Economist and New York Times columnist Paul Krugman says the only way the U.S. will get its debt crisis under control is by the use of "death panels" and a national sales tax.The national sales tax, referred to as value-added tax (VAT), which governments across Europe use widely, will help cut the U.S deficit, Krugman argues.Krugman made his comments on ABC's “This Week with Christiane Amanpour” during a roundtable discussion about the economy and the recent findings of the U.S. Debt Reduction Commission.Here's the key excerpt:"Some years down the pike, we're going to get the real solution, which is going to be a combination of death panels and sales taxes. It's going to be that we're actually going to take Medicare under control, and we're going to have to get some additional revenue, probably from a VAT. But it's not going to happen now."The Obama healthcare plan passed by Congress in 2010 includes government-run healthcare committees with sweeping powers, including the power to engage in competitive pricing and cost analysis, a system Britain uses that has led to rationing of medical care for the elderly.Critics of the Obama plan, including former Alaska Gov. Sarah Palin, quickly dubbed the committees "death panels," saying government agencies would decide who would live and who would die. Supporters of the Obama health plan dismissed such suggestions as nonsense.Krugman apparently thinks otherwise, and suggests that such death panels could be one way the federal government will be able to keep soaring medical costs under control as baby boomers enter retirement.He continued: If the Debt Commission "were going to do reality therapy, they should have said, ‘OK, look, Medicare is going to have to decide what it's going to pay for. And at least for starters, it's going to have to decide which medical procedures are not effective at all and should not be paid for at all. In other words, it should have endorsed the panel that was part of the healthcare reform.’"Krugman also criticized Republican plans to extend the Bush tax cuts fully, including those who make more than $250,000 a year.He said: "The cost of permanently extending just the upper-end Bush tax cuts, as opposed to only extending the middle-class tax cuts, the 75-year cost of that is just about identical to the 75-year accounting shortfall in Social Security. So we've got people who are saying, ‘Oh, Social Security, got to do something about it, but let's extend those tax cuts for rich people. This is showing how the priorities are all skewed.’”Apparently realizing his comments were inflammatory, Krugman took to his blog immediately Sunday afternoon to “clarify” his comments.“I said something deliberately provocative on 'This Week,' so I think I’d better clarify what I meant, which I did on the show, but it can’t hurt to say it again,” he wrote. “So, what I said is that the eventual resolution of the deficit problem both will and should rely on “death panels and sales taxes.”“What I meant is that:"(a) health care costs will have to be controlled, which will surely require having Medicare and Medicaid decide what they’re willing to pay for — not really death panels, of course, but consideration of medical effectiveness and, at some point, how much we’re willing to spend for extreme care"(b) we’ll need more revenue — several percent of GDP — which might most plausibly come from a value-added tax"And if we do those two things, we’re most of the way toward a sustainable budget."He then provided a link to a June 20 column in which he also described “death panels,” but only in passing and in a mocking way. The column is actually about budget deficits.What he doesn't say is that he has written at least half a dozen columns repeatedly referring to death panels the last year in an ongoing effort to malign Palin and other conservatives.Krugman also conceded his solution may be “politically impossible.” But, he added, “I believe that some day — maybe in the first Chelsea Clinton administration — it will actually happen.”