Pulling the ‘trigger’?

PULLING THE ‘TRIGGER’?…. Several months ago, Sen. Olympia Snowe (R-Maine), arguably the most important lawmaker in the known universe right now, recommended the idea of a “trigger” in health care reform. As she saw it, Congress could create a public option, but it wouldn’t be implemented until private insurers were given another chance to achieve key goals (lower costs, widen access, etc.).

Leading Senate Democrats balked. Snowe took her idea to the Gang of Six, which also ignored the idea after Sen. Mike Enzi (R-Wyo.) objected.

But now that the Senate Democratic caucus is back to 59 votes, and Snowe is the only Republican lawmaker in Washington that’s open to the idea of reform, the White House is prepared to make the senior senator from Maine happy. And that means trigger talk is back.

The compromise plan would lack a government-run public health insurance option favored by Obama, but would leave the door open to adding that provision down the road under an idea proposed by Snowe, the sources said. […]

The potential deal would give insurance companies a defined time period to make such changes in order to help cover more people and drive down long-term costs. But if those changes failed to occur within the defined period, a so-called “trigger” would provide for creating a public option to force change on the insurance companies, the source said. […]

The source told CNN that the White House staffers increased their phone calls to Snowe aides and their interest in her trigger idea this week.

Marc Ambinder reported that White House Chief of Staff Rahm Emanuel “has been pushing the idea of a ‘trigger’ internally, and he and Snowe regularly trade legislative and political intelligence.”

Glenn Thrush added, “This so-called ‘trigger’ option may not be a silver bullet for a bipartisan breakthrough on health reform, but it might draw just enough hesitant Democratic moderates — with cover from Snowe as a Republican supporter — while appeasing liberals who are insisting on some kind of a public option.”

That last point — about “appeasing” the left with a “trigger” — seems unlikely. It’s predicated on the idea that reform advocates wouldn’t understand the trade-off here.

We’ve talked about this before, but since this talk is becoming more serious, let’s recap. Everyone floating the “trigger” idea seems to realize that a public option would be a far more affordable way of delivering care.* A public plan would lower costs, expand access, and use competition to improve efficiency. Those are, by the way, good things.

Those who like the idea of a “trigger” argue that 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.

The problem should be obvious: if proponents of such an idea realize 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 that lawmakers already realize would help?

Or, put another way, if Snowe and Emanuel know a public option is a good idea, there’s no reason to push it off to some arbitrary date in the future, as the system deteriorates in the interim.

As for the right, the “trigger” will never be acceptable, as Enzi’s opposition makes clear. The goal for conservatives is to protect private insurers and prevent competition. Whether a public option is effective now or in the future is irrelevant — it’s not about what works; it’s about philosophical objections to public-private competition.

* edited for clarity