Trigger trouble

TRIGGER TROUBLE…. The latest talk from the Hill is that health care reform could include a public option, but only at some undetermined point in the future, if certain conditions “trigger” the option’s necessity. Sam Stein reports:

The Obama administration and Senate Democrats are debating a health care reform outline that will insist upon a public option for insurance but leave open the possibility for it to be kicked in via triggers.

Multiple Democratic sources tell the Huffington Post that the White House and key members of the Finance and Health, Education, Labor and Pensions (HELP) Committees are in the process of hammering out key principles on health care reform…. One of the components will be music to progressive ears: that any bill includes an option publicly run health insurance coverage. But it also comes with a caveat that could engender opposition from that very same constituency.

A trigger would pave the way for public option to come into place only after certain market conditions are met — mainly if private insurance companies are unable to achieve various metrics for coverage within a certain time frame.

As the argument goes, the public option would improve the system by lowering costs, expanding access, and using competition to improve efficiency. But, “centrist” Dems who have ideological problems with this argue, if we pass a reform package and private insurers can lower costs, expand access, and improve efficiency on their own, we wouldn’t need a public option. It’s better, they say, to wait for the system to get really awful before utilizing a public option to make things better.

This, not surprisingly, is not going over well with supporters of real reform, who are right to see the trigger as a mechanism to effectively kill the public plan.

Indeed, the closer one looks at a possible trigger, the worse the idea sounds. If lawmakers agree that a public option would necessarily improve the overall system — and they must, otherwise there would be no need for the trigger to kick in when things got even worse — then why deliberately delay implementation of the part of the policy we know would help?

Igor Volsky had a good item on this the other day, explaining, “[I]t’s unclear why we’re bending over backwards to give private insurers the benefit of the doubt … yet again. … Health reform isn’t about protecting private industry; it’s about adopting policies that are most likely to lower health care costs. A robust public option — the Kennedy proposal — is likely to score well even with a conservative CBO because it will be able to use its inherent advantages (lower administrative spending) and Medicare leverage to negotiate lower prices with providers and lower health care spending.”