The devil is in the details with the public option trigger. The only way we’ll be able to tell if one is going to work is to see how insurance companies react. If they fight like hell against it, then it’s probably a good idea. If they don’t, it’s probably toothless. I don’t know what to make of the fact that Ben Nelson might be willing to support it:
“If, somehow, the private market doesn’t respond the way that it’s supposed to…it would trigger a public option or a government-run option,” Nelson said Sunday on CNN’s State of the Union, “but only as a fail safe, backstop to the process. And when I say trigger … I don’t mean a hair trigger. I mean a true trigger.”
I’m guessing a hair trigger means something that might actually get pulled whereas a true trigger means something that never will. But maybe I’m being too cynical.
srv
Would this be semi-automatic, or full?
4tehlulz
If this gets something tolerable out of Baucus’s committee, then do it.
If it shitty trigger, eliminate it or modify it in reconciliation, then watch Baucus’s and Nelson’s impotent rage against the final bill.
General Winfield Stuck
I would guess it would be tied to reducing the rate of inflation for healthcare down to the rate for the rest of the economy, instead of three times the rate, and also cover a whole lot more people.
I think the danger is that wingnuts and maybe Nelson will demand wheel barrows full of taxpayer cash for wingnut welfare subsidies to the insurance companies in order to reach those goals. As well as the other reforms such as not denying insurance for Preexisting conditions etc…, or least to cover more people with crappy policies no doubt with gazillion dollar deductables and a bill shot full of loopholes. Don’t think it will fly with the House liberals though, But who knows?
SiubhanDuinne
O/T but Obama has just started speaking. The young man who introduced him brought tears to my eyes (through the smiles). At moments like this all my negativism and pessimism and disappointment just melts away.
It’s on C-SPAN and the usual cable outlets.
feebog
I’m wondering how, exactly you put together the metrics to even create a trigger. If there is no sunset on the trigger, and if some realistic goals are set, maybe it could work.
Roger Moore
The intended implication is that a “hair trigger” would be just about guaranteed to be implemented, while a “true trigger” would give the insurance companies a real chance to avoid setting it off. Of course what he really means is probably closer to what you think; a better analogy would be a “true” trigger and a “safe” trigger, i.e. a gun with the safety welded on.
Xecky Gilchrist
But maybe I’m being too cynical.
As may be, but if you are, so am I. I think your “do the insurance companies fight it” test is spot on.
Derelict
You’re not too cynical. It’s guaranteed that the insurance companies would mount a major legal challenge under a “true trigger” to get it declared illegal or unconstitutional–and probably get the entire reform effort tossed out, too.
That setup lets Baucus and his buds claim they tried–really, really, REALLY tried to do something, but, well, you know, those activist judges struck again!
JenJen
@SiubhanDuinne: Any subliminal messages about Marxist Madrassas, yet?
I was so disgusted to learn this morning that even after seeing the speech transcript, so many school administrators decided to stick to their initial, cowardly knee-jerk by refusing to show the speech. I’m trying to stay optimistic, too, but half of my countrymen are really making me doubt their intelligence, sanity, and guts.
J.W. Hamner
The fact that it was Olympia Snowe’s idea and Ben Nelson supports it makes me optimistic that it will be the compromise to get it passed in the Senate… but of course the fact that it was Olympia Snowe’s idea and Ben Nelson supports it makes very pessimistic about it sucking or not.
Assuming it is still the kind of “public option” available to small businesses with 20 employees or less, then I doubt it will have much impact on anything.
r€nato
I have little confidence that the trigger will be anything but window dressing, but hey we might be surprised. What really pisses me off is the utter lack of discipline on part of the Democrats. The GOP got all their congressmen and senators to march in lockstep. But then again, that was for war. This is merely for health care. War is always much more sexier (profitable) than health care (BOOOOORRING).
Rick Taylor
There is no point to public triggers. How ever they are written, they will end up being toothless; that is the whole point.
You’re not being cynical enough.
kay
@r€nato:
It’s not a fair comparison, IMO. Democrats aren’t just pretending to be diverse, ideologically and geographically, they are.
Republicans are lock-step far right. Conservative Democrats are center-right Republicans. That’s just the truth.
There are two parties, but they’re both in the Democratic Party.
Lola
The good news is that our new lowbar in the Senate is a public option with a trigger. If the House holds firm that there is a chance that a public option may pass in the reconciled bill. Olympia Snowe is far more liberal than Ben Nelson on heath care, plus Snowe represents a blue state. We are better off with Snowe’s plan than a Nelson or Conrad plan. I am starting to finish the line. I think we have a 50/50 chance of a public option. Most of this will depend on what House and Senate progressives do. The president only plays a minor role, IMHO.
aimai
the thing that is so astonishingly dumb about this is that the Senate Finance Committee is, in fact, dominated by Dems. Baucus had to withdraw into the gang of six to create this mess because otherwise they were outnumbered by Democrats who actually say they want a public option. I have no idea why the other Democrats let themselves get pushed out of the process of drafting the bill inthe first place. But even though they let the bill get drafted without them its totally unclear to me why they need to let it pass without forcing the public option back into it. Perhaps there are some arcane senate finance committee rules about their own bills that prevents kerry from walking in on Baucus and saying “put the public option back in or else” (other than kerry’s fucking stupidity) but I don’t see it.
This has been kabuki on the grand stage with no one reporting on the actual necessity or lack thereof of this moronic “bill.” It appears that the rest of the finance committee is just going to vote to pass it along on the theory that the good stuff will get “put back in” or “kept” when the various bills merge but I just don’t see what you get by even allowing the weaker version to go forward since you are then put in the position of “reconciling” a good bill (Kennedy’s) with a bad bill (Baucus’s).
aimai
BombIranForChrist
I think you are right, doug:
Hair trigger: Actual reform.
Real trigger: Insurance company bonanza.
El Cid
We were told in 1993 that HMO’s were an example of how private insurance was fixing the problem.
But then, if we’re stupid and cowardly enough to go along with some bullshit about how let’s choose a worse solution until such time as we’re absolutely forced to do the better thing after having suffered more and wasted more money, then let’s do it.
That way if the Supreme Court rules on Wednesday that corporations have an irrepressible free speech right to participate in federal elections, we can ensure how swiftly lame-ass idiotic “trigger” ideas can be employed on all policies affecting corporate profits.
Climate change goals? Triggers.
Transaction fees for Wall Street? Oh, of course, triggers.
Upper class tax increase? You know it’s triggered, baby.
kay
I look at it like an ideological line, left to right, and all points are going to be represented on that line. Republicans are clustered on the far right. Democrats hold every other space.
I feel as if this situation was inevitable, actually, when Republicans all ran to the far right end of the line.
We’ve watched it happen, over ten years. I think we have to strop thinking in terms of Party, until that other Party comes back.
Keith
Does it really matter whether the insurance companies like it or not? The Republicans won’t support it because they don’t believe in compromise, and there’s always gonna be at least one Blue Dog willing to sink the whole bill over it.
The Grand Panjandrum
Did you know that Medicare Part D has a trigger? It would have created a “public option” prescription program. This was in lieu of having an actual public option plan to compete with Big Pharma. It has never been pulled. If that is the kind of trigger being considered, then it is worthless. If insurance thresholds are set so low anyone can meet them they will never be “triggered”.
Derelict
Maybe the trigger will be something like “When healthcare aggregate expenditures exceed 50% of GDP, we’ll send the insurance companies strongly worded letters.”
kth
Imagine the worst coming out of the present legislative battle: health insurance reform that requires everyone to buy coverage, requires participating insurers to offer coverage to everyone at community-rated prices, and subsidizes the purchase of that insurance for people making up to 4X the poverty rate, but no public option.
It’s possible that yay! everyone will be covered. But it is equally possible that premiums will skyrocket, no private-sector competition emerges, and the government is on the hook (via the low-to-moderate income subsidy) for much of the increased cost of these policies.
We’ll face a fork in the road then, because the status quo will be (again) unsustainable. Either we pass a public option at that time, or re-de-regulate the insurance companies and go back to what we have now.
Does anyone think the latter option will be tenable in such an eventuality? I really don’t. So I’m thinking that a public option is certain to be “triggered” by public demand, even if it isn’t written into the current bill (or what is the same, it’s crafted so it is nearly impossible to be tripped).
Including the public option now saves the wailing and the gnashing of teeth if/when the private insurance premiums spiral out of control and a public option has to be passed later. It’s really better we do it now. But it isn’t the end of the world if we don’t.
El Cid
Yes. That’s the kind of worthless “trigger” being considered, and Ben Nelson wouldn’t be in favor of it if it were any other.
Besides, again, why don’t we do the beter policy FIRST instead of sticking to the known WORSE policy with some fairy “trigger” promising change?
ericvsthem
Someone this weekend suggested (I caught it on Schuster’s Twitter feed) that a good compromise could be to pass the Public Option with a trigger where it does NOT go into effect in 2013 if specific criteria is met by private health insurers. Of course the criteria is still critical but this way is better than waiting until years after the legislation goes into effect to provide a Public Option.
Ash Can
@kay:
Bullseye. Like you were saying yesterday (IIRC) in another thread, the real policy debates are currently taking place within the Democratic Party itself. The GOP has been reduced to static. Unfortunately, static can be quite effective in obscuring transmissions, but that’s the long and short of it.
Martin
Isn’t the mere fact that we need ‘reform’ the very trigger we seek? What are we changing in the free market to make it run better in 2 years compared to today?
Boiling it down, isn’t the argument being presented by proponents of the trigger plan that with this added regulation, the markets will hopefully be more efficient, but if not we’ll do the public plan? Who’s worldview does that actually fit in?
The Grand Panjandrum
BTW now that Obama is done indoctrinating the nation’s children can we get back to more important things like looking for his birth certificate. Sheesh.
r€nato
I generally hate to call people in general stupid… but in this case, the sensible and better policy is not selling. This is generally phrased as, “not letting the perfect be the enemy of the good.”
The best policy would be single-payer government-run health care, or alternatively a Switzerland-style system with private insurance that is HEAVILY regulated.
But those cannot be imposed (at least not until we have more and better Democrats in Congress, apparently), so we have to negotiate something less than optimal which can pass Congress. This is why we call it the sausage factory…
Leo
In theory, a trigger is the perfect compromise. If insurance companies can contain provide an affordable product universally in a post-reform environment (i.e., one where rescission, capped payouts, etc. are off the table), then more power to them. That’s the Swiss model and it can work. And if they can’t, then the public option triggers and we try to ensure affordable insurance that way.
In practice, I fear you are right that the trigger level will be set so that it’s totally toothless, and will substitute for real regulation that could ensure affordability in other ways.
r€nato
… I meant to say… (to continue the point of not calling people ‘stupid’) that in this one instance, people in general are being stupid. They don’t know what’s best for them, and what’s best for them would be single-payer or at least a public option.
Medicare faced the same sort of hostility and fear mongering from the far right but back then they did not have Fox News Channel and AM radio hate mongers to amplify their ridiculous propaganda.
Tsulagi
This trigger stuff is just smoke and mirrors bullshit. Just a way to punt the ball down the field. Yeah, could just see these Dems punting on first down.
The Grand Panjandrum
Ezra has the Max Baucus framework for reform here. I started reading it. Need time to digest it.
Zifnab
Wait, so let me get this straight. We’ve got a public option program that isn’t even set to be available till 2013. And we’re including a “trigger” option in the legislation to push off even beginning to organize this bureaucracy for another 3-5 years. This sounds sickeningly similar to the Iraq Timetables, where we “evaluate” the situation for half a decade while shoveling money into the money pit, so that we can conclude by the time we’re done that we should have done what we said we were going to do 3-5 years earlier.
It also seems like it’s phase 1 in of Operation: Stall For A GOP President.
I mean, why have a trigger? What else are we looking to prove? Health care costs are up right now. Did we wait 3 years to give the banks or the car companies a bail out? Did we sit on our asses for half a decade before passing the Patriot Act or invading the middle east (again)? Were the Bush Tax Cuts passed in ’01 and enacted in ’05? When have we ever entertained legislation like this?
Llelldorin
@Ash Can:
It occurs to me that we could clarify matters enormously by formalizing the “caucuses” that exist within the Democratic Party, and allowing primary candidates to be listed on the ballot with caucus affiliation. Thus, in a primary election you’d see:
JOE PROGGY — Progressive Caucus
FRED DOGGY— Blue Dog Caucus
BILL RED — Socialist Caucus
JIM MONIED — Republicans-in-Exile Caucus
and so forth.
That would make the political gamesmanship within the Democratic Party much clearer, particularly if caucus subbreakdowns could be listed in Congress and in the Senate.
Mike G
“If, somehow, the private market doesn’t respond the way that it’s supposed to…
Translation:
Give it another decade or two for the magic of the marketplace to deliver, because we can’t possibly start the clock until now. Then if things aren’t working out, we’ll appoint a commission to examine the issue In Great Seriousness for a few years and issue some watered-down recommendations rubber-stamped by our
paymastersadvisors in the health insurance industry.And Al Gore uses electricity.
Jim Crozier
Maybe I’ve grown too cynical about the Blue Dog Centrist Democrats…
…but this strikes me as a “no, no! Don’t go forward without us and use reconciliation to pass a strong bill. Honestly, we’re truly willing to help you craft a compromise bill that can pass with 60 votes. Ben Nelson isn’t just saying he’s open to a public option with a trigger in order to continue the delaying process. We promise!”
Mark my words. If they go back to trying to get Democrats like Ben Nelson on board, he’s left himself more than enough wiggle room later on to say that he came to the table willing to explore a public option but those meanie liberals were unreasonable.
That’ll be where he ends up after about another four months worth of delay.
Forget the Blue Dogs. Forget the Republicans. Use reconciliation and pass a GOOD bill on a party-line vote if necessary.
r€nato
funny how there was no ‘trigger’ for war on Iraq.
funny how nobody fussed over the cost of war in Iraq. Funny how the wingnut brigade (and plenty of compliant, cowardly “Democrats” as well) believed all those patently absurd promises that it would pay for itself.
funny how the nominally ‘pro-life’ party is always in favor of war but against providing health care for all Americans.
SiubhanDuinne
@JenJen 12:15 pm
Absolutely, the Pied Piper Preznit’s entire speech was larded with secret nazi-fasco-$0c1a£1$t dog-whistle messages. It was shameful.
/snark
I flipped over to MSNBC for a couple of minutes after the speech and they were interviewing some lamebrain from Texas who was saying that parts of the speech were actually illegal. To her credit, the anchor just kind of rolled her eyes at the guy, said “Are you fuckin’ JOKING?” and then said (paraphrasing) “now let’s turn to someone in the studio who actually knows what she’s talking about.” Maybe a few people in the MSM are actually beginning to get it.
(No, of course she didn’t say “Are you fuckin’ JOKING?” — but you could just tell by her body language and tone of voice that she was fuckin’ thinking it.)
Tsulagi
@srv: Would this be semi-automatic, or full?
Doesn’t matter, there’d be no firing pin. Or a round in the chamber. A full magazine? That’s in one of those other dimensions where they’re playing chess.
ericvsthem
@Zifnab: ..which is why the public option should go live in 2013 and the trigger should be that it is postponed – not repealed – if private health insurers fail to lower their costs. They have had decades to get their costs under control. They have no one to blame but their own greedy selves if they cannot get their costs in line by 2013. They can put up or shut the fuck up.
Zifnab
@SiubhanDuinne:
You sure she wasn’t thinking, “Tehe, Ima news model. Look mom, I’m on TV!” Because, MSNBC is Serious Journalism(tm)! And I wouldn’t want to think a blonde 20-something anchoress was being anything less than fully professional.
El Cid
@r€nato: Good thing you didn’t call me stupid, because that’s one of the shittiest arguments I’ve ever seen. Don’t let expressions like “Don’t let the perfect be the enemy of the good” substitute for actual argument and analysis — the map is not the territory.
kay
@Ash Can:
I have some sympathy for Obama, because this frame is dishonest. Democrats aren’t like Republicans, for a coupla reasons, but one of them is diversity, geographical and ideological. That just…is. It’s fact.
I’m as frustrated as anyone, but Obama’s got a brooooaaaad group to wack into line. It’s difficult.
Democrats run from liberal to conservative. That just isn’t true on the other side.
rcman
You need to look no further than the regulations that were put in place for power plants to upgrade their emmissions control when they were doing major upgrades. Step by tiny step the enforcement of those regulations were chipped away at until now they exist in name only. There will be high-fives all around the health insurance community when the trigger option is passed. Ten more years to chip away at the enforcement and wait for the election cycle to be more freindly. This is so demoralizing.
Zifnab
@ericvsthem: Building the bureaucracy is going to cost money. Like any start-up business, there are going to be huge up front costs to getting this beast moving. If, by 2013, we have a public option policy set to go, but an unfriendly Congress or White House trying to kill it, we get to spend millions – maybe billions – of dollars building an Insurance Company to Nowhere.
No thank you.
Ash Can
@SiubhanDuinne:
LOL! That’s beautiful. I figured the objections would be along the lines of “too complicated for kindergartners” or “not white/Christian (the right kind, that is)/free-enterprise enough.” “Illegal” never even occurred to me. I’ve learned through years of observation, though, that the more contorted the justification, the more obviously wrong the viewpoint being justified.
serge
I don’t think you’re being too cynical.
KG
@aimai: My initial thought is, if the Democrats are smart (and, really, history suggests that’s a huge “if”), then the Finance Committee bill is the ace in the hole to freeze out the GOP.
The way that I see it, and the way that I’d play it if I were them is like this:
You have one of the Blue Dogs work with members of the GOP to give them a bill that has most of what they want. Then, when the debate starts, the GOP will of course scream about the bill that has most of what they want to begin with, because that’s what they are about these days. Then, the Dems can say, “hey, look, we tried, we gave them everything but tort reform, and they still said no; we can’t compromise with them, so we’re just going to do this ourselves.”
It’s a game of chicken, to be sure. There’s a chance that the GOP actually falls in line behind the “compromise” bill, but give their actions over the last 15 years or so, I’d say that chance falls somewhere between slim and none.
Ambergris
I think the trigger is a good idea, in theory. It depends on how you do it. One big upside is that the ensuing discussion will resolve around the setup of the trigger, and the countdown to reconciliation (Oct, 15th) will continue to loom in the background. I could imagine that the Finance Committee votes on Max Baucus’ bill this week. How long does it take to unify the House bills and the Senate bills? When will the conference committee start working? I’d guess it would be around Sept. 20th, maybe even later because the bills need to be voted on and Republicans have got a few (cough, cough) amendments. That’s less than a month of time to reconciliation. That’s a lot of pressure on those who still want to have a hand in the game.
I’m no legal expert, but maybe there is a way to construct the trigger in a way that makes it passable through reconciliation, and a 51-vote-trigger would be pretty strong. It would almost ensure a public option, and remember, the house bills map out an incremental change that isn’t completed until 2017. There is no reform-on-day-one anyway.
And finally, the conference committee may still decide to kick the trigger out of the bill if there is no agreement, and then still go for the 51 votes.
ThatLeftTurnInABQ
@aimai:
IIRC there is an arcane rule specific to the Senate Finance Committee and dating back to the early 19th Cen. that a bill can’t make it out of committee without at least one minority party vote. Why? Because shut up, that’s why. If one thing has become clear from this whole mess, it is that your average run of the mill Senator would rather screw the whole country over than fiddle around the arcane rules in the Senate, because that’s just how they are. Hence the following joke:
Question: What’s the difference between the Senate Finance Committee and an Al Queda bio-terrorist cell?
A: One of them wants millions of Americans to suffer agonizing deaths from preventable illness and disease, and the other is a bunch of Arabs playing with petri dishes in their refrigerators.
Silver Owl
The private health care industry has had full access to a dedicated market and decades to actually meet market need. They failed. They continue fail. They testified that failing is a corporate goal and policy. Yet the Senate and House say, “well if they don’t behave and shape up we will yell at them next time and maybe just maybe we might actually do something sometime in the future. When we get around to it.”
One thing about my nation I can always count on is for it to take centuries for the adults to actually handle important issues.
Bill E Pilgrim
Matt Taibbi’s opus on health care is out:
http://www.rollingstone.com/politics/story/29988909/sick_and_wrong
Depressing but satisfying.
In addition to everything else, anyone who thinks he’s all that as a writer should read Taibbi and weep.
r€nato
@El Cid: I was simply describing the way it works, not the way it ought to be.
if you know of some way to get sufficient votes in both the House and the Senate for single payer or public option or whatever your perfect world version of health care is, I highly suggest you give Rahm a call and tell him how to get it done.
The fact is, we don’t have the votes for either right now, unfortunately. I do not know whether it would be better to pass no health care bill at all if it doesn’t have public option (no trigger). The idealist in me says, no public option then no health care bill. The pragmatist in me says, you gotta pass a bill otherwise Democrats are going to be demoralized and Republicans can claim victory and they will surely be re-energized.
In a sane world, Republicans would consign themselves to electoral defeat now and for the next 20 years if they crow about defeating health care reform. In a sane world, the general public would realize that they are better off with a public option or single payer.
We don’t live in that world.
geg6
The only trigger any legislation that depends on the health insurance companies reigning themselves in from killing people for profit that will be pulled will be the one attached to the gun in our mouths when we find out we can’t afford our heart conditions, our cancers, our diabetes, or our Altzheimer’s because health care reform has been turned into Medicare Part D.
There are triggers in Part D. Notice how they’re never even mentioned, let alone pulled?
Stock up on guns the muzzles of which fit comfortably in your mouth. ‘Cuz I’m betting that’s what we’re gonna get.
r€nato
@Bill E Pilgrim:
I have a twisted idea for a TV show called, “TeleTaibbis”…
geg6
@r€nato:
“The pragmatist in me says, you gotta pass a bill otherwise Democrats are going to be demoralized and Republicans can claim victory and they will surely be re-energized.”
A bill without a public option will have the same effect on everyone I know, so I say go for what will actually work and have real impact. Incrementalism worked so well with civil rights that we should try it with this, too? Just sayin’.
Bill E Pilgrim
@r€nato: Someone has to explain that one to us here in ferriner land.
Telemundo? Tele… something?
PeakVT
The thing about triggers is that one should have been pulled when health care expenditures reached 12% of GDP. They are at about 16% today. Dorking around with a trigger now means costs will go up until they reach the trigger point – and then will keep going up until whatever plan that will (hopefully) control costs is fully implemented. We’re likely to see costs at 20% of GDP before growth is halted if the sausage factory churns out some trigger-based “bipartisan” kludge.
Ed Drone
I think the ‘trigger’ should be more a ‘dead man switch,’ where it automatically goes into effect UNLESS things change enough. And put in the law that that portion of the law cannot be changed except by a super-majority of 2/3 of the House and Senate, severally.
As is pointed out above, by @Zifnab: the start-up costs are going to be being incurred, so we should avoid the ‘good money after bad’ thing and make the start of the public option certain and sure unless an independent commission on health insurance declares that costs and coverage have been brought to the standards needed by the people.
Ed
r€nato
@Bill E Pilgrim: It’s a wordplay with “TeleTubbies”. Have you never heard of them? You know, Tinky Winky and Po-Po and so on? Kid stuff. People in goofy, brightly colored costumes. Kind of like Smurfs brought to life.
Sort of.
Bruce (formerly Steve S.)
“I’m guessing a hair trigger means something that might actually get pulled whereas a true trigger means something that never will. But maybe I’m being too cynical.”
A toothless “trigger” gives the insurance companies a few years to figure out how to game it so that it will never get meaningfully used. A “trigger” with some actual teeth would prompt them to make huge rate increases right before the legislation goes into effect (see the recent stories out of Michigan). The only worthwhile “trigger” is one that is a genuine threat and that would retroactively punish companies for rate hikes, but your average politician is too goddamned stupid or corrupt to figure that out.
r€nato
@Ed Drone: That’s a great idea and I hope that the progressive Dems counter with that one. Otherwise the ‘trigger’ will be a dud.
r€nato
Again, you gotta have the votes. We had the votes in 1965. We did not prior to that. And, the Democratic party surely paid a political price for the Civil Rights Act of 1965, you know.
So you’re talking about getting some middle-of-the-road Congressmen to do the right thing even at the risk of putting their jobs in danger.
I really wonder if the Civil Rights Act would have ever passed, had the right had the media noise machine they now have.
Svensker
@r€nato:
Word. Or, words.
ThatLeftTurnInABQ
@r€nato:
With the passing of time I’m coming to appreciate what a unique moment that was. The power balance in the Senate was more centralized, and LBJ knew where everybody in the chamber kept their nuts and just how much to squeeze. He had southern Democrats by the balls, and the northern wing of the GOP was liberal on civil rights ideologically. Combine that with the right wing noise machine being in the shop for repairs after JFK’s death and the epic Goldwater blowout in the 1964 election (which put the GOP moderates and liberals back in command).
I coming to appreciate that in Congress it is damned hard to get folks to vote for Mother’s Day and Apple Pie, much less anything more controversial, unless the planets are aligned in just the right way or reps are scared half out of their wits that the entire system is going to collapse any minute now and the raving red hordes are going to eat them for breakfast (aka FDR and the New Deal). Anything less than that, and our system of govt. has “gridlock” written all over it. Unless the Dems are rolling over for a Republican President who says “BOO! Osama’s gonna get uuuuu!” – then its “please sir, may I have some more?”
Bill E Pilgrim
@r€nato: Ah. Thanks, no I haven’t, but I’m a TV illiterate, partly due to living abroad but also never had one there much either.
Except for the West Wing which I watched on DVD. All of it. Oh and I’ve been downloading Whale Wars this year, which I found fascinating in a morbid sort of way.
Zifnab
@r€nato:
We had the votes because LBJ took a few Senators behind the woodshed and threatened all their local pet project funding with an endless filibuster followed by a crippling veto if they didn’t get in line.
And as was discussed on 538, the middle-of-the-road Congressman with a (D) in front of his name doesn’t have anything to gain by opposing the option. If he runs against it, his Republican opponent will still run the same “He’s a socialist! He’s a baby killer! He’s gonna raise your taxes!” platform as he would if you did vote for it. Meanwhile, your base voters to the left aren’t going to forgive you for abandoning them, and you run the risk of a primary challenger.
“Moderates” gain nothing by fighting this. The GOP is out for blood. It’s not interested in a Dem coalition. The only people motivating the Blue Dogs and other moderates are the insurance lobbyists. Any Dem that votes down health care legislation has been bought. It’s that simple.
jl
The trigger is BS. It will just set an upper limit on how much the health insurers can rake in and keep the current dysfunctional system in place. From current versions of the proposals I have read, there is not enough reform in health care reimbursement, or in establishing a stable and functioning market for basic coverage with a uniform basic plan, or definite commitment to universal coverage to solve the other problems of the US health care market.
So, it will be feel good BS which will start falling apart in a couple of years, requiring a redo.
If we do not go to a system something like the Swiss have (those notorious communists), then a private based system will not work.
Even Switzerland is relatively expensive, but a similar system would provide better health care, better population health, at 2/3 of our current costs.
All this ‘let’s find an American solution’ or ‘let the market work’ is just empty BS and word games used to cover up politician’s being bought by big rich industry.
We use an Australian ballot, and that did not destroy our Americaness. If we want all private health insurance we need to go Swiss, with strong regulation of contracts and at least a soft rate regulation regime.
If we regionalized, the Netherlands system of periodic public and private negotiation might work in place of strict regulation.
But, so far, it smells like half-assed ‘scam spirit’ to me.
r€nato
I wish someone could beat this into the heads of the ‘moderates’. Apparently they didn’t learn shit from the 2002 vote on the Iraq war and how that went down for the Democrats who voted for it.
“Vote against a war you know is wrong, and get beat over the head as a, ‘terrorist-lover’. Vote for a war you know is wrong, and get beat over the head slightly less over some other issue.”
Iz our Democrats learnin’?
Zifnab
@r€nato:
We had the votes because LBJ took a few Senators behind the woodshed and threatened all their local pet project funding with an endless filibuster followed by a crippling veto if they didn’t get in line.
And as was discussed on 538, the middle-of-the-road Congressman with a (D) in front of his name doesn’t have anything to gain by opposing the option. If he runs against it, his Republican opponent will still run the same “He’s a soc ialist! He’s a baby killer! He’s gonna raise your taxes!” platform as he would if you did vote for it. Meanwhile, your base voters to the left aren’t going to forgive you for abandoning them, and you run the risk of a primary challenger.
“Moderates” gain nothing by fighting this. The GOP is out for blood. It’s not interested in a Dem coalition. The only people motivating the Blue Dogs and other moderates are the insurance lobbyists. Any Dem that votes down health care legislation has been bought. It’s that simple.
jeffreyw
@r€nato:
made me laff hee hee
Bill E Pilgrim
@r€nato:
What’s pissing people off is the feeling that the Democrats and the WH gave away the store, when they didn’t have to.
This idea of whether you have the votes can be seen another way: To me it looks like by scrapping any proposal to include real universal single-payer insurance (which Barack Obama, remember, has expressed is what he thinks is really needed) it was like going into a haggling session by saying, “Okay, forget my offer, let’s just hear your price and I’ll offer a little bit lower”.
You don’t do that. You start low, and then they have to come down to meet you. Both sides move.
Giving away the single-payer proposal right at the start was like wanting to propose 50 or 60 bucks, then on hearing “$100” from the seller, proposing “$85” as your starting point. Or something, you get my point.
Now what happens next is that the right, of course, takes your first proposal as the starting point. Suddenly single-payer (which Obama wanted, let’s not forget) is way, way off the map, and now the public option is the opening proposal from the Democrats. To which the Republicans counter-offer way over on the right, i.e. no public option, and maybe not even any reform at all, or toothless reform.
The important thing here is that this determines in part where the Blue Dogs stand, what they have to fight against and negotiate with. If the starting bid from the WH was single-payer, then maybe the Blue Dogs would be feeling pressured from the right…… to fight that idea, and to go with the public option, as the compromise. As the negotiated center.
Saying simply “We don’t have the votes” ignores all of this, ignores why we don’t have the votes, at least in part why we don’t have them.
That’s a simplified view of it but the principle is sound. Matt Taibbi does a good job of going into much more detail about exactly how this came about, for anyone interested.
The Republicans were going to vote no. On ANYTHING. How that was either missed, or disbelieved, or somehow thought worth ignoring, is the big mystery here to many of us.
Bill E Pilgrim
@Zifnab: We had the votes because LBJ took a few Senators behind the woodshed and threatened all their local pet project funding with an endless filibuster followed by a crippling veto if they didn’t get in line.
Took the words out of my mouth, er keyboard.
Letting a relatively small group of right-leaning Democrats- who aren’t even, strictly speaking, essential to pass a bill — have all the power in this was a big, big mistake.
JHF
The insurance companies aren’t behaving NOW. But surely they’re clever enough to be nice until the deadlines passes and then sock it to us. What madness and cruelty this is.
Shawn in ShowMe
LBJ didn’t threaten to cut off existing funding — he promised to provide it. From Robert Dallek’s Potrait of a President:
Though Johnson largely left the lobbying and head counting to Humphrey, he had promised a Central Arizona water project to Carl Hayden for his backing–a vote which seemed likely to tip several other senators to the administration’s side, including the two from Nevada.
And then there’s this:
Kenny O’Donnell remembers Johnson telling the southerners, “You’ve got a southern president and if you want to blow him out of the water, go right ahead and do it, but you boys will never see another one again.”
So to sum up, LBJ was cajoling his fellow rednecks. Obama, to put it mildly, is in a totally different position.
Robertdsc-iphone
Obama wanted single-payer only if we were starting from scratch. A proposal to scrap all insurance companies & plans would be DOA in the Senate. The campaign he ran stated that the public option was his choice to provide coverage to all if they so chose. Single-payer was never part of the equation.
That said, triggers are bullshit. The public option already has a trigger built in since it doesn’t activate until 2013. Nelson & Snowe are full of it because the situation is already too serious for their games. But protecting profits is their goal, so they’re doing what they’re doing to meet that goal. The public health disaster is a distant second.
Bobby Thomson
“True trigger” means “kick the can.” A “hair trigger” goes off automatically, without any additional action required. What Nelson has in mind is, if the conditions of the trigger are satisfied, then Congress starts the debate all over again and he has another chance to kill it.
Guaranteed.
PhoenixRising
Iz our Democrats learnin’?
That betraying their specific promises to, and general principles shared with, their base costs them loyal supporters and doesn’t gain them anything from the right?
Sure, they iz. Even my Rep, who was the first Dem to win this district since its establishment in 1968, and who is no fire-breathing liberal, gets it–he’s not voting for anything that doesn’t include a public option because the people who knocked on doors for him will gather torches and pitchforks if he disregards us.
Should this have happened sooner? Yep. Was there a craftier, more insightful way to increase political capital with it? Yep. 12 dimensional chess my ass.
Brachiator
@r€nato:
Of course, the problem here is that some American liberals take it as an article of faith that single payer is the best option ever, and assume that everyone else should just fall in line. But they never lay out a coherent argument for this, or adequately account for the diversity of methods that other industrial countries use to provide for universal health care.
This has been one of the Democratic Party’s weakness since they announced health care reform as a top priority. In the absence of any consensus as to what they wanted, they allowed the GOP to fill in the gaps with fear-mongering nonsense.
I think this lays out the dilemma quote nicely. The GOP is hot to hand Obama a defeat. The Democrats should steal a page from Dubya: get as much as you can now for healthcare reform, and make sure you get enough to get credit for a victory. And then continue to push for more at every subsequent session of Congress.
Shawn in ShowMe
If premiums actually come down by 2012 and millions of voters get access to healthcare coverage that don’t have it now, they’ll get plenty of credit. The right-wing noise machine won’t matter.
Calouste
@SiubhanDuinne:
I wonder what happened to “If the President does it, it’s not illegal”.
Leelee for Obama
@Shawn in ShowMe: Precisely! A bill that is at work making people feel secure is what is needed to keep voters voting for Democrats. A bill that make Ins Cos happy is not helpful to Democrats.
Simple answers, for the simpletons in the Congress.
Zhirem
props for the Elvis Costello reference (I think).
– Z
Joshua
I’m not sure what to make of his comment about the private market not working the way its supposed to.
From where I sit, the private health insurance market is working EXACTLY the way its supposed to; that is, it is selectively choosing what to treat and what not to treat based on profit margins.
That’s why we need a public option, because the private market does not work in this industry. I realize Ben Nelson is one of those people who automatically think private markets are innately superior to anything anybody in government could possibly do, but that is what makes Ben Nelson a moron.
Sly
By anything closely resembling a reasonable metric in terms of micro/macro costs, market concentration, or availability, such a trigger would be pulled immediately upon the legislation’s enaction. Ben Nelson is essentially saying he only wants a public option when 100% of health insurance markets are concentrated and not 95%.
Besides, a public option is a rather tame penalty for an out-of-control insurance industry. A better threat would be to say “Unless you insure everyone, become less monopolistic, and bring costs down, we’re going to go through all the Medicare statutes and wherever we see the words ‘Over 65’ we’re gonna put a big red line through it.” In other words, clean up your business or you won’t have one in five years.
The real question, however, is not whether Nelson will vote for a bill if it contains a public option. The real question is whether he’ll support a Republican filibuster of a bill if it contains a public option. Those are too radically different things. If he does support a filibuster the left will crucify him, and rightly so.