Here's a little noticed moment from House Speaker Nancy Pelosi's press conference earlier today.
"[T]his, as I say, is the legislative process. And right now, we will have a public option in our bill," Pelosi said.
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.
Emphasis mine.
It would be premature to say that this is the deal being hashed out behind the scenes right now. But this seems like a clear warning from Pelosi to insurers--and also a signal to public option skeptics within her own party--that if the House backs a plan to "trigger" the public option, it will only do so if the triggers are affixed to a stronger, more robust public plan. That's a bit of a tell, I'd say.

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Indie Pro
September 8, 2009 5:56 PM
if they defeat a public option now, why would insurers be scared they couldn't get rid of a trigger?
you want to scare the insurance industry, talk about taking away the mandates!!
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mans_best_friend
September 8, 2009 6:05 PM
The votes aren't there for a robust public option. They just aren't. One way to attract the needed votes is to water it down to the point of being useless. The other way is to tie it to a trigger. As long as the trigger is a real trigger and not a fraud, this is the better way to go. If we're going to get half a loaf, let's get the good half.
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Indie Pro
September 8, 2009 6:07 PM in reply to mans_best_friend
you realize a medicare trigger was just killed last week?
A trigger is no option. Triggers can be killed after they are enacted.
At minimum, a trigger tells the insurance industry to do what they like for x number of years.
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mans_best_friend
September 8, 2009 6:09 PM in reply to Indie Pro
Then you'd better be prepared to get a watered-down bill, because those are the two options. The votes for a robust public option just aren't there.
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Indie Pro
September 8, 2009 6:13 PM in reply to mans_best_friend
then this is dead, unless a meaningful way of reducing the cost of insurance is found before you force people to buy it.
a watered down bill is what you are supporting.
it is a bill the insurance industry will support because they have everything to gain, atleast all our tax money, and the money of others forced to buy their product regardless of the costs.
you realize this is the proposal from those in the back pockets of the industry?
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mans_best_friend
September 8, 2009 6:29 PM in reply to Indie Pro
You're assuming a faux trigger. The prerequisite condition of my comment was a real trigger that limited the cost of insurance. Nate Silver has a fuller discussion here:
http://www.fivethirtyeight.com/2009/09/trigger-with-teeth.html
A robust public option right away is obviously a better choice (you do realize that "right away" means 2012), but the votes just aren't there no matter how much you wish they were. If you'd rather have nothing, then that's what you'll get.
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Indie Pro
September 8, 2009 6:35 PM in reply to mans_best_friend
are you saying the trigger they just overturned was less serious when enacted, than what is proposed now?
I think Nate is being naive. When republicans were in control, they simply threatened to remove filibusters all together, remember?
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mans_best_friend
September 8, 2009 6:47 PM in reply to Indie Pro
This has nothing to do with filibuster. There aren't more than 47 votes in the Senate. That's the reality. I'll be very happy to be proven wrong, but I don't see a public option passing without major changes. Of all the changes they can make, a trigger is the least objectionable, but it depends on the particulars of the trigger.
If you'd rather have nothing in the name of ideological purity, you're going to love a return to Bush politics, because that's where that leads.
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Kevin Sutton
September 8, 2009 7:12 PM in reply to mans_best_friend
There are enough House members on record demanding a robust public option to kill a bill.
On the other hand, there is not a majority of Senators saying that they will vote against a robust public option. 47 commitments in favor is not the same as 53 commitments against.
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Indie Pro
September 8, 2009 11:34 PM in reply to mans_best_friend
this has nothing to do with ideological purity. You are the one going for anything regardless of the cost.
If all that can pass it a great big giveaway to the insurance industry, what are you winning?
If this legislation forces people without the means to buy insurance, what is gained? But hardships for people who have been getting the shaft for decades now.
Most of the Insurance Reforms people want can be done without the public option and without mandates. Why are mandates so important. Because the industry demands it.
What is funny is all you people arguing for the insurance industry. That is what the blue dogs are arguing for, the insurance industry. Atleast people and congress are getting paid, you're just a dupe.
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Indie Pro
September 8, 2009 6:39 PM in reply to mans_best_friend
and rather than a plan forced on working people for the benefit of a political party and the insurance industry, yeah, I'd rather have nothing.
but that being said, if everyone is so cool with incrementalism, why not drop the mandates with public option.
You know, this idea of Universal healthcare can wait for later. Baby steps. Do as much Insurance Reform as can be done. But don't sacrifice people who can't afford the rising costs of insurance.
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The Commenter Formerly Known as NCSteve
September 8, 2009 8:06 PM in reply to Indie Pro
You don't think it's even remotely possible that things like getting everyone into pooled coverage, getting rid of the need for hospitals to overcharge insured patients to pay for indigent and bankrupt patients' unnecesarily expensive care, and ending the perverse market conditions that create an incentive for insurers to spend vast sums of money trying to have a better pool of insureds than their competitors might possibly have some impact on cost?
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Indie Pro
September 8, 2009 11:40 PM in reply to The Commenter Formerly Known as NCSteve
that can happen without a public option and without mandates.
atleast, pooled covereage is nothing new. A national exchange can be set up without mandates or a public option.
Are you saying Obama was lying when he said that a public option was the way to keep the insurance companies honest, and bring down premiums. I guess the public option was just an afterthought on the bill. Had no real purpose.
Why are you arguing like a blue dog democrat? I guess you are one. They argue for the wants and needs of those who pay them. yet you do it for free. I don't get it. Eitherway, your argument is less than convincing.
If you are all for incremental healthcare reform. Back up a couple more paces, and across the mandates line. You're used to that right?
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Indie Pro
September 8, 2009 11:50 PM in reply to The Commenter Formerly Known as NCSteve
here's where you are calling Obama a liar:
* In a news conference on June 23, Obama said: "As one of those options, for us to be able to say, 'Here's a public option that's not profit-driven, that can keep down administrative costs, and that provides you good, quality care for a reasonable price, as one of the options for you to choose' -- I think that makes sense."
* On June 16, Gibbs briefed reporters and said: "If I understand the free enterprise system . . . increased choice in competition drives down the prices for other insurance. That's why a strong public option is necessary to ensure that competition."
* On June 15, speaking to the American Medical Assn. in Chicago, Obama said: "You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package. . . . one of these options needs to be a public option that will give people a broader range of choices and inject competition into the healthcare market . . . [to] force waste out of the system and keep the insurance companies honest."
* In an interview with CNN on June 14, Sebelius said: "The president feels that having a public option side by side, same playing field, same rules, will give Americans choice and will help lower costs for everybody. And that's a good thing."
* On June 11, speaking to an audience in Green Bay, Wis., Obama said: "If you've got a private plan that works for you, that's great. But we want some competition. If the private insurance companies have to compete with a public option, it'll keep them honest and it'll help keep their prices down."
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bluebell
September 8, 2009 6:39 PM in reply to mans_best_friend
I'm going to save that "the votes just aren't there" phrase for the party when it calls in 2010 and 2012.
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lousgirl84
September 8, 2009 7:11 PM in reply to bluebell
Go troll somewhere else please.
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lousgirl84
September 8, 2009 7:11 PM in reply to Indie Pro
Do you have insurance Indie Pro?
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Indie Pro
September 8, 2009 11:42 PM in reply to lousgirl84
why? are you selling it?
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The Commenter Formerly Known as NCSteve
September 8, 2009 7:59 PM in reply to Indie Pro
According to Ezra Klein at any rate, who knows a thing or two about these things, the public plan as you seem to concieve it doesn't exist even in the House bill.
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Indie Pro
September 8, 2009 11:47 PM in reply to The Commenter Formerly Known as NCSteve
oh, I see, you and Ezra are calling Obama a liar.
Krugman disagrees:
But what is one to make of the practical, political argument from the likes of Ezra Klein, who argue that any public plan actually included in legislation probably wouldn’t make that much difference, and that reform is worth having even without such a plan?
There are three reasons to be suspicious of that argument.
The first is that I suspect that Ezra and others understate the extent to which even a public plan with limited bargaining power will help hold down overall costs. Private insurers do pay providers more than Medicare does — but that’s only part of the reason Medicare has lower costs. There’s also the huge overhead of the private insurers, much of which involves marketing and attempts to cherry-pick clients — and even with community rating, some of that will still go on. A public plan would probably be able to attract clients with much less of that.
Second, a public plan would probably provide the only real competition in many markets.
Third — and this is where I am getting a very bad feeling about the idea of throwing in the towel on the public option — is the politics. 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.
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Philv
September 8, 2009 7:05 PM in reply to Indie Pro
By both the House and the Senate or just the House? Takes two to tango you know...
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El Puerco
September 8, 2009 9:15 PM in reply to Indie Pro
The Medicare trigger, passed by a Republican Congress and signed by Bush, required that the President outline ways to cut Medicare costs if more than 45% of Medicarea funding came out of general revenues rather than from Medicare taxes and fees. It was a Republican ploy to gut Medicare if costs increased. Getting rid of this trigger was a good thing.
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Indie Pro
September 8, 2009 11:53 PM in reply to El Puerco
but the trigger was removed. triggers ain't forever.
it is pacification at best
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Richardxx
September 8, 2009 10:34 PM in reply to Indie Pro
Any trigger needs to include a provision that it cannot be eliminated unless there is a clear vote on an isolated bill that does nothing but eliminate the bill and one that requires a record vote so that everyone is on record.
And no, I don't even like that. That's a dead minimum last ditch position.
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mrtoad47
September 8, 2009 10:58 PM in reply to mans_best_friend
"The votes aren't there" thing keeps being repeated as if it were so. How 'bout bringing it to a vote? See if dems join in a filibuster. Then, see if you can't get 50 to vote for it. Get them on the record. At that point, we can change the bill (and primary challenge those dems), but why give up without even trying?
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bluebell
September 8, 2009 6:10 PM
By the time the bill is finished, you'll be mandated to serve cake to big insurance and ice cream to big pharma.
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matyra
September 8, 2009 7:29 PM in reply to bluebell
And if you don't deliver the icecream on time, there's the fine. Nice.
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lousgirl84
September 8, 2009 7:12 PM
As long as I don't have to serve it to you!!
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Karl the Marxist
September 9, 2009 5:40 AM
I cannot but be amused with this rather pathetic fist-shaking. There is no chance in hell that there would be changes of heart when - gasp - it turns out that the insurance companies are not all that great.
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sisterkevin
September 9, 2009 11:20 AM
Pelosi's threat is pathetic. It's feeble, it's ALL feeble. I'm negotiating with you and it goes something like this -
"yes you can date my wife but you can't sleep with her. I'm drawing a line in the sand"!
The POTUS possesses no leadership, has lied to us, is in way over his head, has real psych issues, and has already become so marginalized already, before tonight's speech, that only a "line-in-the-sand" moment will save him from becoming, to me, a bewildering and devastating disappointment. This guy has real issues.
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