Obama, Senate Dems Consider Public Health Care Option With A Trigger

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 -- with a meeting scheduled at the West Wing this afternoon. 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. The proposal would placate many of the private health care actors who consider a public plan the first step towards a single-payer system. Progressives, however, view it as reform in name and not substance.

"This is really, obviously, a mechanism to kill the public plan," said one progressive health care reform advocate. "We will see what comes out, but the fact that they are debating this is problematic."

An official at the White House said he could not immediately confirm the report.

The proposal for a public plan with triggers has been welcomed among some moderate Democrats who want to forge a compromise on what is shaping up as the major fault line on health care reform. Sen. Max Baucus, one of the major players in the debate, has offered his support for this approach. As have Senators Ron Wyden (D-Ore.) and Thomas Carper (D-Del.).

That said, opposition to the proposal is fierce.

"I would have very strong reservations about [a trigger], but I think we have to keep talking," said Sen. Barbara Mikulski (D-Md.), a powerful subcommittee chairwoman on the health committee.

Senator Chuck Schumer has insisted that, if anything, "reasonable criteria for triggering a public plan has already been met."

"Premiums are high," the New York Democrat said, "and either one or two insurers dominate the market. As we've seen with Medicare part D, a trigger option has so far meant no public option at all."

Indeed, as Schumer notes, there is a trigger in the Medicare part D program and, to this date, the conditions have never been met for a public option for prescription drug coverage. The standards were set by private market, all but ensuring that they would remain unreachable. Progressive officials working on health care reform worry that should the same system be put in place for insurance coverage, the same result will occur and public health care will never come to pass.

With additional reporting by Ryan Grim.

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Comments

[Turtleposer]

It doesn't matter what Obama does. Even if he were to privatize every single department of the Federal Government, he'd still be called a socialist. He will be blamed for anything no matter what by neo-cons. So given that, why doesn't he just insist on a public option & go for the whole enchilada.
Bipartisanship is cool, but not if he's going to lose sight of what people voted him in for.

The Democrats are in the majority for a reason, the people wanted a center-left government. The Republicans are out of power because the people didn't like their ideas.

Why are the Dems caving into people who will always label them socialist? Be popular with over 70% of the American public. Demand, Insist & Deliver on the public option.

[pirk1146]

The title of this article implies that Obama is considering the trigger for the public health insurance option. That is not so. Only rather conservative Democrats are considering that and they must be stopped! It would effectively kill the public option.

[wdw505]

good i hope it does fail.......hey MRbo did bring change

[maxfax]

Insurance companie have destroyed health care in America.

[Alienhairdo]

The way I see it, there are 3 ideologies in the USA. 1 is the zealous religious bigots. These people are not taken seriously by anyone. 2 are the libertarians. We call them Conservatives. This group is what republicans are drawn to. 3 are the social democrats. They favor a European type of socialism/­capitalism­. These are progressives. We call them Liberals.

Progressives and Libertarians-- Democrats/­Republican­s-- want the same thing: Take the power back from the corporations and government. These two groups simply believe in different paths to the same end.

To the Libertaria­n--Republi­cans (who are not already retired) I pose the following: Every country worth living in has high taxes and lots of regulation. (Canada, Europe, Australia & Japan) And every country with low taxes and few regulations is an oppressive dictatorship-- often with violence, war and terrorism.

So please, show me an example of this Libertarian Paradise, where their are no taxes and no government. PLEASE. I am willing to join you. I think you will realize libertarianism is no option at all.

[NewGenerationNewIdeas]

Wow, great post.

Totally agree, all the good countries have "high taxes" and "lots of regulation", except us. We all know how well that's going for us now...

[Turtleposer]

What? Are you some sort of socialist that can't build your own roads or hire your own police force?

[Alienhairdo]

The ignorance of Americans is breathtaking.

[FaceReality2]

That's the source of all our problems.

[Beachchick]

The U.S. doesn’t have a free market. It is a myth. Furthermore, health care is not a specific thing bought and sold in a market. There isn’t a unit of health care to graph. To suggest that there is a market for health care that responds to market forces is absurd. A market within the health care industry doesn't exist either. You can’t apply a free market solution to an industry that doesn’t have a market. Health care costs are determined by industry norms and negotiations among providers.

Besides, the private insurance and pharmaceutical companies don’t really want a free market solution or smaller government; they want the government to grow larger and continue subsidizing their profit. The U.S. government --the taxpayer--spends more per person on health care than the UK but leaves millions of people uninsured, under insured, and bankrupt. U.S. health care is a mess.

[FaceReality2]

"the private insurance and pharmaceutical companies don"t really want a free market solution or smaller government; they want the government to grow larger and continue subsidizing their profit."

Yes. Big corporations want the government to protect them from competition. Competition and the real "Free Market" is for the little people.

[Beachchick]

Imagine the heavily subsidized pharmaceutical industry actually being forced to compete, it might actually invest in developing something other than a copycat drug to peddle on TV.

[FaceReality2]

The Republicans are pushing a Free Market solution. The Republican plan would allow you to buy insurance across state lines where "cheaper" plans may be available. Sounds great on the surface, but this would be made possible by voiding state health insurance regulation through Federal preemption. Many (or at least some) states have good consumer health insurance regulations which prohibit the abuses the insurance companies get away with in unregulated states like Texas. If the Republicans succeed, the insurance companies will be able to screw consumers everywhere like they do in unregulated states like Texas. Texas has the highest health insurance rates of any state in the country and the greatest percentage of uninsured. That's the "Free Market."

[FaceReality2]

Republicans say the source of all our economic problems is regulation. Let's get rid of the criminal laws, and crime will go down.

[Beachchick]

The Republicans posting in this thread apparently don't even know what a market is or how it functions.

[Turtleposer]

A "free market" solution doesn't really exist. All insurance companies do is collect premiums, pool risk & sometimes pay claims. The object of the game is to get the the people with the least amount of illiness to pay premiums while removing or limiting claims paid out on sick people. There's no incentive to compete or offer value to anyone other than presumably healthy people. Once you get sick, there's no catering to you.

Insurance Companies are the middlemen -- cut them out!!!

[myptofvu]

From campaign contributions to the electoral process, we need to change politics, a complete overhaul.

[PINO]

Here's a new trigger: Despite campaign rhetoric, obama pivots on taxing health care benefits. Whoa. Didn't he promise us that he WOULDN'T raise taxes on those making less than $250K.

Washington Post-
"President Obama, in a pivot from some of his harshest campaign rhetoric, told Democratic senators yesterday that he is willing to consider taxing employer-sponsored health benefits to help pay for a broad expansion of coverage."

Come hell or high water, wrong or wronger, it seems that obama will cram his universal single-payer health plan down the American peoples throat using any means to achieve his crappy goal.

Gosh, don't you just love democracy in action.

[jmpurser]

President Obama is NOT for a universal single payer government run health insurance.

[PINO]

You are really uninformed. He has been touting this sort of plan from Day 1. Get with the program or get off of this blog.

He rejects an immediate shift to a single-payer system, but his plans are to move this form of health care. Back in 2003 he declared himself a proponent of a single-payer universal health care program. In that speech six years ago, Obama said the only reason single-payer proponents should tolerate delay is "because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."

He and the other dems maybe dressing this down in the media, but please don't be so stupid to think that this is NOT obama's goal. Because it is.

[Jane48]

What? Do you own an insurance agency where you can prey on Americans? or are you just working for the RNC?

[Marcospinelli]

There are some things that shouldn't be "for profit". Police and fire services and health care are three such things.

Health insurance companies make their profits by denying health care. If ever there was an evil business, that's it. Health insurance companies pay bonuses to employees for denying claims. They pay even higher bonuses to their CEOS -- In the millions each year. Health insurance companies (HMOs, PPOs, etc.) keep the actual health care practitioners (doctors, nurses, etc.) on low, fixed reimbursement rates that create overbooking, less time spent with patients, poor medical practices, etc.

Single payer universal health care isn't Obama's goal, but it is the American people's, and it's the only solution that will work to save our economy, jobs, and people's lives.

[FaceReality2]

Makes you wonder whether or not we really have a democracy or a representative government.

[Beachchick]

You've got that right. The health care industry will collapse without reform. The U.S. government can't continue to subsidize profit health care without going bankrupt, and without subsidies, the vast majority of Americans can't afford the premiums.

[boomerbabe]

I just don't understand how we all don't recognize that if a company operates for profit, that it will make the cost of health care more expensive. What is so hard to understand?
New York State is looking at over $800 Million in profits to be paid out to share holders. That is money from the sweat of the small businessman, laborer, and denied coverage and reimbursements that are forcing doctors and hospitals out of business or at the very least long waiting time.. because they must see so many more patients. We all know the only way to rescue health care is a single party .. no for profit will work.. ever. .because controlling cost will not control their profiteering at the expense of not insuring and denying care. It is our responsibility to send a message to congress that if they don't take care of their constituents, all the money from the lobbyists will not get them reelected. It is up to us.. speak out!

[Onepebbleinthelandslide]

Could it be that we have failed our leaders by not stating clearly enough the impacts that the outrageous gouging by insurance companies continues to have on American families? Perhaps we should take a minute and reflect on our role as citizens.

We the people already pay for the best coverage money can buy for the families of the men and women who make our laws. I’m sure they see nothing wrong with the current state of our health care system. Free healthcare recipients, many whom have been called out by their colleagues for being “owned” by giant corporations, are going to decide what sort of reform, if any, is best for the rest of us. Really?

How can we expect them to fix anything if they’re unaware it is broken?

If there is a congressman or senator who’s in-box isn’t log jammed with e-mails from people demanding action, (and if this health care bill gets a slight touch up like the credit card reform just did), at some point or another we’ll have to assume some of the responsibility for our state of affairs.

Or, we can continue to do nothing other than complain amongst ourselves, and nothing in the way of change is what we’re likely to get.

[Marcospinelli]

They know.

Joe Scarborough told a story on the air a few years ago, about when he decided to leave Congress and not run again. A fellow member of Congress urged him to change his mind, and in a hushed voice said, "Joe, this is the easiest job in the world, you're never going to get as sweet a gig as this!"

They get paid extremely well, money and opportunities for a phat life for them and their families, fame and fortune, for doing what corporations tell them to do.

All they have to do is learn the spin game, the lingo, and how to manage their voting record (hiding the votes that screw over their constituents, swapping votes with other party members from other states, etc.).

If they weren't in Congress, most of these people would have wound up in prison.

[taricaziz]

good comments

[FaceReality2]

Most of the politicians are sociopaths.

[NotBrainwashedByMedia]

The current economic conditions puts Obama and the country in a Pickle! The top 10 Health Insurance companies have a Market Cap of over $70 BILLION. These companies Liabilities are HUGE!

Now, the companies bring in Premiums etc... and invest the money in Treasuries etc... Sorry for brevity, but trying to make this short.

Switching to a Single-payer system would be catastrophic for these companies and the economic recovery.

So if you want to argue national Healthcare is what you ultimately want, but now is not the time... this should satisfy that argument. This needs to be spread out of over 10-30 years!

[jmpurser]

The insurance companies control billions because they sucked it out of the American economy using a scheme that kills Americans.

I don't know what your vision of "recovery" is but mine doesn't include them.

[NotBrainwashedByMedia]

These companies employee over 500,000+ people. We made the excuse for GM...

Just not the right time.

[Jane48]

Stock is generally owned by the very, very rich. The same folks that have insider trading for lunch every day. In fact, yesterday the gains in the stock market was LED by ...the HEALTH INDUSTRY!

I've always maintained that our Health care should never, ever be on the NYSE--like a piece of meet up for auction.

It's all excuses that the Big Health/Wealth Industry hopes will satisfy us drones.

[Beachchick]

BS. The rest of the world buys U.S. treasuries. The notion that an industry that is bankrupting the already bankrupt government is actually its savior is news speak at its best.

[globality]

There goes our healthcare promise

[Oldchef]

The "trigger" option is the blue dogs' plan to kill any option we might have for a reasonable solution. It spells the death of any workable plan and sentences us to dependence on for-profit health insurance instead of health care.

[Lemeritus]

Interesting article on a health march in Seattle on Sunday: http://seattletimes.nwsource.com/html/health/2009282093_healthmarch31m.html

Perhaps we should use this as a template for action.

Also, a pessimistic view from Dr. David Himmelstein, founder and spokesperson for Physicians for a National Health Program (and lead author of a Harvard study on medical precipitated bankruptcy):

"The President once acknowledged that single payer reform was the best option, but now he's caving in to corporate healthcare interests and completely shutting out advocates of single payer reform. The majority of Americans favor single payer, and it's the most popular reform option among doctors and health economists, but no single payer supporter has been invited to participate in the administration's health care summit. Meanwhile, he's appointed as his health reform czar Nancy-Ann DeParle, a woman who has made her living advising health care investors and sits on the board of many for-profit firms that have made billions from Medicare. Her appointment --and the invitation list to the healthcare summit -- is a clear signal that the administration plans to propose a corporate-friendly health reform that has no chance of actually solving our health care crisis."