For those interested in health care reform, the word of the week is "trigger." Trying to find a compromise on the controversial public option that's politically palatable to both liberals and moderates, Sen. Olympia Snowe -- currently the only Republican interested in finding common ground with the Democrats -- has been pitching the idea. How would it work? Essentially, health care legislation would establish certain benchmarks for affordability. If private insurers could not find a way to lower premium costs for enough people in geographically distinct markets by a still-undetermined deadline, a public option would be introduced into the health insurance exchange. (The New Republic's Suzy Khimm has a good rundown here.)
On MSNBC earlier today, Illinois' own Rep. Jan Schakowsky made clear that she isn't too fond of the idea, reiterating her support for a "a robust public health insurance plan upon implementation, no triggers."
There are good reasons to be skeptical of the trigger approach. For one, to modify their behavior, insurance companies would need to feel threatened by the looming public option, something that isn't likely if the legislation envisioned by Snowe is ultimately implemented. As Ezra Klein notes today, "I've not yet seen a proposal for a trigger where the trigger is set sufficiently low and the public option it would create would be national, rather than state-by-state."
That brings us to our second problem: special interests. Robert Reich explains how insurance companies could use the grace period to blow holes through the trigger instead of working to lower costs:
First, it's impossible to design airtight goals for coverage and cost reductions that won't be picked over by 5,000 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.
If designed differently, however, the trigger option could ironically lead to a more robust public option. Before the recess, members of the House Energy and Commerce Committee stripped out a provision in their bill that would allow the public option to be based on Medicare payment rates and allow the Secretary of Health and Human Services to negotiate directly with providers to set rates. The Senate HELP Committee's bill follows the same "level-playing field" model. In other words, the best congressional Democrats might be able to get through now is a weak public plan that would be small and negligibly cheaper than other private options on an exchange.
But what if the private insurers really did fail to make changes? House Speaker Nancy Pelosi thinks her caucus would have a lot of leverage:
They'd be better getting a public option now than one that is triggered because if you have a triggered public option, it's because the insurance industry has demonstrated that they're not cooperating, they're not doing the right thing, and I think they'll have a tougher public option to deal with.
If Congressional leaders want to pursue the trigger option, they must ensure that the eventual public option is worth the wait. Otherwise, the bridge will serve no purpose other than to ease short-term pressure on insurance giants. And that's obviously not the goal of this reform effort.
Comments
jacksmith (not verified) on Thu, 09/10/2009 - 16:21
Why A Strong Public Option Is Essential - By jacksmith — Working Class
Robert Reich explains the pubic option: http://bit.ly/19tHF4
It's not just because more than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 77% of all Americans want a strong government-run public option on day one (86% of democrats, 75% of independents, and 72% republicans). Basically everyone.
It's not just because according to a new AARP POLL: 86 percent of seniors want universal healthcare security for All, including 93% of Democrats, 87% of Independents, and 78% of Republicans. With 79% of seniors supporting creating a new strong Government-run public option plan, available immediately. Including 89% of Democrats, 80% of Independents, and 61% of Republicans, STUNNING!!
It's not just because it will lower cost. Because a strong public option will dramatically lower cost for everyone. And dramatically improved the quality of care everyone receives in America and around the World. Rich, middle class, and poor a like.
It's not just because it will save trillions of dollars and prevent the needless deaths of millions more of YOU, caused by a rush to profit by the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX!
It's not just because every expert in every field, including economist, and Nobel laureates all agree that free market based healthcare systems don't work. Never have and never will. The US has the only truly free market based healthcare system in the World. And as you all know now, IT IS A DISASTER!
It's not just because providing or denying medically necessary care for profit motivations is wrong. Because it is WRONG! It's professionally, ethically, and morally REPUGNANT!, Animalistic, VILE and EVIL.
THE REASON THE PUBLIC OPTION IS ESSENTIAL:
The public option is ESSENTIAL because over 200 million of you are trapped in the forest of the wolves. Which is the forest of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! With no way out except through needless inhumane suffering, and DEATH. While the wolves tear at your flesh, and rip you limb from lib. Then feast on your lifeless bodies like a dead carcase for transplant parts.
At the most vulnerable times of your lives (when you were sick and hurting), millions of you have had to fight and loose cruel, but heroic battles. Fighting against the big guns of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! in the forest of the wolves. All because you have no place else to go. You have no other CHOICE!
But the PUBLIC OPTION will give you someplace safe to go. And it will give us someplace safe to take you. The public option will be your refugium (your refuge). Where the wolves cannot get at you when your down, hurting, and vulnerable. Where everyone who needs it can find rest, security, comfort and the care they need. Protected by the BIG GUNS of We The People Of The United States. THE MOST POWERFUL PEOPLE AND COUNTRY ON EARTH.
This is why it is so critical that we do not lead another 50 million vulnerable, uninsured Americans into the forest of the wolves, without the protections of a Strong Government-run public option. We The People Of The United States MUST NOT LET THAT HAPPEN to any more of our fellow Americans. If healthcare reform does not contain a strong public option on day one. YOU MUST! KILL IT. Or you will do far more harm than good. And millions more will die needlessly. Rich, middle class, and poor a like.
To those who would continue to obstruct good and true healthcare reform for the American people, and who seek to trap millions more vulnerable Americans in the forest of the wolves. We will continue to fight you. We are prepared to wage all out war against you, and will eagerly DESTROY! you. Time...is...UP! YOU HAVE BEEN WARNED! No Co-op's! No Triggers!
Healthcare reform can be the GREATEST! Accomplishment of our time and century. A time when future generations may say of us, that we were all, AMERICAS GREATEST GENERATIONS.
BUT WE MUST ACT!
I therefore call on all my fellow Americans and the peoples of the World. To join us in this fight so that we may finish becoming the better America that we aspire to be for everyone.
SPREAD THE WORD!
I have been privileged to be witness as many of you fought, and struggled to take your first breath, and your last breath on this earth. Rich, middle class, and poor a like. Life is precious.
Whatever the cost. WE! MUST SUCCEED.
God Bless You My Fellow Human Beings
jacksmith — Working Class
Senator Bernie Sanders on healthcare (http://www.youtube.com/watch?v=RSM8t_cLZgk&feature=player_embedded)
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