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Why a 'Trigger' for the Public Option is Nonsense
GOP Sen. Snowe suggests we give private health insurers a shot at reforming themselves first. Yeah, right
I was just on the phone talking with a reporter for a national media outlet who referred to Senator Olympia Snowe's idea for a public option "trigger" as the "centrist position." Whoa. When the mainstream media start naming something "centrist" the game is almost over, because just about everyone with any authority in our nation's capital wants to be at the "center."
Let me back up a step. The public insurance option has become a lightning rod for Republicans, hate radio jocks, Fox News, the Wall Street Journal's editorial page and lobbyists for the health-industrial complex who accuse the White House and Democrats of planning a "government takeover" of healthcare. Anything that has the word "public" in it is always an automatic target for their rants. But most Democrats understand that a public insurance option is essential to control healthcare costs and expand coverage -- both because private for-profit insurers now face so little competition in most markets that only the prod of a public option will force them to lower costs and extend coverage, and also because a nationwide public option would have the scale and authority to negotiate lower rates with drug companies and healthcare providers, thereby pushing private insurers to do the same.
The White House is looking for a way to be in favor of a public option but also get enough Blue Dog Democrats -- many of whom hail from swing districts and states, and therefore need some cover -- to vote for it. One such cover is a Republican senator from Maine named Olympia Snowe. If she votes for the bill, Blue Dogs can calm their constituents -- who have been worked up into a lather by the right -- by saying "You see? Even a prominent Republican senator is voting for this."
So will Snowe play ball? It depends. Her idea (evidently encouraged by Rahm Emanuel, the president's chief of staff) is to hold off on any public option. Give the private insurance companies a period of time -- say, five years -- within which to make changes that extend coverage to more people and also drive down long-term costs. If those goals for coverage and cost aren't met by the end of the five-year grace period, kaboom: The public option is triggered -- which will force such changes on the insurance companies.
The beauty of Snowe's proposal is that it seems to offer Blue Dogs a way out and liberal Democrats a way in. Nobody has to vote for or against a public option. The public option just happens automatically if its purposes -- wider coverage and lower costs -- aren't achieved. And the trigger idea seems so, well, centrist.
The problem is twofold. First, it's impossible to design airtight goals for coverage and cost reductions that won't be picked over by 5,000 lobbyists and as many lawyers and litigators even if, at the end of the grace period, it's apparent to everyone else that the goals aren't met. Washington is a vast cesspool of well-paid specialists who know how to stop anything resembling a "trigger." Believe me, they will.
Second, any controversial proposal with some powerful support behind it that gets delayed -- for five years or three years or whenever -- is politically dead. Supporters lose interest. Public attention wanders. The media are on to other issues. Right now the public option is very much alive because so many Democrats care deeply about it, with good reason. But put it off for years, and assign it to the lawyers and lobbyists I just mentioned, and you can kiss it goodbye forever.
If the idea is to have a public option waiting in the wings in case private insurers blow it, why wait for it at all? If it gets lower costs and wider coverage, it should be included right from the start.
What worries me isn't just that the mainstream media are calling Snowe's trigger "centrist," but that the White House might see it as an easy out. "I continue to believe that a public option within that basket of insurance choices would help improve quality and bring down costs," the president said Monday. Fine. But he hasn't yet said the public option is essential. He hasn't threatened to veto a bill lacking it. There's even reason to believe the White House has quietly encouraged Olympia Snowe to pursue her "trigger."
The best way to give Blue Dogs cover is for the president to explain clearly and boldly why the public option is essential to healthcare reform, and why he's ready to veto any bill that doesn't include it. That's also the only way to give the nation a good chance of getting true healthcare reform. Hopefully, that's what he'll do Wednesday evening.
Otherwise, we get a trigger to nowhere.



24 Comments so far
Show AllAnyone who has ever served on so much as a university committe can translate the "trigger". In other words, "table it." In other words, "send it back to committee." In other words, kill it.
Good analysis, Mr. Reich.
Let's simplify the debate for the average American:
1) Single-payer = HEALTH CARE REFORM !
2) Public Option (still a nebulous term as of 9/9/09) = SOMEWHERE BETWEEN A MARGINAL COMPROMISE AND CAPITULATION
3) Triggers, regional co-ops, drug makers' promises, insurance company promises, criminalizing businesses and individuals that refuse to buy defective insurance =
HEALTH CARE DEFORMED (far worse than what we have now)
If Obama picks #3 DEFORMING HEALTH CARE will be his well-deserved legacy.
Re raydelcamino September 9th, 2009 10:33 am
Good analysis of Reich's analysis. No bill at all (what we're stuck with now) will be better than what waits in the wings.
Only a complete sucker would bet against number 3. No matter how an idea or a bill starts out, regarding any subject or issue, the only version that can get through the Congress and president is something that is primarily corporate welfare.
Careful, there could be a number 4 coming soon. Until recently public option triggers wasn't even brought up. Who knows how many more dumber "choices" there will be until the failure bill finally makes it to the president's desk ?
Just in case you have not figured it out yet. Obama is an appeaser of the neo-conservative movement. He fears the right wing more than he does the left.
Excellent analysis.
Best option is single payer.
Obama, Rahm, Max and Steny say off the table.
Next best but limited is the public option.
Rahm, Max and Steny say no. Nancy says yes.
Repugs say no vote on any Obama plan.
Here's hoping that Obama will LEAD and come out strongly for the public option
and say he'll veto anything less. I can dream...
Robert, why do you think Obama will do the right thing? He's not hanging with you and he not worried about alienating progressives. His constituency is the Blue Dogs. It's time to realize who he is, who he supports and who he is really accountable to-- and it ain't us.
Robert, why do you think Obama will do the right thing? He's not hanging with you and he not worried about alienating progressives. His constituency is the Blue Dogs. It's time to realize who he is, who he supports and who he is really accountable to-- and it ain't us.
"Otherwise, we get a trigger to nowhere."
Good line.
If Obama waffles tonight on the "public option" (which he probably will if Press Sec. Gibbs' tone today is any indication) we're all screwed. We'll get a mutant Mitt Romney plan and all be the poorer for it.
-30-
We don't want a Snowe job. I fully expect Obama to sell us out on a public option in his speech this evening but we do not have to accept it. It he sells us out tonight or indicates that he will do so, let that be a "trigger" for citizen outrage and an all out push for Single Payer.
The trigger is a dud! Let's defeat the Blue Dog/GOP/Obama/Emmanuel Plan and say hell no to crumbs from the corrupt US power elites and watch them squirm. With this depression, triangulation is dead in the water. This president had better get that through his head. People are fed up with weasel words from political weasels.
AD
A trigger won't kill the push for national health care. If the public option is delayed for five years, the situation will become, worse resulting in more people clamoring for a public option, not less. RR's mistake is assuming that people can lose interest in their own health care. Not likely.
Delay may kill bills that deal with certain issues. But that observation cannot be universalized into a rule. Sometimes delay heightens interest in an issue. For instance, delay in implementing the New Deal created more pressure to do so, not less. Also, there is now more pressure to implement health care reform than there was when Clinton suggested it. Thus, we already have a counterexample to RR's contention.
Even though a delay will not kill health care reform, it is still not desirable. It will mean delayed coverage for some and delayed treatment for some. Delayed treatment will mean earlier death for some. Thus, a "trigger" is not undesirable because it will kill health care reform, but because it will kill people.
Nice thought, there are some of us who have been working on healthcare reform since the 1960's. Just because Barack the Equivocator decided to talk about it now, doesn't mean we haven't been working for years. We GAVE the insuance industry its chance to shape up, cover everyone and hold down costs. Instead, they have refined their exclusionary rulings, learned more and better ways to defraud Medicare and us, and raised costs overall more than any sector of spending except the defense budget. How long do we need to build critical mass, and how many more people die or go bankrupt because of the "negotiating? Any reason given to wait, be patient, or delay is a lack of courage on the part of the protected class who are supposed to represent us, but really represent their corporate whoremasters. Time's up, single-payer, NOW!!!!
You may rest assured: any legislation that contains a trigger lacks a firing pin.
· Yr Obd't Servant
An American dies for lack of health care every 24 minutes. What more could it possibly take to "trigger" a change in our system?
Triggers, death, health care, insurance companies, and insurance company CEOs all maybe should fit together in one idea, but I don't think it is the idea that is being talked about in the elite circles in Washington.
Instead, they should pass single-payer.
If the country is not satisfied after five years a referendum is held.
If 51% wish to return to the for-profit model a "trigger" kicks in.
"Triggers" can work both ways.
The public option "trigger" is a centrist position. Yes it is. Like keeping 80,000 troops in Iraq instead of 150,000 or 100,000 in Afghanistan instead of sending the whole army, or, let's see, only blowing up Afghan villages once in a while. Centrist is anything the MIC and the bankers want. Anything else is extreme leftism.
How about you get one pull on the trigger of a gun pointed at a bribed politician, lobbyist, or insurance executive of your choice if you are bankrupted or someone in your family is denied health care.
That is the kind of trigger we can all support!
The only reason anyone wants the "trigger" is to disable the public option.
The only reasons anyone wants "public option" is to disable single payer or to eventually pass single payer by rendering private companies moot.
The news gets more ridiculous each day with how much this healthcare bill becomes watered down. Sad to say, but this is what comes of bipartisanship.
http://www.mindwafers.com/3/post/2009/09/hmohhhshit-part-ii-the-return-of-the-coop.html