Will Obama Stop the Trigger?

For the past few months, President Obama has clearly shown that he’s an excellent student of history, neatly side-stepping the management mistakes that helped sink Bill Clinton’s health care efforts.  Now, with bills set to drop in both relevant Senate committees, all indications are Obama will be taking a more hands-on approach.  But will he use his considerable clout, popularity and grassroots support to continue discussing health care in the vaguest terms?  Or will he aggressively push back against measures designed to water down or kill his preferred solutions – most notably, the “trigger” against a public plan?

Obama’s approach thus far has been more reminiscent of Lyndon Johnson on Medicare than it has Clinton – keeping above the fray while the appropriate Congressional leaders hammer out details, but continuing to use the bully pulpit to make sure the emphasis on health care never ebbs.  These past few days have been vintage Obama -- the newspapers have spent three out of four days talking about health care in the absence of major developments, all because of the White House.  He could have released his public letter to Kennedy and Baucus indicating the policies he favors in health care reform, well, after he met them on Wednesday.  But of course, he got headlines just by meeting with them.  Instead, the letter dropped on Thursday, where it got its own day of press.  Organizing for America conducts their nationwide health care house parties today.  And instead of a traditional and safe radio broadcast remembering veterans on D-Day, Obama’s radio address this week is on health care (albeit once again in vague terms.)

This approach has had a good run, but now we’re hitting a make-or-break stretch where many elements of Obama’s vision of reform are about to either drop out of the bills altogether, or be subjected to “Stupid Senate Tricks” that will water down their effectiveness or delay them altogether.  Hence, we have “The Trigger,” a proposal by Senate moderates and, now, House Blue Dogs (though not all of them).  In essence, it says that yes, we acknowledge we need to create a public health insurance option, but we won't offer it right away and maybe won't offer it at all.  We’ll wait a few years to see if private insurance gets its act together.  In the mean time, since the Obama/Baucus/Kennedy proposal also includes subsidizing those without insurance who cannot afford premiums, those subsidies will all go non-competitively to private insurance.  And we’ll take insurance’s word that it can actually help us reduce costs, expand access, and improve quality without a competing public plan forcing it to pay attention.

Here’s the thing – this isn’t just eliminating choice and competition out of reform.  It’s the standard Congressional trick of saying you’re doing something to create change when you’re really reinforcing the status quo.  It’s also giving private insurance companies, whose business practices have helped create this mess of a health care system, a “Get Out of Jail Free” card.

Paul Krugman writes:

How could the industry spend 15 years failing to make even the most obvious reforms? The answer is simple: Americans seeking health coverage had nowhere else to go. And the purpose of the public option is to make sure that the industry doesn’t waste another 15 years — by giving Americans an alternative if private insurers fall down on the job.

Obama has made no secret that he prefers a public plan.  In his letter to Kennedy and Baucus, he wrote, “I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”  HHS Secretary Kathleen Sebelius spoke in support of the public plan to the Wall Street Journal the very next day.  It’s been part of his health care plan since May, 2007.  Although it might be understandable that he doesn’t want to wade into the specifics on, say, the exact provider rates for such a plan, this is different.  A “trigger” will kill the public plan entirely.

Write to Congress and the President now.  Let them know private insurance shouldn’t get a “Get Out of Jail Free” card, and a trigger on a public plan is unacceptable.

Just because we don’t know yet if Obama will fight for it doesn’t mean we have to take this Stupid Senate Trick lying down.