In his efforts to fashion a bipartisan compromise on health reform, Sen. Max Baucus (D-MT) has been trying to find alternatives to a robust public plan, which many Republicans refuse to consider. One of Baucus’s ideas has been to institute a public plan “trigger.” Under this proposal, the public plan would be created only if private insurance companies don’t make “meaningful, affordable coverage available to all Americans” within a certain period of time.
The Wall Street Journal reports that White House chief of staff Rahm Emanuel is now lending Baucus his support for the public plan “trigger”:
Mr. Emanuel said one of several ways to meet President Barack Obama’s goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect. […]
On Monday, Mr. Emanuel said the trigger mechanism would also accomplish the White House’s goals. Under this scenario, a public plan would kick in under certain circumstances when competition was judged to be lacking. Exactly what circumstances would trigger the option would have to be worked out.
The concept of a public plan “trigger” seems to be driven by a desire to protect the private insurance industry. As The Wonk Room’s Igor Volsky writes, “Why shouldn’t we require private industry to deliver on their promise to contain costs? Health reform isn’t about protecting private industry; it’s about adopting policies that are most likely to lower health care costs.” And as former Sen. Tom Daschle said, “I can’t think of a tool that more effectively controls costs than a public option.”
Sen. Chuck Schumer (D-NY), who has been pushing the Senate Finance Committee to adopt a public plan, said a “trigger” is unacceptable. On Face the Nation this past Sunday, he said a public plan “has to be available on the first day to everybody…so there shouldn’t be a trigger.”
One of the other alternatives to the public plan being considered by Baucus is the creation of health care cooperatives. The New York Times writes today that the record of co-ops “on holding down costs has been mixed.” Paul Keckley, Executive Director of the Deloitte Center for Health Solutions, said co-ops can take decades to fully develop. “If we had 25 years, and we weren’t staring down the barrel of a shotgun on health costs, it’s a pretty neat concept,” Keckley told Bloomberg. “It’s a politically interesting solution. I just don’t think it’s a real practical one.”
,President Obama issued a statement this morning, reiterating his support for a public plan:
I am pleased by the progress we’re making on health care reform and still believe, as I’ve said before, that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest. I look forward to a final product that achieves these very important goals.