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Sunday, October 25, 2009

New health insurance public option idea: BOTH opt-out and "trigger" -- in that order

The opt-out idea continues to gain major traction, with Pelosi and Reid both saying they can pass it and one major Democrat after another expressing support. However, the White House has yet to signal acceptance, with reports saying the administration still is leaning towards Olympia Snowe's "trigger" concept. If you haven't been following all this closely, the trigger most likely would consist of quantitative criteria of competitiveness in a market (a state) using the kinds of market-share analysis that are used in antitrust matters -- but it still means there would be no public option at the outset, but only if the trigger is activated. For that reason, it is utterly despised by virtually all public progressives and, it appears, most Democratic congresspeople, all of whom are insisting on a real non-profit, Federally-run public option to assure the most affordable insurance possible is available to those who need it. By setting a cost-pricing standard based on a huge pool, no profit component and use of Medicare rates in some fashion, it should also help force down insurance costs generally.

Since I'm making the still-unrebutted claim of being the first to introduce this concept into the national discourse back at the beginning of September, here's a new wrinkle for further isolating the public option opponents. To paraphrase my earlier challenge to objectors to the public option: "You want a "trigger"? OK, here's a trigger." Put them both in, but in a different order from the one contemplated by the current (tiny handful) of "trigger" aficionados. Yes, as proposed in the opt-out concept, a state by appropriate means (preferably a referendum) would have the right to opt out (a step I feel certain no state would ultimately have the guts to take), any opt-out actually implemented would itself be automatically invalidated if that trigger of well-defined criteria of non-competitiveness is tripped. In other words, the trigger is not a method of introducing the public option in a state, but could defeat the opt-out.

Hey, it's the best of all possible Democratic worlds: the state's opt-out right popular now with most Democratic legislators who have been exposed to it, and the trigger that only a Blue Dogs could love (and apparently a trembling, hand-wringing White House). That should shut them up for awhile -- maybe for good if we're lucky.

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