Thursday, September 3

Will Congress Pull the Trigger (Option)?

Next week President Obama will address a joint session of Congress with his vision of Health Care Reform. The question of course is exactly what will he say, but almost more importantly - what will the member of Congress and the Public Hear?

Some including both Olympia Snow (R-Mn) and Joe Lieberman (Joe-CT) are showing limited support for the Public Option, if it comes with a "Trigger".

From Thinkprogress.

The White House is “holding intensive talks” with Sen. Olympia Snowe (R-ME) about her “proposal to use the public plan as a fallback option.” In Snowe’s vision, “if prices don’t fall by a certain percentage and coverage doesn’t expand beyond 95% in a given state” after reforms have been implemented for a time, “the plan would call for adding a government insurance option to that state’s choices.

Sen. Joe Lieberman (I-CT) said yesterday “that he would not vote for a health care bill that included a government-run option.” “There will be no shot at 60 votes, because I’m not the only one,” said Lieberman, adding that “if we start this out and three years from now a case can be made that the private market is not working effectively, I would support the public option.

So if these negotiations go forward we might actually have a Public Option on the table With 60 Votes to Implement it - IF - and that's a big "IF", the private sector fails to contain costs within a fairly short window.

In recent days I've argued that the Public Option isn't the be-all-end-all of the bill, and received quite a bit of push back, which was fair enough. What's currently on the table without contention is the opening of a new Health Exchange, affordability credits, a permanent ban on both pre-existing conditions and insurance rationing of care based on cost (no matter what the screamers might say about "End of Life Consultation" or "Comparitive Effectiveness Studies") - that's a good thing.

The debate coming from those such as Anthony Weiner have been, That's Not Enough! The CBO has reported that significant cost savings are unlikely unless a Public Option is included in the plan as a competitor to private insurance. From TPM.

The plan carries a 10-year price tag of slightly over $600 billion, and would lead toward an estimated 97 percent of all Americans having coverage, according to the Congressional Budget Office, Sens. Edward M. Kennedy and Chris Dodd said in a letter to other members of the Senate Health, Education, Labor and Pensions Committee. [...]

The [employer mandate] provision is also estimated to greatly reduce the number of workers whose employers would drop coverage, thus addressing a major concern noted by CBO when it reviewed the earlier proposals.

Without the Public Option the initial CBO cost estimate of the Kennedy/HELP bill as over $1 Trillion, afterward it dropped by $400 Biliion over ten years.

With this information on our side We have the Factual Advantage and need to press it. The only question is whether the Threat of a Health Exchange and a Public Option is enough to change and improve the behavior of Private Insurance Industry?

No, we don't have to give the insurance companies a multibillion dollar windfall - not if they don't improve costs and stop dropping people from coverage. We can bring them to heel, the question is how agreesive does it need to be?

During the last attempt at Health Reform - such a threat actually did help. At the beginning of Hillary Clinton's proposed care system the rate of Medical Inflation (if I recall correctly) was somewhere around 8%. The goal of her plan was to bring that rate down to about 2-3%, and even though the plan didn't pass congress...That's exactly what happened as the private industry actually implemented many of her suggestions on their own as a way of Pre-Empting her. They moved more to a focus on HMO's, they began implementing thier own version of "Associations" (Which in the current plan is called an "Exchange" in the House or "Gateway" in the Senate)

You can even see that the current debate is aleady makind a difference, I just saw a commercial for a private based exchange called EHealth.Com where you can price and feature shop on your own for health insurance (just like Federal Employees do through their own Exchange)

Go ahead and take a look and see for yourself, from what I saw the prices are actually pretty good. And with Pre-existing Conditions Banned and subsidies available for those who are out of work or poor, it all gets all the better.

Here's the thing, I'm absolutely for a Public Option. But if we can get the private industry to straighten up and fly right with simply the mere Threat of it, and not implement it until they Fail (which of course they might, but then again - if they do that completley destroys all arguement against a PO doens't it?) - then I'll go for that too.

It might have to happen as through a split bill in the end, but I don't care. Getting the job done is getting the job done.

If we can accomplish what the threat of Hillary Care did, and have the Public Option sitting on the shelf ready to go when needed in a year or two - if the only thing we're arguing about is how SOON the Public Option will kick in - I think we win the best of all possible worlds in both the short and the long term.

I'm sure many will disagree, but maybe it's worth considering, maybe it's worth supporting if it gets us exactly what we want. Better quality health care available to All Americans.


1 comment:

Jim said...


Medicare already has some "trigger" legislation that is actually working against the long-term sustainability of the program.

Read overview here:

In my view, "trigger" is just another way to spell "screwed".