Pelosi Starting To Warm To The Trigger...
It looks like all the Washington gossip has gotten to Nancy Pelosi, seen today trying to thread the needle on triggers.
But I said it before and I'll say it again: The health insurance industry, which is out there fighting the public option tooth and nail because it does increase competition, which they don't want. They'd be better getting a public option now than one that is triggered because if you have a triggered public option, it's because the insurance industry has demonstrated that they're not cooperating, they're not doing the right thing, and I think they'll have a tougher public option to deal with.
She's trying to keep progressive activists on her side by saying that she would only accept a trigger that would bring into existence something like Medicare for All. But that assumes the trigger would be written in such a way that it could ever conceivably get pulled. And I think we all now that's not how this works. The formula for pulling the trigger would get debated endlessly, insurers would sue based on their version of the formula, and conservatives would call it a government takeover of health care and the beginning of the death panels and all the things you saw on display in August.
Pelosi's trying to sell a dead fish as a pet. There's nothing called a "triggered public option" that will satisfy progressives who think the market for health insurance is irreparably broken and private insurers are not to be trusted. Triggers are a Washington type of solution, where the solution isn't offered, but gives everyone involved something they think they can run on down the road.
As Paul Krugman describes well, the politics of reform without a public option will be extremely damaging to the Democratic Party for years to come.
Remember, to make reform work we have to have an individual mandate. And everything I see says that there will be a major backlash against the idea of forcing people to buy insurance from the existing companies. That backlash was part of what got Obama the nomination! Having the public option offers a defense against that backlash.
What worries me is not so much that the backlash would stop reform from passing, as that it would store up trouble for the not-too-distant future. Imagine that reform passes, but that premiums shoot up (or even keep rising at the rates of the past decade.) Then you could all too easily have many people blaming Obama et al for forcing them into this increasingly unaffordable system. A trigger might fix this — but the funny thing about such triggers is that they almost never get pulled.
Let me add a sort of larger point: aside from the essentially circular political arguments — centrist Democrats insisting that the public option must be dropped to get the votes of centrist Democrats — the argument against the public option boils down to the fact that it’s bad because it is, horrors, a government program. And sooner or later Democrats have to take a stand against Reaganism — against the presumption that if the government does it, it’s bad.
But they're not doing that. They're sensing an opportunity to pass something, anything, and because Olympia Snowe supports triggers, they figure most ConservaDems will agree. So we have the half a loaf caucus in the House telling Democrats that they'll have to accept whatever the Senate rams down their throats. (The Senate could actually pass a public option as a deficit reduction play through reconciliation right now - but nobody wants you to know that.)
Rahm Emanuel was been pushing for triggers since well before the summer. It protects the insurance industry while allowing everyone to pretend they passed a strong bill. And that means industry will still line the pockets of Democrats as a token of thanks for preserving the status quo.
That's the decision for people to make when they assess this - whether to endorse that.