
Dr. K., what can we do about the cruel, irresponsible hostile people who have defunded Planned Parenthood in Texas? They have done so much damage to low-income young and older child-bearing women who have the legal right to choose whether to remain pregnant or to have zygotes in their bodies removed. These Texas women are poor and desperate and yet another unplanned pregnancy is the issue of their lives - Texas and the red states are for declaring a woman's egg as a person. Demented! State overnment cruelty to the unfortunate! Gross misogyny and racism and bigotry are alive in Texas and in the campaign of the worst Republican candidate for the Presidency we have seen in our lifetimes (and long before that). Attention must be paid to the most unfortunate Americans in our midst. Seems like Texans are anti-everything but guns. It is a death penalty of a state. Dr. K., we the people need help in solving nasty inhumane issues in such states as Texas. Maybe Texas will "unfriend" the rest of the US and take their miseries and secede from the Union as they did once before. Devoutly to be wished!
Marc Anders (NYC)
One thing to do would be to bring suit demanding that it is unconditionally inconsistent not to equal limit the destruction of viable embryos that is an integral part of fertility treatment (which currently is favored by even the most avid "Right To Life" 'ers).
Charles (holden)
We Democrats need to grow up and smarten up. The Republicans and their deep-pocketed sponsors know how to build an organization from the ground level and up. They vote in the mid-terms. Hell, they probably even vote for a Republican dog catcher. They know that all politics is local, and policy is made locally. We show up every four years like clockwork to vote in a Democratic president, then go to sleep for another four years, occasionally waking up to curse the Republican party. And we wonder why our Democratic figurehead can't accomplish anything.
Vernon (Portland, OR)
You have it right. Oregon is known as a blue state, only one Congressman is Republican. Democrats control the State House, but Republicans, largely tea party types have a large majority of municipal, county and school boards.
vulcanalex (Tennessee)
Well Gee it seems like Hillary has a massive organization and plenty of money as well. I keep hearing about how she is spending massive amounts on ads, while Republicans are not.
Charles (holden)
I'm talking about lower positions, not national races.
Tom (Earth)
Texans believe that if you want to be happy and healthy, you should own an oil well or two. They believe it's in the Constitution.
Jeremy Mott (West Hartford, CT)
"Depart from me; I never knew you." That's what Jesus told us He will say to those who have not truly followed His teachings.
RJ (Londonderry, NH)
"This should be a no-brainer: If Washington is willing to provide health insurance to many of your state’s residents — and in so doing pump dollars into your state’s economy — why wouldn’t you say yes?"

If it's such a great deal, then why didn't the Fed fund the expansion at 100% in perpetuity? Pretty sure it drops to 90% after the first 4 years. Maybe these states recognize that the majority of the expansion in Health Insurance after Obamacare is coming from Medicaid, not the exchanges, and they're worried about yet another unfunded liability?
vulcanalex (Tennessee)
Because your assumptions are incorrect. The states have to pay a portion and in the future it might increase. We already pay way too much for healthcare at the state level.
Len Charlap (Princeton, NJ)
RJ, the answer to your question is that the Republicans fought the expansion and what came out was a compromise.
Hugh Massengill (Eugene)
It's been about racism for a long time. I remember going to the University of CT. in 1965 and asking my father why there were no black students, other than ones from Africa. The North End of Hartford would explode into fires and riots at the end of every summer, but the University was very white. At that time the State provided a lot of funding. Costs to attend were low.
Then there was a breakthrough, and blacks attended the University in greater numbers. And the State Legislature did what it could to lower funding. That process seems to have been going on in most every state, as non-whites gain the ability to attend college, the tax payers stop their funding. From Oregon to Connecticut, racism and withdrawal of public funding seem to be hand in hand.
Hugh Massengill, Eugene
Ludwig (New York)
Hugh, and what do you think is the reason? Are Africans not really black? If racism was the reason, then Africans who tend to be darker than African Americans would be treated worse. But they are treated with less prejudice.

I am afraid the real reason is that people from Africa and black people from outside America have not been spoiled by white liberals, and they act like ordinary middle class people.

I remember an African doctoral student of mine who insisted that when he and I were walking together HE carry my briefcase. He would explain saying that it would be an embarrassment for him if he allowed his teacher to carry his own briefcase. A young black woman from Grenada was the best student in my class at Brooklyn College.

My daughter in law is also of African origin but again from Trinidad. She has a doctorate and a brain smarter than any two NYT posters.

Why are these people doing better than African Americans?

Daniel Moynihan warned long ago that white liberals motivated by guilt and looking for black votes were allowing the black family to collapse.

African Americans will not get out of the hell hole they are in until they realize that white liberals are not really their friends. Tolerating the killing of white cops, and looking away from black on black killings is NOT the way to improve your lives.

Liberals, do you feel guilty? Go into a church or a temple and beat your breast.

But please do not destroy the lives of African Americans!
JSK (Crozet)
Here is a link to the full text of the article under discussion: http://d279m997dpfwgl.cloudfront.net/wp/2016/08/MacDormanM.USMatMort.OBG... . The abstract concludes that "Despite the United Nations Millennium Development Goal for a 75% reduction in maternal mortality by 2015, the estimated maternal mortality rate for 48 states and Washington, DC, increased from 2000 to 2014; the international trend was in the opposite direction. ..."

The discussion also notes: "It is an international embarrassment that the
United States, since 2007, has not been able to provide a national maternal mortality rate to international data repositories such as those run by the
Organization for Economic Cooperation and Development. This inability reflects the chronic underfunding over the past two decades of state and national vital statistics systems. Indeed, it was primarily a lack of funds that led to delays (of more than a decade in many states) in the adoption of the 2003 revised birth and death certificates."

The piece does not exclusively blame the defunding of Planned Parenthood for the alarming Texas numbers, but it is certainly part of an embarrassing mix that creates an accurate representation of the USA moving backwards in this crucial public health arena. One gets the sense this is part of an embedded political fabric that can also be tied to guns and public health.
JT FLORIDA (Venice, FL)
You're right about the manner in which this cruel ideology has taken over in state houses and local governments. The Tea Party was successful in working at grassroots organizing, particularly in off year elections.

Now we're seeing in GOP primary contests candidates trying to outdo each other to be Trump-like to curry favor with voters.

"The fever" as President Obama called it, hasn't broken and " the vast right-wing conspiracy" as Hillary Clinton called it, is alive and well in places like Texas, Kansas, and Florida where money to help poor people gets rejected and thanks to Citizens United dark money flows to election campaigns.
Magpie (Pa)
JTFlorida:
Funny that the Tea Party seems to have outmaneuvered the oh so smart Democrats. What should we do about this?
tony zito (Poughkeepsie, NY)
Someone once opined that states are the laboratory of democracy. Today, they are more often laboratories of tyranny - the tyranny of a majority poorly constrained by courts not committed to the US Constitution. Who will protect the rights of American citizens living in Texas?
vulcanalex (Tennessee)
What "rights" are you talking about. The "right" to a "living wage"? "free healthcare"? Just what "rights" that can be found in the constitution?
bob (Houston, Texas)
Actually, In Texas the problem also stems from voting districts gerrymandered into pretzel shapes designed only to elect Republicans, and to the most horribly ineffective state Democratic Party you can imagine. With essentially no opposition, the result here is reflected in your column, only much worse.
Jackie (Missouri)
I'm not sure that gerrymandering is the problem here in southwest Missouri. What I do know is that the Republicans often (or usually) run unopposed. There are also no voter education booklets to tell voters about the issues on the ballot, how their prospective or current representatives vote on any issue and more importantly, who backs them. Except for political advertising, voters are, I feel, deliberately kept in the dark so that those who are in power remain in power, especially if they are hard-core conservative and Republican.
Yuri Asian (Bay Area)

Too bad for Texans that their state is a political heart of darkness. But whether it's apathy, corruption, racism, right-wing/religious hegemony, or just something in the drinking water, it's their problem.

Texans can vote for change or vote with their feet. It's not a prison camp, though some parts of Texas have health, education and poverty statistics that give prisons in developing nations a run for their money.

All the critical elements of democratic self-determination are available to Texans as they are to all Americans. If a majority prevails on the side of "cruelty" election after election, and the politicians enact policies that don't violate the U.S. Constitution, it's their bed to make and sleep in.

What's objectionable isn't what they do to themselves (or more to the point fellow Texans devalued by bigots) but what they do to the rest of us with the idiocy they send to Congress, whether it's indicted pest exterminators like Tom Delay, or Phil Gramm, the czar of corruption (who did more than anyone to deregulate Wall Street and usher in casino banking), or Ted Cruz. They're probably happy to claim renown water-colorist Dubya as a native son too.

Their bumpersticker reads "Don't mess with Texas". Seems they've done a fine job all on their own. Where trigger warnings at the UofTexas is a conceal/carry bump under a NRA T-shirt and safe space is wearing a bullet proof vest.

There's a reason Texas rates just one star on its flag.
JABarry (Maryland)
This is not all about money. Religion is a driving force in Republican ideology of small government. For example, defunding Planned Parenthood and refusing to expand Medicaid are not about balancing the budget, reducing government, cutting taxes; this is about practicing trickle-down Republican Christianity: putting into practice the Republican belief that truly it is better to appear cruel to pregnant women and sick children because you know that it is the will of god that you must suffer the scorn of others for appearing insensitive when you cannot offer a helping hand while you need both to hold your bottle of wine and loaf of bread to your mouth. The more you merrily eat and drink, knowing that god has rewarded you with your food and wine for the goodness in your heart, the more spillage and crumbs will fall to the least of your brothers and sisters. Fundamental Republican Christianity teaches you must suffer the misunderstanding of others for your appearance of cruelty while trickling your inner goodness on others.
Judith Testa (Illinois)
In a word: Calvinist Protestantism: the belief that wealth is a sign that God loves you and poverty a sign that God hates you. No need to worry about the poor--Gid has already judged them unworthy of your concern or help.
Oliver Jones (Newburyport, MA)
There is some good news for Texas residents: they can move, and they can vote. Either course of action has the prospect of changing things for them.

The Texas government's choices are unpleasant for somebody who believes the measure of a society is how effectively it helps the poor.

But the people of Texas have voted for those choices, over and over again. We can certainly argue that the votes weren't fair. But they were the votes. The people of Texas have spoken. I hate to be harsh, but deteriorating public health in Texas is Texas's problem.
GTM (Austin TX)
Agreed - and this is exactly why we left Texas this year. Texas politicians have intentionally and knowingly put a whole range of policies in place that are harsh to its citizens who are struggling economically. For a state with such abundant natural resources, it never made sense to us that helping out others was seen so negatively. Texas can be a good place to live IF you're educated and affluent, and preferably Anglo-Saxon heritage - for everybody else, not so much.
Ed Bloom (Columbia, SC)
" I hate to be harsh, but deteriorating public health in Texas is Texas's problem."

No. Texas is doing just fine. It's overall prosperity is good. It's the problem of the people who find themselves in unfortunate circumstance through no fault of their own. Since category includes children, this is a very large number of people.
Stephen Hoffman (Manhattan)
Forget being mild or harsh, try making sense. "Texas" never had a miscarriage due to inadequate prenatal care—unless you count the poor and disenfranchised as Texas, too. High infant mortality might not be "Texas"'s problem, but I think it's mine. We do live in a union (not to mention the same world) after all.
PB (CNY)
The South in general and Texas in particular seems to have a death wish-- not that southerners and Texans consciously or unconsciously want to die themselves--they just don't mind at all if other folks who are not like them disappear or die. In fact they are willing to speed the process to purify their towns and state. Death penalty, anti-abortion, guns...

I think is comes from the legitimation of a culture of cruelty tied up with the southerners' defense to the death over slavery and the Texans' land grabs, treatment of Mexicans and Indians, and their high regard for the viciousness of the "oil men." As one liberal from Texas told me, "In Texas, we have an oil-depletion allowance, when what we really need is a people-depletion allowance!"

There is a real duplicity to the Texas culture. While you are supposed to pretend to care about other people like good Christians and be seen at church each week, you can spend the rest of the week demeaning and punishing others every way possible. This is taken as a sign of machoism and strength. Liberals are hated for their misguided do-gooder humanitarianism and making people dependent on the government. Betraying this culture is reinforced by punishment--of course.

Do we have any better example of the Texas death wish (for others) than the conservative Texas legislators playing high noon drama with the University of Texas in Austin over the university's refusal to allow concealed weapons on campus? See Times' article this weekend.
B (Salem, MA)
If Texas were a family, social workers would take away their children.

Way back when Nixon called it the "New Federalism," allowing states to distribute and manage federally-funded social welfare programs was a "wink-wink" concession to local racism and stinginess. Not surprising that it has become more horrific as the Republican Party has grown more racist and stingy.
Tom (Midwest)
The article can be summed up simply. Trickle down economics does not work. People keep reelecting the same politicians at the state level and to the Federal Congress and expecting a different result. Those who have health care apparently don't want other people to have it.
Kimbo (NJ)
It is only a civic lesson and a state of cruelty if the Democrats disagree with it. Only then does it get demonized in this paper. A
Ann (Norwalk)
Denying people healthcare for ideological reasons is cruel.
Ed Bloom (Columbia, SC)
But if it"s about gun control or the cruel "death tax" then gets demonized in the Wall Street Journal.
RJ (Londonderry, NH)
@Ann - How about denying people healthcare for fiscal reasons?
Steve Landers (Stratford, Canada)
The United States is a baffling country to observe. When the attack on the World Trade Center occurred, America was united in it's grief. And yet, when thousands of your fellow citizens die each year because of a lack of access to timely medical care, or because of your adoration of guns, that's just the victims' tough luck. Those people who die or suffer are your fellow citizens just as much as those in the Twin Towers. Where is the feeling of community?
Ludwig (New York)
As Trump and others have pointed out, PP does have good aspects and it does cater to women's health. My own daughter has gone to them for help (not with abortion).

I recommended a long time ago that PP should split itself into two organizations, one concerned ONLY with health and only the other, smaller part would be concerned with abortions.

Not that I am anybody and why should people listen to me?

But tying women's health to the killing of fetuses is insane. Ireland bans abortions and Irish women live longer than American women. South Korea severely restricts abortions, and South Korean women live MUCH longer than American women.

Why do you pretend that abortion is women's health?
Ann (Norwalk)
Because every doctor will tell you that abortion is a women's health care issue. Who are you to lord your personal religious views over anybody else?
UH (NJ)
Oh great... Another man telling women what they do wrong.

How about for men we create two doctors, one that handles EDF and one everything else. That way we can also too enjoy the benefit of two appointments instead of one.

Or perhaps we should just mind our own business and let the doctor and patient decide what's best. No that will never do - they might get away with something we don't approve of!
LAllen (Broomfield, Colo.)
Apples and oranges, Ludwig.

Both Ireland and South Korea have longer life expectancies for women, but both countries also have universal health care. That alone will make a huge difference in the quality and length of life for both men and women. Also, women in Ireland can travel to England to have abortions and obtain birth control without all the guilt and shame associated with sex you find here in the U.S. A trip to England is easier because the public travel system in Europe is far better than the infrastructure in Texas, so is cheaper as well.

Apples and oranges, Ludwig. That's why the medical industry won't listen to you.

Abortions are most certainly women's health. Men don't have them, (although they most assuredly contribute the sperm that causes pregnancy). Reproductive functions are part of our human biology for both men and women, and are treated by doctors and medical professionals. Birth control, pregnancy, abortion, childbirth . . . all fall under the rubric of health concerns and medical care. Incidentally, abortion causes fewer maternal deaths than childbirth.

Apples and oranges, Ludwig. People live longer in those two countries because their government recognize the importance of life-long health care, unlike the narrow-minded, pseudo-Christians running (and ruining) Texas.
Harold (Winter Park, FL)
Mega donors to the conservative party are said to be focusing on local politics. This does not bode well for the country, and for Democrats hopes to turn red to blue.

Hypocrisy rules the conservative theology. Example, defunding Planned Parenthood, a prime example. Poor women rely on PP to provide inexpensive access to health care, including birth control and education. So, denying them access to this resource means more unplanned pregnancies - more unwanted children. Those who are slaves to the conservative theology represent themselves as devout Christians for the most part, the epitome of hypocrisy.

Education suffers generally as well, except in states like California and Minnesota, as conservatives pull funds for education in favor of reduced taxes for the wealthy. Jeb! initiated an attack on public education in Florida with his 'voucher' program that enabled parents to send their children to Christian schools. The voters elected Gov Scott, a known criminal, to the Gov's office twice. He is a 'good' conservative.

I recall Bush I's derogatory use of the capital 'L' which stands for the evil Liberals. Now, we have the chance to use the capital 'C' in the same manner. Tomorrow is the Democratic primary here in Florida. Looking at the sample ballot and deciding on who to vote for is a challenge. Staying informed is a challenge here as well. There is no media outlet that is of any assistance in Florida. Another tool for the big 'C', keep us in the dark.
Harold (Winter Park, FL)
Continued: Public education in Florida has continued to suffer. The elementary and high schools are still 'separate and unequal'.

Tuition at public community colleges and universities have more than doubled in the last few years. I recall the old C saying "you can't have good education by throwing money at it". Depriving it, on the other hand, is short sighted and just plain stupid.
Socrates (Downtown Verona, NJ)
Greed Over People is not that catchy of a political platform in and of itself, but once you dress it up in a KKK robe and hood, give it a deadly assault weapon, drape the American flag over it and give it 'God's blessing', you'd be surprised how many crusty white folks come running out of church, the Cracker Barrel and trailer parks nationwide to support Grand Old Poverty of the mind, soul and body as the greatest thing since Velveeta 'cheese' burgers swept Dixieland as haute cuisine.

There is nothing close to the Republican Party in other civilized countries; there are liberal parties and conservative parties abroad, but America doesn't even have a conservative party --- instead it has that special brand of political party and sociological mutation called Republicanism where poor, propagandized whites blindly follow their white-robed leaders of Grand Old Poverty while screaming "Keep your government hands off my Medicare!"

The highest food stamp (SNAP) usage municipality in the USA is not in any Democratic stronghold; it's a place that is 99% white and 95% Republican.

Owsley County, Kentucky is ground zero for dirt poor whites on food stamps (52% of the population) that support Republicans (trying to slash food stamps).

Let's just call Republicanism what it is - a mental disorder, a Stockholm Syndrome political outfit, a Grand Old Poverty trap door, a KKK rally with no place to go and the worst case of organized brain damage since organized religion opened for business.
William Dufort (Montreal)
"There is nothing close to the Republican Party in other civilized countries; there are liberal parties and conservative parties abroad, but America doesn't even have a conservative party."

Some would say that America doesn't have a liberal party either. An exceptional country indeed.
Concerned Citizen (Anywheresville)
The people of Owsley County are 99% white, then who is it exactly they are being "racist" against?
Christine McMorrow (Waltham, MA)
"But why are states like Texas so dead-set against helping the unfortunate, even if the feds are willing to pick up the tab?"

Because, in the age of partisanship, these people are more likely to vote Democratic. Using religion as an excuse, they attack free clinics such as Planned Parenthood, long seen as "abortion central"--missing the fact completely that no PP funds can be used for termination of pregnancy. Without annual mammograms, checkups, and contraceptive education, such women in essence forfeit healthcare.

Dr. Krugman you use the word "cruelty" in describing red states and their policies. But I'd go one better and just call it indifference, or neglect. The poor, particularly poor women, are faceless--unseen, unheard, and lacking any power at state capitols. As such, when creating state budgets, lawmakers see their causes and funding for same as easy slashes .

Something is indeed going on in Texas, Kansas, and the like. State cultures of bias against people who need help, particularly when it comes to reproductive health. Who better to defund, than the very women who represent one's view of "sin?"

You think old Salem was judgmental? I think these states easily top that culture of cruelty.
Lewis in Princeton (Princeton NJ)
Paradoxically, California cited by Prof. Krugman as an example to follow, is listed as one of the most "unaffordable" places to live in the USA based upon wages and cost-of-living. Somehow we must find a balance between the needs of the poor and those who are working to provide for themselves and the poor.
Concerned Citizen (Anywheresville)
One in four Californians is POOR. California has the highest poverty rates in the nation -- higher than Mississippi or Alabama. The cause is very high housing costs. You can have a fulltime job in CA and be HOMELESS.

Oh, and California also leads in the number of homeless -- and the number of illegal aliens!

DO THE MATH.

Most Californians cannot possibly ever dream of affording to buy the median home in their state -- which is now $1.2 million.
Janis (Ridgewood, NJ)
I disagree with your point with local elections and people not liking the idea of helping neighbors who do not look like them. Many people are tired of continuously (throughout their lifetime) voting and paying for the masses of t unfortunate. It does not change. When one has any candidate from any election who does not care how many of these people are (and will continuously) come to this country and it will require constant financial support (and strain) from working taxpayers.
UH (NJ)
You are certainly free to like or dislike neighbors who don't look like you - that's a matter of taste, openness and degree of Christian charity.
However, just because you claim that these people "will require constant financial support" does not make it true.
Len Charlap (Princeton, NJ)
I remember a cartoon fron the New Yorker. There is a man in Pilgrim garb standing on the bow of a sailing ship looking at the shore. The shore is guarded by a high fence of logs stretching out in both directions, There is one gap which is being filled in by an American Indian who turns to the Pilgrim and says, "We don't want any of your kind here."
TDurk (Rochester NY)
It's kind of hard to get past the fact that most of the 19 states that refuse the Medicaid expansion were members of the Confederacy that seceded from the United States. The others were either battleground states, like Kansas and Missouri or dead red quasi theocracies like Utah. The real outlier in the group is Wisconsin.

Their common denominators are republican party hands on the tillers funded by the likes of Koch and company.

At some point, you'd like to think that even republicans would recognize the failure of their trickle down economic policies.

At some point, you'd like to think that even republicans would realize that their oppressive social legislation is merely this generation's version of the Missouri compromise, or Dred Scott.

At some point, you'd like to think that even republicans would realize that universal healthcare is this generation's equivalent of mandatory and free public schooling.

Unfortunately, when it comes to republicans you really have to ask yourself, what's the point of trying to reason with them given their intransigence to move the country forward and their determination to preserve their peculiar institutions.
Jeff (Westchester)
There is a debate going on as to whether Trump is better described as a Psychopath or does the term Sociopath fit better? Which term is more accurate for his behaviors? Here is a brief description which differentiates between the two from WebMD:

"A psychopath doesn’t have a conscience. If he lies to you so he can steal your money, he won’t feel any moral qualms, though he may pretend to. He may observe others and then act the way they do so he’s not “found out,” Tompkins says.

A sociopath typically has a conscience, but it’s weak. He may know that taking your money is wrong, and he might feel some guilt or remorse, but that won’t stop his behavior.

Both lack empathy, the ability to stand in someone else’s shoes and understand how they feel. But a psychopath has less regard for others, says Aaron Kipnis, PhD, author of The Midas Complex. Someone with this personality type sees others as objects he can use for his own benefit.

In movies and TV shows, psychopaths and sociopaths are usually the villains who kill or torture innocent people. In real life, some people with antisocial personality disorder can be violent, but most are not. Instead they use manipulation and reckless behavior to get what they want.

“At worst, they’re cold, calculating killers,” Kipnis says. Others, he says, are skilled at climbing their way up the corporate ladder, even if they have to hurt someone to get there."
Thomas Renner (New York City)
Texas has been in the news a lot lately, and to tell the truth all of the positions the state has taken are 100% opposite to those I take. I chalk this up to the fact I am a New Yorker and we just have a very different culture. That said I feel people are people and the average Texan cares about their fellow human being as much as I do. I just think they are stuck with a bunch of local politicians that really, really HATE president Obama. Your advice is correct, be sure to vote in general elections!
reader123 (NJ)
It's official. Voting Republican is bad for your health.
graceD. (georgia)
I find stories like this just appalling! I am a retired nurse, southern born, living in Ga. And we hear these kind of stories, almost daily.
We have a recalcitrant republican legislature with gerry mandered districts.
I just stay sick at the way our people are treated.
Richard Luettgen (New Jersey)
It’s a fundamental disagreement about the primary legitimate purposes of government. Paul doesn’t seek to analyze this disagreement or provide insight on how its sharp edges might be softened: he merely demonizes the side with which he disagrees.

Some believe that government has an obligation to provide our people not with a temporary social safety net, but a guaranteed and perpetual minimum standard of living irrespective of their efforts; but that they are not, in fact, capable of self-sufficiency but must be handed it by the state. From this ideological conviction everything else follows – the need to tax exorbitantly at federal, state and local levels to pay for such guarantees, the willingness to accept debt at astronomical levels whose service is rising again despite low interest rates, the unsustainability of such a view that requires more and more of a people’s production every year to support its maintenance, irrespective of other priorities.

Texans (and many other Americans) disagree. Their views often are extreme as well, but, hey, they’re battling those who would level society to establish basic sufficiency as a right and not as the reward of hard work, right choices and prudent living.

Paul’s piece won’t have an impact beyond his choir because his convictions are presented as unanswerable premises when they’re merely ideological arguments that ignore all others, and in the teeth of Republican success at capturing the reins of our governance at ALL levels.
RHJ (Montreal, Canada)
"establish basic sufficiency as a right and not as the reward of hard work, right choices and prudent living."
How about equality of opportunity? Can you honestly claim that states with a history of segregation and official bigotry have placed all inhabitants in a position to exercise your enviable reward system? The true answer is, "No, I cannot."
C Simpson (New GA City, Johns Creek)
Two thoughts come to mind. One, that failures of Republican policy in state and local governments will eventually cause them to fall in on themselves when the effects of those policies start to affect a wider set of the population. And, two, when taxpayers discover that they are footing the extra costs inherent in maintaining order in other ways than by taxes, i. e., health insurance and hospital costs, costs for providing private schools for their children, additional policing, they will push back. Unless they are gluttons for continued punishment. Which it appears so many red staters are. Is it something in the water, I wonder?
Bartolo (Central Virginia)
Let's see how you would do with "hard work, right choices and prudent living" on ten dollars an hour.
Patrick Moynihan (RI)
Again, where are the editors of this page. Paul Krugman starts by admitting that there is no clear research clearly connecting the defundng of Planned Parenthood to the issue of the mortality rate increasing among pregnant women. However, this does not stop him from writing paragraph after paragraph insinuating a relationship between the increase and the opposition to publicly funded abortions. (note: No one is picketing OBGYN clinics that simply provide prenatal care.)

Certainly, the picture speaks the exact baseless point he wants to make. Except if you notice how many women are in the picture.
Leslie (Virginia)
And there's the red spin: Dr. Krugman discussed decreased funding for Planned Parenthood's health care, not abortion. The vast amount of service offered by PP is in birth control and women's health care, not abortion. And the expansion of Medicaid has NOTHING to do with abortion. Patrick Moynihan conflates access to health care with abortion so he makes the ludicrous statement that no one is picketing OB-GYN clinics that simply provide prenatal care. No one pickets them because they've been de-funded.
OldBoatMan (Rochester, MN)
Your comment might be persuasive if Texas had not advanced women's health care concerns as its reason for closing down Planned Parenthood abortion clinics. Krugman is pointing out that women's health care in Texas is making strides in the wrong direction.
Bob (Rhode Island)
If you are against a woman's right to choose, because life is "too precious" but, you still haven't adopted a precious orphan then you are the worst kind of hypocrite.
Concerned Citizen (Anywheresville)
There are few if any orphans anymore; do you see any orphanages? Most children in foster care today have one or even both parents! but the parents are on drugs, or mentally ill or both.

We have a huge shortage of ADOPTABLE infants and toddlers. Ask any infertile couple! Any healthy infants born would be snapped by adoptive couples in an instant.
WFGersen (Etna, NH)
It isn't just about race... it's about the oligarchs keeping the poor in their place and their shareholders happy. Two articles in today's paper offer examples: the editorial on school funding; and an article on the federal district court's decision to deny broadband to rural residents in NC and TN. Why are half of the states spending less now on "government schools"? To keep taxes down and profits up and... in some cases... to open the door to "for-profit" charter schools to take over "failing government schools". Why are legislators keeping broadband out of rural communities? To protect the oligarchs who operate telecomm businesses and offer broadband only to those who can afford it. Who benefits from denying services to children raised in poverty? Those who would be asked to pay more in taxes... and the politicians who, in turn, rely on their largesse to get elected.
ACM (Austin, TX)
Offering broadband to some rural areas of the country (north Texas and northeastern New Mexico cone to mind) may also help to break the virtual monopoly currently enjoyed by the right-wing Christian radio and television broadcasters, who control the hearts and minds of the citizenry precisely because there are no other affordable media alternatives. If you have no access to unfamiliar ideas, of course your outlook is going to be narrow-minded.
Irma MyersDonihoo (Dallas TX)
The idiots in charge here in Texas, otherwise know as the GOP, will never listen to reasonable, logical arguments. To them, women need controlling and the minority poor need disdain. They are a business only concern, human beings matter not. We don't tax our gas enough, our citizens enough, and given businesses too much in tax breaks.
Greg Abbott, Dan Patrick, Ken Paxton, John Cornyn and Ted Cruz; all synonymous with a big FU to the little purple. And the craziest thing??? Are the people that keep voting for these morons against their best interests!
I keep hoping we'll turn purple soon, but then I talk to my neighbours and realise that won't be happening!
PaulB (Cincinnati, Ohio)
My error: of the dozen states with the most lynchings, eight (not mine) refused Medicaid expansion, all under Republicn Governors.
Robert Stewart (Chantilly, VA)
Dr. Krugman is spot on with this op-ed. Although he cites Texas as his "poster child," he could have just as easily included Virginia, where I live, as one of the "states of cruelty."

If Virginia would expand medicaid, that program would provide medical care for some 400,000, mostly working poor Virginians. Why the refusal of the "free money," the federal tax dollars we in Virginia have already paid to fund the program? The answer is the Republican-controlled Virginia House of Delegates and Senate -- thanks much to gerrymandering -- that abhor any program associated with "Obamacare."

Although Virginia has voted for Obama twice, has elected two Democrats to the Senate (including Clinton's running mate Tim Kane), and elected a Democrat for governor, the state's House of Delegates and Senate are controlled by hard-hearted, cruel legislators that have refused to expand the medicaid program.

Yes, local elections are as important as national ones, and "America would become a better place if more of us started paying attention to politics beyond the presidential race."
Walter Kelly (Keene, Va,)
Our legislature, the General Assembly, is a mess, painful to observe from here near Charlottesville. It's as if there were a New Mason-Dixon line at a latitude which runs South of Charlottesville and North of Richmond. To get elected South of it all a politician has to do is be against abortion, against government, against regulations, against taxes, and for religion, for guns. I know, I know, this sounds like a gross oversimplification, but it isn't. The level of hypocrisy is astounding.
rareynolds (Barnesville, OH)
When our daughter, who lives in Austin, Tx., could no longer be on our health insurance, she applied for the exchanges. But even to buy on the exchanges, you have to income qualify. Her income was too low. The normal answer would be the Medicaid option, only Texas doesn't have one. She qualified neither for the exchanges nor for Medicaid. When she asked how, exactly, she was to obtain healthcare, she was told the state had walk-in clinics (except they have been shutting them down.) She somehow managed, with employer help, to get on the exchanges, but not everyone in the world is going to be able to do that. I was appalled. Also, I am certain she is underemployed (with an IT bachelor's degree) because of tech jobs being shipped overseas. (She is a natural with technology). In any case, I agree things have to change, but how can they when a liberal city like Austin is gerrymandered and, if I understand correctly, sliced like a pie into something like six different Republican Congressional districts? The point is, all of this is interrelated: lack of jobs, offshoring, gerrymandering, a (still) insane health care system. A normal federal government would start to tackle these not-so-difficult problems so we could join the rest of the civilized world: let's hope we begin the process by electing the right people.
seeing with open eyes (north east)
Obama strongly and publically supports Congress to up the number of H-1B visas to allow more foreign IT "consultants" to enter the country in order to displace employed, highly qualified and experienced IT workers.

Disneyland is just one example of Americans losing jobs but having to train their replacement from this 'inshoring' of inadequate but way cheaper workforce.

Way to go politicians!
Concerned Citizen (Anywheresville)
I am more interested in how an INFORMATION TECHNOLOGY (IT) specialist with a bachelor's degree can't find decent work -- with paid health insurance! -- in a booming Texas economy based on tech!

While some IT jobs are outsourced, many are hiring right here and at good wages. Are you SURE that is the problem? And not that your daughter doesn't want a job, or doesn't want to work full time? A gifted female in a mostly-male job market would be able to write her own ticket -- companies SEEK OUT females for these jobs!

My stepdaughter is in IT; she was recruited before she graduated. So was her fiance (now husband)! They both had fantastic jobs the first week after graduation. And this is the depressed Rustbelt!

Maybe your daughter should move back to Ohio?
PaulB (Cincinnati, Ohio)
Here's a correlation that demonstrates the "states of cruelty":

Of the 12 states with, historically, the highest incidence of lawless lynchings, nine also are states that have refused Medicaid expansion: Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, Texas and Virginia. Of the remaining four, Kentucky, Arkansas and North Carolina had a Democratic governors who accepted Medicaid expansion, while the fourth, Louisiana, just accepted Medicaid under new Democratic Governor John Bel Edwards.

This strongly suggests a couple of things. One is that the arc of history is long. The other shows that the Republican Party's gradual takeover of the states of the Confederacy starting in the 1960s with passage of the Civil Rights Act, has merely prolonged and exacerbated a festering wound to American politics, almost but not quite exclusively in the South, that has sickened our nation since its earliest years.

We are, despite Lincoln's warming, still a house divided.
new conservative (new york, ny)
Texas is not only an economic success story due to its supply of energy and cheap land. It has a major technology sector and yes, low taxes which attract all sorts of businesses there. California on the other hand is successful due to the best climate conditions in the nation and a largely elite wealthy population that is subsidized by low income immigrants.
DC (Ct)
Alot of low income immigrants in Texas also.
LG (NYC)
Huge growth in low wage jobs is not a success story
Patrick Weaver (California)
This suggestion is somewhat puzzling in light of the fact that, 5 years ago, after eight years of Republican administration, although our devastating and historically unprecedented drought had not yet begun, and with the California on the verge of financial collapse, those same immigrants were being blamed by the 'Old Conservatives' for POOR economic conditions. It appears that "new conservative" is a euphemism for finding a 'new' rationale for a legacy of failure...
KHL (Pfafftown)
Just as pernicious an issue as racism is misogyny, and when it comes to women’s health, it is the primary one. There is a lot of talk about tax dollars going to “the other”, but the campaign against Planned Parenthood is about a closer, deeper male fear, that of controlling the people he shares a bed with (his wife) and a home with (his daughters). This fear is the basis of religious dogma from time immemorial.

For the bastions of patriarchal rule such as inhabit many state houses these days, ensuring the extension of a man’s progeny takes precedence over any rights of self-determination or bodily integrity that a woman might presume for herself.

Until we can constitutionally codify the rights of women as equal to men, women will suffer the health and civic consequences because they will remain second-class citizens.
Joseph Huben (Upstate NY)
Patriarchy, and sex-repressing laws are the expression of religion. Our First Amendment is supposed to protect us from establishment of religion by the government, and it does not. On what grounds can government compel women to bear children, prevent women from aborting unplanned pregnancies? On what grounds are the protections guaranteed to all citizens subordinated to a fetus? How is sex education deprived to our students? How is contraception denied to our citizens? All of these efforts are Religiously based and should be renounced on that basis.
"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances" "Establishment of religion" that does not include the name of a religion but supports a religion's dogmas is a violation of the Amendment.
We cannot be a Christian nation by our own laws. We are not America if we are a Christian nation.
mj (MI)
And these very same men are the men who spout fountains of vitriol at HRC not for her policies or her ideas but simply because she is a woman. It was bad enough a black man won the Presidency. At least he was a man. Now it's women. Who... no WHAT do they think they are? Half the population?
Paul (Westbrook. CT)
I have the feeling that you have no idea how small the closed mind can be. Your depiction of the people who oppose health care for the less fortunate is accurate. They are largely racists and misogynists, at least, at the local level. Once these people pronounce their stand against the less fortunate, it is useless to talk to them about how unfair their position is. It is like talking to a stone. And they a very outspoken even when nobody asks them a question. They start their rants against the poor with wild abandon. I suspect that working in a university one would hear an attempt at a rational argument for any side of the issue, but that's not what one hears out in the trenches. Just as we have had generations of poor people , we have generations of bigots who turn a deaf ear to the rational discourse. Even here, in New England, we have a state like New Hampshire whose slogan is "Live free, or die." I have news for them. They are going to die whether they live free, or not. I think the only hope of making society better, and more caring is to outnumber the bigots.
Marc Anders (NYC)
Given New Hampshire's longstanding aversion to taxing it's citizens - position that predates even the "Kansas Experiment" , but with similar unsavory results - I have long thought that, to be honest, their state
motto should read: "Live For Free Or Die".
OzarkOrc (Rogers, Arkansas)
I open the local ("Arkansas") news feed on my smart phone this morning, and the only two (Non football) stories are about how the jury rigged Medicaid expansion ("Private Option") may not be affordable, especially since despite restrictions on eligibility, "over 307,000" ha0ve enrolled, vs. 250,000 expected. Of course the Republican legislators first response is "we can't afford that."

And, a local college is offering all incoming freshman a course in the costs of becoming a single parent. Also in the Sunday paper. My takeaway from the paper was that families and schools do not do a very good job of sex education, mentions of "abstinence only" as the only school teaching point. Even if you are aware of the need for Contraception, it has to be available.

My takeaway? The Default Republican health care plan for poor people seems to be, crawl off under your bridge and die.
Concerned Citizen (Anywheresville)
I personally know at least two people, who QUIT jobs to make themselves "poor on paper" in order to get very cheap or free Obamacare. They were able to live off of trust funds, savings, retirement monies - - not counted as income by Obamacare.

I am sure there are people who can easily manipulate Medicaid eligibility like this....

BTW: contraception is legal everywhere. It is sold EVERYWHERE. It is sold at Walmart and the drugstore, in gas stations and public restrooms. It is 100% FREE for women under Obamacare. It was always 100% FREE to poor women on Medicaid!

How much cheaper than FREE can it be?
Nemo Leiceps (Between Alpha & Omega)
Liberals reading this smugly tisk tisking conservatives--NOT SO FAST.

What I learned from the few years in New York as a creative and and the six years after is this is NOT limited to just conservatives. Liberals, too, have their speeches that run inside their heads that keeps them from voting, allows them to judge so they don't lift a finger, the telephone either. Nowhere has this been better proven than the success of Bernie Sanders resulting in the put-downs, insults rising to out right name calling even by Paul, and demands to put up and shut up because asking for relief from near to extreme poverty has been decided by liberal VSP's is impractical.

Yes, there are race issues driving the cruelty, but the fact that there are more white people than black with SNAP benefits points strongly that the cause is that those who are not subjects of that cruelty willfully don't know, if they do blame them all reinforced by the reward of such beliefs, that they are obviously superior in every way over the poor even in pretty blue states.

I moved to Indiana for a job and was shocked at the difference in political thinking and policy. What was even worse was that when entrapped in the cruelty, my liberal friends did not believe me even thinking I was paranoid.

All I can say: Do you believe me now? Will you finally get off your liberal entitled toushies and walk the walk about being centrist to liberal? I'm still looking for a real job by the way, I could use some help.
Jay (Texas)
If Texas didn't give $16 billion in annual tax abatements. most in the form of tax cuts to big business, there'd be adequate money to help the poor and educate our kids. When a friend moved from Texas the disdain about the state's mean spirited politics was obvious in his voice when he said, "he had enough of Texas!"
Anne-Marie Hislop (Chicago)
You left out another important factor: the judgmental way in which a significant subset of the population (and a particular large subset in red states) view the poor. In that mindset, the poor are lazy or "undeserving." Folks believe that their own comfort in life or success are purely the results of their own efforts; that they pulled themselves "up by the bootstraps." Therefore, anyone who is poor or struggling is simply not trying. This belief is the root of the opinion that any government assistance is harmful because it reinforces the inertia. Instead, the good red state people, believe in forcing the poor to grab hold of those old bootstraps by mostly taking away the safety net.
Glenn Ribotsky (Queens, NY)
And that view, Anne_Marie, has deep roots in our Calvinist history, which produced the capitalist drive to accumulate goods/possessions as proof of God's favor--those who did not have those were undeserving and obviously not favored by God, so why should anyone else give to them or help them?

Add to that a healthy dose of social Darwinism, and the idea that people might be poor due to wider social and political forces beyond theri control just didn't take root here; being poor was your own fault, and we should not only not help them, we should actively encourage their passing, as they were a burden in a limited resource world. It's a very convenient view as it allows for a lot of closet bigotry and discrimination.
Richard Green (San Francisco)
This is even a more interesting set of attitudes when one considers that most (not all) of the deepest red states are recipients of substantially more federal tax dollars than they pay. Ift it weren't for the taxes paid by those of us living in "donor" states, Mississippi, Alabama, and others would barely have state economies.
underhill (ann arbor, michigan)
the phrase "to pull oneself up by ones bootstraps" came into use in the 19th century as an example of an impossible task (it is impossible, just try it sometime). So those who firmly believe that the poor should pull themselves up by their bootstraps are asking, and expecting them to perform an impossible task. Next time someone suggests that the poor pull themselves up by their bootstraps, ask that person to demonstrate. It ought to be amusing.
Ian MacFarlane (Philadelphia PA)
Nothing to question, discuss, or argue with here.

The solution as you so clearly state is to exercise our most important right. Vote.
Deborah (Ithaca ny)
Here's the rub. American women have been key in the fight against Planned Parenthood and Roe vs Wade.

Whenever I try to figure this out, I think of my mother, who grew up in St. Louis, resisted her violent father (lobotomized in 1950), loved her mom, our Gramma, and often visited Gramma while she (daughter of a woman who died of a botched illegal abortion in 1903), worked as an underpaid nanny in a big white suburban house to hide from her husband.

My Mom knew how she wanted us to behave and dress. We attended a conservative church. When we turned 12, my sister and I each resisted Mom, in different ways. Only now do I begin to appreciate her courage and recognize what she hid from us as she climbed out of her difficult life into a prettier one.

Would she have chosen to pay higher taxes for poor women (by that I mean Dark-Skinned Women) who needed either STD testing, contraception, or a safe abortion? Nope. Though, as the record shows, her own Gramma, in 1903, died of a septic abortion (probably after having been pressed to it by her German husband, a tin smith, who didn't want a second child so soon).

Women are not naturally gentle.
Cathy (Hopewell Junction NY)
Krugman blames race and misogyny. and that is certainly a baseline.

But look a little deeper and question the influence of the business organization ALEC. States with strong ties to ALEC have fewer government programs, and more private initiatives. Expanding medicaid doesn't improve the bottom line or maximize shareholder value. Mix that philosophy with bigotry and zealous religious convictions, and Medicaid and Planned Parenthood were doomed.

When the constituents that must be served are shareholders, not individuals, and the issues that must be addressed are private profits and not mortality, you end up with people dying, whether it is driven by a private desire to gouge people for EpiPens, or a public desire to let people hang when they need medical care.
Richard A. Petro (Connecticut)
Dear Mr. Krugman,
Let's not forget the toxic effect of "religion", translated into Bible thumping white folks refusing abortions to poor people of color because, well, god told them so and "Planned Parenthood" is merely a scheme to promote all those "abortions".
Of course, these "praise the lord" types will have no truck with "taking care" of the unwanted children because, after all, the poor are poor because they really are lazy and enjoy tons of free money from, well, somewhere so, consequently, they should have no prenatal care whatsoever.
But you can "pack heat" at the University of Texas!
I know "all politics is local" but, apparently in the "Red" states, it seems "all politics is local and loco" with the "Lone Star State" merely leading the pack.
Larry (Bay Shore, NY)
"Most Americans are, I believe, far more generous than the politicians leading many of our states."

You take one look at those smug, cheering, sneering faces in the accompanying pic to know those "most Americans" aren't all Americans.
R.C.R. (Fl)
We need single payer healthcare as all the other developed, sane countries in the world.
Concerned Citizen (Anywheresville)
Only 3 nations in the world have single payer. One is Canada. The other two are in Asia.
John (New York City)
All politics is local. Paul is on point with this.

Yes the campaign for who is to occupy the Power Oval is important. Federal government structure is important as it represents the totality, the larger face we American's present to the world.

But there is a reason why the Republican party went on the offensive, a couple of decades back, at the State and local level. They understood that the Federal represents but the top of a large, complex (somewhat hierarchical), pyramid we as a society have constructed as a governing structure. Its power derives from the base. All truly effective action occurs at the State and local level (excepting international matters and such). The Republicans have reaped the gains of that focus, though mostly to the chagrin of the opposition to say nothing of those local citizens now being impacted by their ideology.

So...my advice as an American to my citizen colleagues in this grand experiment? Don't become too enamored by the "show" going on right now. It's something of a hall of mirrors game with Power being the goal. And though there is power there its larger aspect manifests at your local level. So get involved in your community. Know who your local representatives are and vote your opinion on their decisions. This is where true power lies. Civic power from the common folk. The Dem's, as a political organization, need to reflect how they got away for this and go back to those basics.

John~
American Net'Zen
Ed Bloom (Columbia, SC)
" Know who your local representatives are and vote your opinion on their decisions."

My representatives are all Democrats and I generally agree with their decisions. But it makes no difference because they are in the Statehouse where the Republicans have a solid majority and can simply ignore the them.

Bing in a one party red state is a lot like being in the old one party red Russia.
SFR Daniel (Ireland)
" The Dem's, as a political organization, need to reflect how they got away for this and go back to those basics. " Voter education, voter registration, civic education, etc. Let's have it.
Dudley McGarity (Atlanta, GA)
Dr. Krugman: Surely you know that there is no such thing a "free money."
Adam (Boston)
There really IS free money in basic healthcare:
Vaccination instead of treatment and work disruptions.
Annual checkups and early interventions instead of ER visits with life threatening (expensive) co-morbidity.

These directly and indirectly save the state money. Now we can argue about the LAST dollar spent on healthcare for the rich and whether that is wasteful...
mark (Illinois)
In various online forums I often engage in (mostly) civil discourse on topics such as the one that Krugman addresses in his post today.

On several occasions I have asked a question of those who disagree with the general premise posited here: that race still matters in this country, especially in red southern states, and that many decent citizens in those states harbor views that they themselves harken back to our country's pre-Civil Rights days.

The question is this: 'Do you believe that the outcome of the Civil War (I.e. the South lost) was the best outcome for the United States?'

A surprising number of thoughtful folks (most of whom self-identify as southerners) answer this question in the negative.

My conclusion? At least some Americans are still litigating the Civil War, at least in their own minds.
Brian (NY)
Well, speaking as a Leftie Northerner, I must say if the Southern States wanted to secede today, I would happily work to help them do it.

It's kind of the mirror of what Prof. Krugman says. I want my tax dollars to go to help poor individuals and families, not to poor States. We have been supporting these States for decades (I except Texas, they have enough oil for now - but once that goes....) and I wonder if the States are just lazy and not willing to grab that rung on the Ladder to Success. In other words, they are too weak to make the move to taxing themselves to sustainability.

I am not a cruel person. Once the Old Confederacy became an independent sovereign nation, I would not fight us giving them the same level of foreign aid we give any 3rd. world country.
Concerned Citizen (Anywheresville)
@Brian: except we fought a war over that, and the result was, the South did NOT secede.

It's funny that today, most of the folks WANT to secede are East Coast lefty liberals!

You need to look at a map of the US, Brian. The "red states" are no longer only in the South. And what about those purple states? An ultra liberal United Swedish States of the Former America would consist of the Eastern seaboard and California, with a HUGE hole in the middle.

Anyhow, the whole concept is childish and very snarky.
Paul (Bellerose Terrace)
Concerned: you conveniently forget then Tejas Gobernador Oops Perry stating that the agreement for the annexation of La Republica Tejana allows them to leave whenever they p,ease. My recommendation at the time was "buh bye."
Tejas may have copious oil and gas reserves, but was in the middle of a five year + drought, with Oops' solution being "statewide day of prayer for rain," which didn't work. So if they secede, they can trade oil for water, that what's left after they're done fracking.
Reality Based (Flyover Country)
The Right has been running the "Small Government Con" for decades. This allows a "race to the bottom" as to which state can provide the least public services in combination with the most corporate welfare like tax abatement schemes. Municipalities literally bid against one another to see which can provide the most taxpayer-funded benefits to prospective corporate migrants, with the least public services. The net job gain, for the country, is zero. But schools and other public investments rot. Conservatives love it.

Red states have absolutely devastated public education through this model. Most rank near the bottom academically. Many of these states school systems are more segregated now than they were decades ago, before conservatives started de-funding education. Not a problem. The last thing conservatives want is an educated public with critical thinking skills.
G. Blaise Williams (Savannah, Georgia)
Most Americans are far, far more generous. The editorialist understates. Which sociopath is he referring to? LBJ? Clinton? Obama? The man from Stonewall, Texas, was a teacher. The other two are lawyers. If you're a lawyer and a politician, what are the odds you're not a sociopath? Or psychopath. Jon Ronson reminds readers there's no difference, one just sounds scarier than the other. If LBJ was terrifying in his bombing campaign, so Obama and his drone-drunk admins are horrifying. If past is prologue, President Hillary Clinton will prove appalling. So we can add to the list of rewrites this: There are two parties in America: The socio and the psychopathic. Occasionally they get together and do something psychotic. More Hellfire missile strikes, please. Does the mortality rate have nothing to do with recent arrivals home country's rates? Who could think such a thought? No doubt the editorialist has read Why Nations Fail? Mexicans more than any other group should be surprised and pleased they now constitute a sixth race of homo sapiens.
Dan Styer (Wakeman, Ohio)
Johnson was not a sociopath. Nor is Clinton. Nor is Obama.

There's your answer.
Darby Fleming (Maine)
I am tired of the intransigence of any state (mine, Maine, is a prime example) that holds its people hostage to the insurance industry simply to deny the President any suggestion of success with any program. They are playing with our lives.
George (NYC)
Between state-level gerrymandering, evangelical intrusion into state government, and hatred of liberals, part of this is explained. But the true root of all these is the power of sheer self-righteousness.

It pervades a lot of what is going on, and as a human characteristic underscores everything discussed here. I would say even more than race or misogyny.

The anti-abortion mob are about judgment on those that cannot control their urges, more than on those who are cultish about sex. The anti-healthcare mob are about those that 'refuse to work'. Anti-liberal fervor is about a repulse of the progressive, ie, relentless pandering to the new.

And they are not wrong. To kill a potential child out of carelessness or contempt is at least a moral wrong. To pay for someone who wants to sit at home all day, the same. Progressivism is merely the intellectual prow of the enemy.

If we wish to curb these ideas and tendencies, and we must, for the good of the majority, then we must attack these underlying ideas, and understand their power is in the tendency to self righteousness.

We need to tell the story of the mother whose partner has lied to her, cheated on her, and abandoned her. We need to tell the story of the generations of neglect that have driven overwhelming despair among the indigent. And we need to remove the progressive movement from the rank of the profane.
benjamin (NYC)
I disagree Professor Krugman, particularly with this , "Most Americans are, I believe, far more generous than the politicians leading many of our states. ". The people of Kansas reelected their Governor despite his policies which decimated the poor and working class while also nearly destroying the school system. Sure , in 1965 the Civil Rights Act and Voting Right's Acts were passed but laws do not change the hearts and minds of people. For 50 years the GOP has worked diligently and effectively to abolish those historic acts or nullify their impact. They have effectively portrayed through lies, distortion and hatred the poor, minorities and those different as the enemy and root of all of America's problems and many American's bought into it. People vote consistently against their own economic interests simply because of hate, prejudice and fear of change. Nothing in this Country will change until the GOP decides to effectively and permanently denounce people like Donald Trump and what he stands for and state unequivocally that prejudice, hatred, xenophobia and homophobia are intolerable and inconsistent with America's ideals.
chickenlover (Massachusetts)
Prof. Krugman is absolutely right in saying that even though we tend to focus on national elections, "many crucial decisions are taken at the state and local levels." This ought to make it even more imperative that we be engaged at the local level.
However our actual behavior diverges from what should be our behaviors. Our participation in local elections is even lower than that in the national elections.
Hopefully we'll pay more attention to down ballot candidates and local state initiatives to ensure that we get the right people into office.
Rolf (<br/>)
It is so simple.
Governments have obligations.
For everyone - for the priviliged and for the unpriviliged, for the fortunate and the unfortunate.
Safety, healthcare, education, quality of transportion, geriatric care, helping people who are unable to cope.
This is not socialism but humanitarianism.
Sally B (Chicago)
Agreed, which is why citizens also have an obligation to stay informed, and to participate. We are the government.
Ann O. Dyne (Unglaciated Indiana)
And then there is the role of organized religion, claiming to be 'Christian', while in practice being very unJesusy.

Examples abound, but just think how different state politics would be if these hypocrites actually followed the philosophy of 'as you do to the least of these, so you do unto Me'.
Chris (South Florida)
I sum it up this way, conservatives are all about me, liberals are about we.
Dudley McGarity (Atlanta, GA)
Why do the "we" always want money from "me"?
Dennis Rockwell (Eastern Washington State)
Because while you make it clear that you don't want to share space with the rest of us in this boat called America, we are all still in this boat together and you need to pay for your ticket to ride just like the rest of us.
Dudley McGarity (Atlanta, GA)
And, your concept about the boat does not work very well when a large percentage of the "rest of us" are not paying anything for their ticket. At that point, the boat becomes overcrowded with freeloaders, and then you know what happens to your boat.
Karen Garcia (New Paltz, NY)
The solution is simple: centralize the medical care payment and delivery system. removing the profit motive from health insurance completely. Join the rest of the civilized world. No deductibles, no co-pays. Everybody gets covered, cradle to grave, no matter where you live. Take the power away from all these sadistic state governments and implement Medicare for All.

Texas is the extreme case, but the maternal death in the US overall is up by 27% - at the same time it has fallen sharply in other countries. It's not only that women in some states don't have access to prenatal care or Planned Parenthood. It's that they have little to no access to any kind of medical care at all, all across this country. According to the journal Obstetrics & Gynecology, the major cause of the maternal death rate increase is the rise in such preventable chronic diseases such as diabetes and obesity.

Black women are two to three times as likely to die as a result of pregnancy and childbirth as white women. According to one 2014 U.N. study, the maternal mortality rate in one Mississippi country surpassed that of countries in Sub-Saharan Africa.

It's a racist war and a class war of the richest elites in the richest country on the planet against the rest of us. Lowered life expectancy is just one glaring symptom of a sick society that puts profits for the few above the well-being of the many.

If we can afford trillion-dollar wars and Wall Street bailouts, we can afford universal health care.
Ron Cohen (Waltham, MA)
Well argued, Karen Garcia. As a friendly amendment, I would add that it's not only a race war and class war, but also a gender war. Male domination is an equal partner with those other ancient instincts, fear of others and social hierarchy, that evolved over eons to ensure the survival of small, ragged bands of early humans wandering a hostile planet, but that today are at odds with modern, global civilization.
alan haigh (carmel, ny)
We are in the midst of a religious "war" and clash of cultures. Red states are in the political control of a culture that doesn't want the government doing what has traditionally been done by churches and neighbors out of "the goodness in our hearts". When a person is coerced to be generous by way of government taxation they are essentially having their ticket to heaven stolen from them.

As societies become increasingly urban it becomes necessary for governments to do much of the traditional good works of neighbors and churches Southern culture is always the last to change in this country, but don't assume that the changes resisted are all good and that the culture they are trying to keep is all bad.

Of course there are political forces outside of this conflict that exploit it for their own interests. Obviously the Republican elite is extremely conscious of the situation and has used it to help inspire voters to vote against their economic interests for decades now.

The one political goal we need to accomplish is to get the majority of Americans to vote their economic interests. That would lead to a fundamental shift in American politics and change both parties and their agendas for the better.
A. Stanton (Dallas, TX)
I wouldn’t buy a used car from Mr. Trump or attend his University or allow him to keep company with one of my
daughters, let alone vote for him.

But I do accept the fact that millions of Americans are hurting badly and that Mr. Trump has succeeded in touching
some dark and ominous forces in the American soul.

The first hundred days of President Clinton’s administration needs to consist of an unprecedented effort to stop the Trump revolution in its tracks.
Magpie (Pa)
A.Stanton:
We will need good luck for this. HRC was the champion of these folks in the 2008 Democratic primary when she was running against Obama and needed these votes. Remember " hard working white people"? This election she pretends they don't exists or wishes that they didn't. Where will she be when elected? Likely she won't see those " hard working white people" as her base.
Concerned Citizen (Anywheresville)
Mr. Stanton, I promise you one thing -- 3 months after Empress Hillary is anointed and installed on her throne -- you will be on your knees, weeping and gnashing your teeth and wondering why you made such a devastatingly wrong choice for POTUS. By then, of course, it will be too late.

I hope at that time, you have the grace to admit your tragic error....but I doubt it.
Mark (Cheboyagen, MI)
I once read that for the right prices Donald Trump would drop out of the election. Perhaps for the right price he would stay in and continue his cookoo bombast,thus giving the Democrats a chance at the house and state houses.
reader (Maryland)
And yet there were nine governors from those laboratories of horror states and one doctor out of 17 candidates in the Republican primary.

So when the carnival barker that won asks what do you have to lose, if you are in blue state a lot. If you are in a red state and poor or female think what you've lost.
Eric Bittman (Amherst MA)
Right-wing politicians found it to their advantage to demonize Planned Parenthood, distorting its mission and conveying the inaccurate impression that its main function is to provide abortions. This works to their advantage because it recruits evangelicals to their alliance, even though providing assistance to the ill and the poor should appeal to Christians. Having succeeded in this maneuver, the right is now dong the same with the Clinton foundation - conveying the impression that it exists solely to line Hillary's pockets while ignoring the charitable causes it supports and the good it does not only in the U.S. but internationally.
JPE (Maine)
It's easy...way too easy... to blame racism for all the country's problems. In the case of some states' refusal to accept federal money for Obamacare, there may well be another reason. Too many times we've seen federal programs started, enlisting state cooperation, with a "commitment" for federal funding. Then, see for example special education, those federal dollars wither away and ultimately disappear leaving local officials to raise taxes to cover the cost of a "federal" program. Fool me once.
Jon Dama (Charleston, SC)
"Medicaid expansion disproportionately benefits nonwhite Americans;" Krugman provides no data to support this assertion; and there is anecdodal evidence to indicate otherwise. Of course, red state governors are acting silly in refusing the "free" - not exactly - Medicaid expansion. Our own Nikki Haley, a usually level headed leader, is among them. And it's probably hurting lower income whites more rather than blacks.

Blacks in red states tend to be well within the income range to already receive Medicaid benefits. And when ineligible they head to the state funded hospitals - such as MUSC here in Charleston - where they are treated at no cost. Lower income white tend to fall into the expanded eligibility income range - not applicable in the red states - and so are excluded from the expansion.

Silly - not spiteful action by the red state leaders.
Lisa (Charlottesville)
"Silly" seems an odd word to describe the refusal of some red states to expand Medicaid, but never mind. What do YOU think motivates these Republican leaders to do this?
Concerned Citizen (Anywheresville)
It's not silly, because after 3 short years, the states are "on the hook" for 10% of Medicaid costs -- which are in the BILLIONS of dollars. This is a huge liability that will only grow with time. ALREADY Medicaid costs in the US are enormous and much of it unfunded. It's a bad system and very unequal and in no way equals "universal health care".
Patrick Stevens (Mn)
What small government thinkers seems have forgotten is that the only entity that makes the United States of America, the United State of America is our Federal government. Without its power and the binding force of law, there is no nation; there is no central purpose. We are no longer a "nation" al all. Until the Conservation movement figures that out, and voters accept that truth of, "One Nation under God" we will continue to fight a pointless battle for some supposed freedom that, in reality, cannot exist for all of us without paying the price of a strong, committed Federal laws and regulation.
Paul Cohen (Hartford CT)
Paul, my own definition of a Republican has always been:

"I've got mine, I'm doing just fine... to hell with you neighbor"

It's incomprehensible to me why so many people identify with the Republican party when they represent the interests of people and business far and above their true interests.
Jeffrey (California)
I like Mr. Krugman's analysis, but I wish he would analyze why Indiana's economy is said to have done well under Republicans, as I'm sure will come up, especially in the VP debates.
mark (Illinois)
Because the Federal government rescued the auto industry!
rareynolds (Barnesville, OH)
I lived part time in Indiana and my son is in college there. Go visit. I don't know what the "numbers" show but that once clearly beautiful, thriving state is now a hellhole. Maybe it is doing "better" now than at some low point a few years ago, but it is heartbreaking to be there.
Wayne (Everett, WA)
I grew up in Indiana, moved away 46 years ago. I agree with your observation. It's truly a hardship to have to return and spend any more than a few days there.
Ron Cohen (Waltham, MA)
Misogyny is not simply "overlaid" on racism, as Krugman suggests, but it is an equal partner. Male domination and fear of others are two ancient instincts, evolved over eons, that continue to plague us in modern civilization. This is especially true in the male chauvinist, or androcentric culture of Texas, where guns are a penis extension.
mark (Illinois)
Well-played, Ron Cohen. Well-played, and I would like to add my opinion: some of those fine American men whose beliefs reside in the gun culture appear to have replaced the constant testosterone-fueled near-obsession with sex that plagues many of us males...with thinking that centers on weapons.
Harold (Winter Park, FL)
Good point Ron. Carrying a gun is compensating. For what? Fear of impotence? A gun is made of steel. It never droops or fails to perform.
Socrates (Downtown Verona, NJ)
Atta' boy, Ron !
R (Kansas)
That is why in Kansas, Kobach is trying to stop minorities from voting. If minorities began voting in Kansas in state elections, we would not have the racism of Kobach or the disastrous education policies of the extreme right. The biggest challenge for Democrats in Kansas is getting the Latino population of southwest Kansas to vote.
PW (Pasadena)
While the maternal death rate in Texas is clearly way too high, I think a lot more skepticism needs to be placed on the data underlying this column. The rate appears to double IN ONE YEAR and yet no plausible explanation for such a 'jump' has been identified. Looks as likely as not to be an issue with the reconnaissance.
See figure 4: http://journals.lww.com/greenjournal/Citation/2016/09000/Recent_Increase...
Concerned Citizen (Anywheresville)
That article is behind a substantial paywall.
Rick Gage (mt dora)
This is one of the reasons I hate the use of the term "Trumpism". Cruelty, bigotry and racism are not hallmarks of one man running for the presidency, they are the cornerstones of the Republican philosophy. Mike Pence, Rick Perry and the other Republican Governors proudly wear their Christianity on their sleeves and then govern as if the devil, himself, ran their Super Pacs. The only way these Republicans could be considered good Christians would be if you took Christ's Sermon on the Mount and turned it on it's head. Blessed are the party of the rich, for they shall inherit Trump.
N B (Texas)
Texans, governor, lieutenant governor on down care more for foetuses thsn children. Now we have a Trump who wants to Russify the U.S. He likes the way cold block women turn out.
Phyllis (Stamford,CT)
Hate radio transmits antisocial messages on stations all over this country. It is a 24/7 advertisement for a nasty form of conservatism. No wonder that too many right wing politicians get elected and many other voters feel hopeless and stay home. These loud mouth radio programs exist tor sell commercials well or are a tool for the elites to control our country. Also, any conservative politician who votes his or her heart on a bill will get attacked viciously for stepping out of line.
Doris (Chicago)
The media made right wing hate radio announcers acceptable, as they now have them as commentators.
Paul (DC)
Let's just call it the way it is, the scourge of racism still drives political and economic decision making, especially in states south of the Mason-Dixon line.
James (Ohio)
I'm not sure where Krugman gets his populist optimism. My old grandaddy used to say "no one ever went broke overestimating the xenophobia of the white American male." Well, he never actually said that, but he would have if he saw this year's election.
NRroad (Northport, NY)
As usual, Krugman can't resist embellishing an argument with distortions. The facts that Texas is dealing with 15.6% illegal immigrants(as opposed to(poorly estimated) NYC's 4%), as well as a leaky border with Mexico that plays a major role in the illegal drug trade and a a population that is 25% Evangelical just might have something to do with its approach to Planned Paenthood.
h (f)
Sorry, hit the recommend by mistake! NRroad, I condemn your comment, and would like to say that the future of the 'leaky' border with Mexico is to dissolve the border, totally, and to form an economic union with mexico, similar to the EU.
N B (Texas)
If mama dies, even if illegal, who cares for the surviving children? The dad who works 12 hour a days? Many rich Republicans benefit from illegal labor in Texas It's a cruel, hypocritical system. Not quite slavery but definitely exploitation.
NRroad (Northport, NY)
So evidently illegal immigrants should be embraced and provided with extended benefits unavailable to citizens. The population of Mexico is 122 million, with another 25 million in Central America. Perhaps they can stay at your house till they get settled.
James Lee (Arlington, Texas)
A column that appeared in the Times last week celebrated the states as laboratories for the discovery of solutions to national problems. This optimistic vision of federalism dates to the Progressive era, when states experimented with different methods of making government more democratic.

Krugman's piece exposes the ugly flip side of state autonomy. A governor and legislature, in thrall to a discredited economic theory, can seriously damage the lives of their constituents in a short period of time. Elsewhere, state leaders can give free rein to their prejudices, with deadly consequences for their victims.

The Democrats, with their focus on the presidency and congress, have forgotten the vital role played by state governments in our system. Control of the executive and legislative branches in Washington would enable the Democrats to accomplish much, but continued GOP dominance on the state level would limit the reach of progressive national legislation.

Observers have complimented Clinton's campaign staff for the powerful 'ground game' they have mounted in the quest for victory in November. The real advantage, on a state by state basis, however, belongs to the Republicans, who have overwhelmed their adversaries in the contests for control of governorships and legislatures. Until Democratic strategy changes, horror stories like the ones recited by Professor Krugman will continue to feature prominently in the records of state governments.
Hannah Gruen (USA)
@James Lee: It's important to mention two tactics that have given Republicans an advantage, helping them grab and keep control of state and local governments: gerrymandering and voter suppression. Exploitation of bigotry, resentment, rage and other human failings helps them, too.
Doris (Chicago)
That reality is thanks to the billionaires who concentrate on states, and they are particularly spending heavily this year as the money is n it going to Trump. Thank the Koch brothers, Robert Mercer, Sheldon Adelson, Larry Ellison, and other billionaires for their buying of elections. A lot of people jut buy into the lies put out by these billionaires unfortunately.
RMG (Boston)
This loss in the states began when John Dean was no longer chair of the DNC. The current DNC is too lazy, incompetent, or corrupt to adopt a 50 state program that works at the local level.
OzarkOrc (Rogers, Arkansas)
It's Race and Class. Red state voters believe that Poor people deserve their fate, and should stay in the 'hood where they belong. They still believe the long discredited story of the welfare queen and her Cadillac, while ignoring the pernicious impacts on our economy of corporate welfare.

They (Red state voters) really believe Poor people should be able to pull themselves up by their own bootstraps, if only we (government) would tumble them out of their all too comfortable hammocks. They really believe that. Our entire political class (on both sides of the aisle) ignores the issue of the transfer of the bootstrap factory to China.

Yesterday (Sunday) the local newspaper's most prominent headline was about the Orange One promising to end "Washington's" war on Farmers. Like any Republican admiration could untangle corporate agricultural subsidies. "Farmers" around here are already corporate sharecroppers or just waiting to cash when development reaches their property.

And it is always about the unfairness of asking the rich to pay taxes. Look at all the things paid for with Tyson and Walton family money around here. Raising their taxes would be unfair.
N B (Texas)
Do poor whites living in red states think they deserve their fate? No they blame their misery on Democrats. .
Bob (Portland)
The flip side of course is that many wealthy people also feel a need to believe that they deserve their fate. They are not content just to be wealthy. They need to be thought of as more than usually virtuous as well, with their wealth as the evidence. In my observation, virtue is not connected to wealth or lack of it.
Carl Ian Schwartz (Paterson, New Jersey)
This dovetails with the obscene implication of Romney's "47%" comment in the last presidential cycle, implying that 150 MILLION fellow Americans somehow are "life unworthy of life" and should vanish at no cost.
Never forget that this number far outstrips Hitlerian genocide (six million, including my family remaining in Europe in 1939), a genocide accomplished through great amounts of money spent on the murder factories, staffing them, and rounding up and transporting the victims over long distances.
And these people claim to be "good Christians." Jesus would puke.
HN (Philadelphia)
I have a really hard time understanding why any government (local, state or federal) would not want to help promote the health of its citizens. A healthy citizenry is more productive, producing more tax revenue (income and consumption).

I also have a really hard time with the hypocrisy of any government that limits healthcare to one particular group (poor women of child-bearing age), while simultaneously avoiding any solutions (like childcare) for their well-being.
Concerned Citizen (Anywheresville)
What about INDIVIDUAL RESPONSIBILITY? why is it societies obligation to give you birth control -- then free prenatal and labor and delivery, because you didn't use the free birth control -- then once the baby is born, you have the state babysit the child all day (free daycare!).

Where does the responsibility of the MOTHER and FATHER come into play? If you can't afford a child, don't want a child or are incapable of raising a child -- do not have sex until you ARE ready, or use contraception.

Yes, it really IS that easy. Tens of millions of normal middle class people have been doing this for generations!
lotusflower0 (Chicago)
@Concerned Citizen - Because not every person is born into fortunate or even modest circumstances. Life is not always as simple as you suggest, some people fall into poverty after one or more job lay-offs in the family.

Yes, tax money pays for healthcare and childcare assistance for the poor, which is how it should be. As a society we should all be concerned for those in need of help.
Tournachonadar (Illiana)
Ah, the venerable concept of women as lesser vessels! And the ironic disregard of Planned Parenthood's anti-minority roots, since Margaret Sanger its most famous founder was notoriously anti-black and put forth her radical birth control agenda with the aim of reducing overall growth of America's colored people. Texans feel beleaguered when they look around and see that Latinos have all but reclaimed their beloved republic from its Anglo hands by outnumbering them but play their transparent game of "god-fearing" to justify this and all their other social repressions, in the name of maintaining the good ole boy hegemony. Nor have the blacks in their midst been persuaded to disappear, despite their most strenuous efforts to disfranchise this segment of the Texan electorate. How long can this farce continue?
David Henry (Concord)
"There’s an important civics lesson here."

The GOP Supreme Court codified the cruelty by permitting reactionary governors to opt out of Obamacare, playing life and death games with peoples' lives. Trump vows to appoint similar judges.

John Kasich, the supposed "moderate" GOP candidate signed legislation defunding Planned Parenthood. Proud as a peacock in the photo-op.

Facts matter! Indeed, civics lessons shouldn't be forgotten, or forgiven.
Anon (Brooklyn)
Regarding Kasich, his state show widespread misery just like the other Republican managed states.
QED (NYC)
There is no "playing life and death games with peoples' lives" unless you assume that health coverage is a right. If you correctly look at it as a service, then the choice between generous and miserly coverage becomes a question of balancing collective vs individual responsibility.

Planned Parenthood could just as reasonably become a privately funded entity with no state funding if the decision is to get the state out of functionally being a healthcare provider for women. This too is consistent with healthcare as a service.

And, for those who will inevitably pile on with "healthcare is a right", I ask you this: how do you abridge a right on the basis of the cost of providing that right? Because that is what happens in any healthcare model - cost has to be balanced against care.
David Henry (Concord)
Saying this doesn't make it so. Nice try.
Free Spirit (Annandale, VA)
Dr. Krugman, Medicaid money is not "free" as you claim. Conversely, it is paid for by tax-paying American workers.
N B (Texas)
True, not free but better than motherless children, so gladly paid.
Ellen (Williamsburg)
FS - and many of the people who use Medicaid have paid into that system for years and years.. and find themselves in need of low cost insurance through loss of job or for working very hard at a job without a living wage...say like people who work for the Walmarts of this country.

Someday, you yourself may need it. Keep that in mind as you cast aspersions on who you think uses what.
lotusflower0 (Chicago)
@Free Spirit - It's free money to the states. They get 3 years before having to contribute 10% of state money to the program. It's a very valid question why Texas would refuse free money to provide healthcare to the poor.
Michael (Rochester, NY)
Something terrible has happened to all women in the USA: New York has produced Donald Trump, who, if elected President, will defund Planned Parenthood throughout the USA...

and legalize bias in renting property by landlords.

So, Texas might be bad, but, what has NY produced lately?

Donald Trump
Amg (Tampa)
He is loosing big time in new York,Texas has embraced him
Robert Eller (.)
"Something terrible has happened to pregnant women in Texas: their mortality rate has doubled in recent years, and is now comparable to rates in places like Russia or Ukraine."

So what, Dr. Krugman? I mean, these women have been born already. They've got souls. That's all that matters. Do they leave other children, a husband, behind? So what? The pro-AFTERlife people are satisfied, their consciences clean and clear before their Lord.
Concerned Citizen (Anywheresville)
That is a useless blanket statement -- "mortality rates have risen".

I have some friends and neighbors who work in hospitals, most are nurses and two are public health nurses. When they discuss this, it is always in the context that most of the women who manage to DIE -- despite advanced medical care and nobody would EVER turn a pregnant woman away from an ER -- are on drugs. A few are alcoholics, or cross-addicted, but most are on hard drugs, like heroin, cocaine, crack, oxycontin, etc.

It is THAT which dooms them and often harms their unborn babies. These women (most are very young, but not all) smoke crack pipes, and shoot up heroin WHILE THEY ARE PREGNANT. They smoke & drink during high-risk pregnancies. They ignore symptoms of high blood pressure. They eat poorly. There is a substantial percentage of those with bad mortality rates, who are morbidly obese -- even super-morbidly obese. I know of one woman who died at only 21, but she weighed over 450 lbs. How is that "societies" fault? Could we have forced her to diet?
lotusflower0 (Chicago)
@Concerned Citizen - Mr. Krugman was specifically talking about Texas. Are you from Texas (or anywhere? why the secrecy)? A couple of anecdotes from acquaintances who work in hospitals is not a study, nor a statistical record.
Paul (Bellerose Terrace)
Lotus, she has revealed in the pat that she's from the Cleveland area.
Alan R Brock (Richmond VA)
"Yet the cruelty goes on. Why?"

The fact that Texas and other red states have a political class heavily weighted with those who cloak themselves in religion should not be overlooked.

Their message seems to be: "Jesus loves you, but I don't".
Jasr (NH)
"The fact that Texas and other red states have a political class heavily weighted with those who cloak themselves in religion should not be overlooked.

Their message seems to be: "Jesus loves you, but I don't."

Alternatively, "Jesus loves you, so I don't have to."
Phyllis Nelson (Austin)
The Lounge Lizards band have a song "Jesus Loves Me, But He Can't Stand You."
I think of it frequently these days, although it was written a number of years ago.
abo (Paris)
"The point is that America would become a better place if more of us started paying attention to politics beyond the presidential race."

How does this help Texas, where the voters have consistently shown themselves to be cruel? Sure America would become a better place if Americans were better. But they aren't.
gemli (Boston)
It's clear that conservatives don't despise Big Government as much as they despise the people that Big Government serves. Get rid of one, and you get rid of the other, without having to mention them by name.

The conservative mindset is full of these hypocritical ploys. When they pretend to care about what Jesus said about abortion (which was nothing, by the way), it has the unintended benefit of making life harder for poor women who aren't ready, willing or able to care for a child. Shielding these women from the twin sins of sex education and contraception will ensure that they need more abortions, which are then denied, or made inaccessible.

Adding one final insult to injury, Texas lawmakers tried to close down abortion clinics by citing concern for the health of the mother. Everything is bigger in Texas, including this monumental hypocrisy. Fortunately, the Supreme Court brought them down to earth, but it won’t be long before they hatch another ploy.

The whole game is about plausible deniability, as the self-righteous mine the Bible for first-century ignorance that can pass for modern-day medicine. But for those who don't respond to the religious angle, there are secular ways to attack the poor. These include an appeal to States' Rights, faux concern about improving personal responsibility, or condemning the poor as moochers and takers while billionaires get tax breaks.
James Lee (Arlington, Texas)
Gemli, the alternate ploy is already in place. Former Governor Perry rejected the offer of an expansion of Medicaid under the ACA, on the grounds that the state could not afford the 10% additional cost, once the federal subsidy expired. As with so much else that came out of Perry's mouth, this statement was a lie.

The state government's stinginess, of course, imposes higher costs on low-income Texans, the group that truly cannot afford even the medical costs they confront now. Every time the federal government attempts to improve the lives of Texans, as when the EPA ordered the state to clean up its air, our vigilant watchdogs (of corporate interests) uses taxpayer money to sue them.

In Texas, we know all about Alice's domain of Wonderland. We live there, and our governor is the Red Queen.
BronxTeacher (Sandy Hook)
That is a first rate description of "the whole game"!
When country folks get fleeced by the slick 3-card-monty rascals, they either stop getting fleeced or they stop coming to the city. As the bigots an ignorant die off we will see a change. I hope I see it and I hope that change is a good one. Thanks again Gemli
Grey (James Island, SC)
@Gemli: Great letter, but I disagree with one word: It has the "INTENDED benefit of making life harder for poor women" because these people deserve to be punished for being poor. It's their own fault.
DavidF (NYC)
The case with Planned Parenthood is muddied by the abortion issue. Some are no no doubt opposed to its existence on those grounds alone. Then there is the fact that some people are just cruel and indifferent and have no interest whatsoever about helping anyone, whether they look like them or not.
One would think that after 35+ years of being wrong about supply side economics this kind of thinking would have been discredited by now, but then who would have thought that a hateful, divisive, flagrant fraud would win the nomination of the GOP for POTUS?
Prof.Jai Prakash Sharma (Jaipur, India.)
Given the flawed nature of the representative democracy and the primacy of elections over the other vital issues of politics crucial to social development, the cruelties cited by Krugman would continue to be perpetrated by the socially insensitive elite through the legislative and administrative instruments available to them.
David Henry (Concord)
Expect voters can say NO. Voters confer power. Got it?
N B (Texas)
Voters in Texas don't say no. They embrace, even sanctify the cruelty.
Richard Gaylord (Chicago)
"This should be a no-brainer: If Washington is willing to provide health insurance to many of your state’s residents — and in so doing pump dollars into your state’s economy — why wouldn’t you say yes?" "A large part of the answer, surely, is the usual one: It’s about race." Professor Krugman should seem to be exceptionally well-suited to answer no-brainers but yet ,he gets answer wrong. The reason not to accept supposedly free (note: TANSTAAFL) 'help' is that once a state (or any organization) accepts money from the government, it follows, as the night the day, that the government will use it as wedge to control and regulate (e.g. colleges whose students to take government grants are forced to obey Title IX in sports, states receiving highway funds are forced to impose helmut laws on its motorcyclists). As Ronald Reagan said "the nine most terrifying words in the english language are "I'm from the government and I'm here to help".
Paula Matos (La Quinta, California)
I guess I don't get your point. Throwing up a Ronald Reagan aphorism about big bad government is supposed to convince me that being forced to wear helmuts (sic) is a bad thing (saving many riders from injury or death along with the associated costs to themselves, their families and, perhaps ultimately,the taxpayer) or that Title IX is a bad thing (given the recent performances of American women in the Olympics)? If that's the case, give me more of that there big ole government! What would you say to someone who was dying because of lack of early treatment that they could have had with the help of that big, bad government? "Hello, I am the government and I'm here to help." "Won't you come in please, because I need that help - and I am eternally grateful that we have a civil society."
Pedigrees (SW Ohio)
I have a feeling that people in Louisiana who have been affected by flooding in the past few weeks are very happy when someone shows up and says "I'm from the government and I'm here to help you." Of course, if asked, they'd say they are against big, bad government. But they'll have no problem accepting help from FEMA now or after the next hurricane. Or the one after that.

Those who claim not to believe in government should be prohibited from accepting help from said government when they need it. Maybe then they'd wake up.
Concerned Citizen (Anywheresville)
And Title 9 in sports is being abused in terrifying ways to force girls to shower with genetic males, and to let genetic males compete on sports teams against biological females. And to force EVERYONE to use unisex bathrooms! That was never remotely what Title 9 is for....and if it is undone by future legislation because of this, YOUNG WOMEN will suffer from reduced opportunities for sports. Many schools will cut all sports, before they allow boys to shower with girls.

Anyhow, the reason for not taking the Medicaid expansion is simply: the government only pays 100% for 3 years. After that, the states are on the hook for 10%. This is 10% of BILLIONS of dollars over time. And likely the Feds will back off more and more, leaving the states holding the bag.

Medicaid expansion is the cowards way to avoiding providing UNIVERSAL health care to every American -- not INSURANCE -- but actual CARE. And sadly, Medicaid often goes to illegal aliens.
Ed (Homestead)
It should be mentioned every time the discussion of small government versus government that supports the needs of poor people, that the reddest states are also the states with the highest level of government subsidies to its residents. Those who complain the most about government handouts are the same ones who are first in line for the handouts. I had a friend for many years who always complained about other people who depended on government subsidies. As soon as he became eligible for any kind of subsidy he took it, never once feeling any contradiction between his politics and his own actions.
Richard (Stateline, NV)
Ed,

It should also be mentioned that "poor people" are targeted for extra taxation by government in the form of alcohol, tobacco and gasoline taxes as well as the sale of lotto tickets. All of these are regressive taxes on poor Americans which reduce the benefits given them by big government.
Kevin Rothstein (Somewhere East of the GWB)
Richard: nobody forces you to buy a Lotto ticket, smoke, or drink alcohol. And many poor people use public transportation.
Richard (Stateline, NV)
Kevin,

I'm glad that your "social conscience" doesn't mind government spending public funds advertising bad things just to raise money. Mine does!

Of course the poor can always take public transit to the AAA, GA, or the lung cancer clinic so I get your point(Not!)
craig geary (redlands fl)
Nothing could be finer than that old time supposedly christian, largely southern, red state hate.
That urge to crucify, burn at the stake and whip insensate.
Praise hayzus.
Robert Prentiss (San Francisco)
At the heart of Krugman's post is that Republican dominated states have peopled Congress with Senators and Representatives opposed to women, low income, minorities and the uninsured. Whatever the reason, just plain ordinary racism or "they're not like me", Texans have committed a serious crime against the rest of us by setting a bad example for the other18 Red states that refuse to adequately fund Medicaid. That's what's driving the Trumpeter.
Hannah Gruen (USA)
@Robert Prentiss: The Red States are increasingly coming to resemble Third World countries--lots of poor people at the bottom living in deplorable conditions and a small number of cruel, greedy, corrupt bullies at the top feeding off the human misery.
Sharon5101 (Rockaway Beach Ny)
Want to know what's even more frightening? It's the photo accompanying Krugman's article showing young white women, their faces contorted with rage, holding up signs demanding Planned Parenthood be defunded. They should be careful what they wish for because it can come true.

However, that's been the Republican presidential campaign strategy for years. The GOP always finds some organization they feel is responsible for the decline of America (NPR and PBS springs to mind) and demand the offending group no longer receive Federal funds so it can be put out of business. The rationale is that why should the government subsidize public TV or healthcare?
Hannah Gruen (USA)
@Sharon5101: The Susan G. Komen fiasco should have served as a warning to the Republicans: attacking Planned Parenthood is a bad idea. Polls clearly show that a significant majority of American women have a favorable view of the organization, and their feelings are strong. Maybe a reason for that loyalty is that one out of every five American women has received some kind of direct service from Planned Parenthood. And all women understand that access to affordable birth control in early adulthood has a huge impact on the course of women's lives, perhaps more than any other factor.

The right-wingers who produced the fraudulent "baby parts" videos seemed to think they could destroy Planned Parenthood the way they did ACORN, through slapdash dishonest means. Planned Parenthood isn't ACORN. It has an impact on the lives of many more Americans. It isn't PBS and NPR either. Healthcare is intimate. It is personal. And women take Republican attacks on Planned Parenthood personally.
Sharon5101 (Rockaway Beach Ny)
@Hannah Gruen--I couldn't agree more Hannah. These angry young women have no idea what life was like in the bad old days when healthcare for women was non-existent. With NPR and PBS I was merely pointing out other examples of organizations that were targets of Republican presidential election year wrath. Just get rid of NPR, PBS or Planned Parenthood declare the Republican candidate and -- Presto -- America's problems will vanish.
ACM (Austin, TX)
Remember the National Endowment for the Arts? It was one of the first major victims.
soxared040713 (Crete, Illinois)
Dr. Krugman, the driving force behind red state autocracy is ALEC. Most folks are not aware of the American Legislative Executive Council.

This pernicious group, mostly coiling and uncoiling in the shadows, directs and controls the legislative agenda in many states, from the grass root level to the governor's mansion. ALEC, very much on the quiet in these people's backyards, authored the gerrymandering of Congressional districts to forge an imbalance of the political parties, heavily in favor of Republicans.

The Koch Brothers, of whom even less is known by these inattentive voters, heavily fund, from their vast energy and real estate wealth, ALEC and vet local candidates for legislative races to insure their conservative (please read: racist and sexist here) pedigree. The Koch Bottles' aim, among many other regressive ideas they want to see as national policy, is the repeal of Roe v. Wade, the Voting Rights Act and all governmental regulation.

The Koch Bottles mean to bottle up all federal intervention in regulating shady or shoddy practices by industries that are profit-driven. So they have ordered their vetted soldiers to tell preach that these safeguards and taxation are un-American, designed to interfere with the free market system that benefits all. So they say.

The Koch Bottles and ALEC know that when the indifferent, yawning citizen stays home, a "no" vote is a tremendous win for them. They preach the evil that "poverty is your own fault. Deal with it."
Robert Eller (.)
And the people who fall for the ALEC and Koch Bottles' spiel? The Koch suckers.
Meredith (NYC)
Thank you...at least from comments we get this description of the 'pernicious group in the shadows'. As you say--- 'Most folks are not aware of the American Legislative Executive Council.' That's because our TV news and op ed pages hardly ever mention them . Such a worthy news topic, especially in an election season.

Krugman might write about Alec sometime, since they engineer many of the things he opposes. They write laws for congress members we elect who go to their conferences, and then return home to put into effect the resultant plutocracy in action.

This should be a focus of op ed page pieces by somebody, since it gets to the heart of what poisons our politics---big money calling the shots, through legalized dominance of both parties. Would krugman ever write about that? Or only about the results, without tracing back the basic cause/effect?
David Henry (Concord)
The force is the GOP which HIRES ALEC.
Ralph Averill (New Preston, Ct)
"The point is that America would become a better place if more of us started paying attention to politics beyond the presidential race."
Agreed.
Example: It is the state legislatures, to which almost no one pays attention, that decides the make up of congressional districts every ten years after the census. Most of those state bodies have Republican majorities and they have done a good job of gerrymandering districts giving the Republican Party an electoral advantage that does not reflect state-wide party numbers. The result is a House of Representatives that is not "representative" at all.
Tip O'Neal said, "All politics is local." He was right.
Janet Camp (Mikwaukee)
This is exactly why Wisconsin, traditionally a blue state, has become rather purple. The consequences of gerrymandering will be extremely difficult to undo. Another effect is that some good people no longer want to even run for re-election because they are so frustrated by a total lack of ability to get anything at all done int he State legislature. One State Rep ran for Alderman in the city for this reason--he felt he could be more effective for this smaller group of people at this time. Sad.
Concerned Citizen (Anywheresville)
Democrats also gerrymander districts; indeed, they invented gerrymandering. So it cuts both ways. I live in a blue union county (in a "purple" state) and my district is a crazy quilt designed by the local Democratic machine, to ensure we always always always send a BLACK Democrat to Congress. Ergo, I have no representation in Congress and my vote is a joke.

What's good for the goose.....
lotusflower0 (Chicago)
@Concerned Citizen - Of course they do, both parties are guilty of it. In Illinois, the state supreme court just ruled on Thursday that a referendum voters wanted on the ballot for November on this issue is unconstitutional....the court voted along party lines, of course.
bill b (new york)
i'ts not complicated if they are dead they can't vote.
it's another form of voter suppression.
Patrick (Midwest, Side)
Consider the efforts of Robert Mercer, a demonstrably intelligent person with massive money leverage.

He supports Ted Cruz, Donald Trump, and the Breitbart nest. These agents, in turn, rage against all manner of malicious evils which government is supposed to be fomenting amongst the masses.

However these dark threats are expressed there is always an accompanying call to palliate the sting of taxation upon the 0.01%.

I can't imagine that someone as intelligent as Robert Mercer places any value on this sort of rhetoric. My guess is that he finds public health much less compelling than maintaining his own personal absolute wealth.

I am extracting this opinion from two perceptions to which I, one of the polloi, have access.
-He has placed financial bets with his colleagues at Renaissance which were fabulously well-constructed.
-He fears a shampoo bottle which is less than one third full, and will dock the bonus of any person working for him who allows such an occurrence. I was kind of surprised by this because I ain't so smart as Mr. Mercer, and I solved this by keeping two bottles at hand so if I find I am in dire straits with one bottle, the other is there to save me.

I have concluded from these two points that Mr. Mercer has mastered the flux of finance, but is still anxious about finding himself deprived.

This seems to be the basis of his public activity: do anything to preserve absolute personal abundance, and exterminate threats from the greedy commonweal.
Tim Kane (Mesa, Az)
"it's past time we joined every other major country on earth & guaranteed health care to all as a right, not a privilege."

- Thus twitted Bernie, the only politician with the courage of his convictions willing to pursue universal health care as a moral issue presented at (or near) the center of his presidential campaign.

Sorry Professor Krugman lacked the courage of his own convictions so as to not support the one candidate that shared his convictions.

If the national candidates don't talk about this, how much of an issue will this be locally? If they do, won't it help focus voters on this issue even in local elections?

On the other hand, if you can't beat up on the poor, who can you beat up on?

& for my conservativ catholic kin out there: There's a reason why Christ said separate church from state. Civics & law must make compromises that religious ethics cannot. You can't have democracy if adult citizens are not sovereign. A sovereign is a political entity that has no superior. The unborn is life but it is dependent upon someone who, under the theory of democracy, is a sovereign. So, civics has to make a compromise in order to effect democracy that religious ethics cannot make. That gives women a right to choose what to do with her own body. The conservative catholic position is set persuasion aside in an attempt at undermining the theory of democracy so that legitimacy of determining government is taken from the people as sovereigns and thus restored back to Bishops.
Meredith (NYC)
Not only did PK not support, but conspicuously ignored, then denigrated Sanders as well as his supporters. He went along with the media trend to kick Sanders. Seemed to regard him as a danger to the nation.

Meanwhile PK rationalizes away the shortcomings of ACA, which forces us all to subsidize insurance profits. In many countries, if not single payer, the govt negotiates prices with insurance and drug co’s, on behalf of the citizens, whose right to health care is an acceptable norm, instead of being fought---since mid or later 20th century.
An enlightened contrast, but never discussed in our media, since it's sticking one's neck out.

But really, to let states opt out of a national health care system in any way, is against the ‘equal protection of the laws’ of the constitution. Accidents of geographical location shouldn’t determines life and death matters in America, Land of the Free.
Janet Camp (Mikwaukee)
There’s a big difference between supporting a concecpt and passing legislation that turns that concept into reality. Blame the fake Democrats Ben Nelson and Joe Lieberman, for making sure we didn’t get a public option. It’s also hard to see where HRC would not do everything she can to improve health care.

People like PK--and me--while we might like some of Bernie’s rhetoric, we recognize the reality. In my case, I happen to think HRC is better qualified.
lotusflower0 (Chicago)
@Tim Kane & Meridith - Will the former Sanders supporters ever stop whining about supposed ill treatment of Bernie in the press? While Sanders supporters loved the ideas of free healthcare, free college tuition and wiping out student debt, there was a complete lack of facing the reality that ALL of these programs would have to be paid for with tax money? Everyone's tax burden would be quite large. You can see why Bernie didn't mention this, it would be quite unpopular, even to his supporters.
Rima Regas (Southern California)
"... states are trying to make health reform succeed. California..."

As a Californian, I have to disagree. Yes, the number of uninsured has come down drastically. No, costs have not been held down in relation to what the population is earning. For those who are not eligible for MediCal, the free version of healthcare in California, costs are out of sight when one adds up the monthly premiums to co-pays, coinsurance, and the very high cost of drug co-pays, which very often come with several hundred dollars of deductibles that have to be met first. On today's salaries, the cost is so onerous that thousands flock to free healthcare events.

The politics of presidential races set the tone for policy over the years that succeed them. Parties get a chance to replace non-establishment lawmakers with candidates of their liking, as is happening in Florida and elsewhere. At a time when there has been no fiscal policy from Congress for a few years, this presidential cycle is crucial if we are ever to get out of the slow recovery we've been mired in. Janet Yellen, who has been in a key position to counteract an obstructionist Congress, is poised to raise rates even though the economic community is united against such a move now. Raising rates could add a pound of salt into open wounds, especially as Dems will likely not regain both houses.

I never thought I'd regret signing that petition to withdraw Larry Summers three years ago. I have to admit, I do. See http://wp.me/p2KJ3H-2ob
Rima Regas (Southern California)
From April 2016:

"Thousands waited in line overnight to get into the Los Angeles Convention Center Wednesday for the first of three days of free eye exams, dental care, minor surgeries and more."

http://www.scpr.org/news/2016/04/27/60047/minor-surgery-eye-care-and-mor...
Concerned Citizen (Anywheresville)
Only HUNDREDS of dollars in deductibles, Rima? that sounds like paradise to me! I have an exchange health policy with a $6800 in deductibles -- I got it in July, so I would have to reach that number in only six months (it is not pro-rated no matter what reason you had to enroll at mid-year!). That is before it pays out ONE DIME of health CARE. In short, I am forced to pay for insurance which pays for NOTHING -- not one thin dime of coverage.
Richard (Stateline, NV)
Rima,

Always be very carful what you ask God for because he may hear you and grant your wish. That is especially true during presidential elections.
Larry Eisenberg (New York City)
To hate Blacks and save money too
Reinforces a vile point of view,
Add misogynous pleasure
At each heartless measure,
And voila, a Masochism Stew!
Tom (Earth)
I'm strongly considering writing in Larry Eisenberg for President this year.