Robert Reich's Logic

I don't buy Reich's logic in a posting he has on his blog about the "trigger" option being discussed in Washington. I'm sympathetic to his cause, but there is something phony about his argument. Here is the key bit:

The White House is looking for a way to be in favor of a public option but also get enough Blue Dog Democrats -- many of whom hail from swing districts and states, and therefore need some cover -- to vote for it. One such cover is a Republican Senator from Maine, named Olympia Snowe. If she votes for the bill, Blue Dogs can calm their constituents -- who have been worked up into a lather by the right -- by saying "you see? Even a prominent Republican senator is voting for this."

So will Snowe play ball? It depends. Her idea (evidently encouraged by Rahm Emanuel, the President's chief of staff) is to hold off on any public option. Give the private insurance companies a period of time -- say, five years -- within which to make changes that extend coverage to more people and also drive down long-term costs. If those goals for coverage and cost aren't met by end of the five-year grace period, kaboom: the public option is triggered -- which will force such changes on the insurance companies.

The beauty of Snowe's proposal is that it seems to offer Blue Dogs a way out and liberal Democrats a way in. Nobody has to vote for or against a public option. The public option just happens automatically if its purposes -- wider coverage and lower costs -- aren't achieved. And the trigger idea seems so, well, centrist.

The problem is twofold. First, it's impossible to design airtight goals for coverage and cost reductions that won't be picked over by five thousand lobbyists and as many lawyers and litigators even if, at the end of the grace period, it's apparent to everyone else that the goals aren't met. Washington is a vast cesspool of well-paid specialists who know how to stop anything resembling a "trigger." Believe me, they will.

Second, any controversial proposal with some powerful support behind it that gets delayed -- for five years or three years or whenever -- is politically dead. Supporters lose interest. Public attention wanders. The media are on to other issues. Right now the public option is very much alive because so many Democrats care deeply about it, with good reason. But put it off for years, and assign it to the lawyers and lobbyists I just mentioned, and you can kiss it goodbye for ever.

I buy the argument that health costs in the US are high because the system is inefficient. All the private insurers are putting big efforts into offloading anybody with a real need for insurance. So there is a lot of "buck passing" along with orphaned seekers of insurance who can't find anybody willing to take them.

Europe, Canada, and Japan prove that mandated universal health care delivers better care at lower cost. The US system is broken. But Reich seems to be saying that if you don't force a public option, then the US system will manage to hobble along. But at the same time, the story is that the US system is (a) much more expensive than that in any other developed country while getting worse outcomes and (b) costs are skyrocketing in the US. Doesn't that mean it will only get worse?

Why isn't Reich sitting back smiling knowing that if this "trigger" option gets passed the system will blow up and the Congress will have to come back and clean up an even bigger mess in 5 or 10 years? I think they will. I think Reich is pushing a phony argument. I'm on Reich's side in the argument, but I don't buy this maneuver in his logic.

On a happier note... Here's a posting by Robert Reich giving the long history of attempts to get health care in America. It is very instructive. It will make you appreciative of the ups & downs, the hurdles, the miscues, and the ugliness of the fight. Go read the whole thing.