Monday, October 26, 2009

The Return of the Trigger

People are talking about a public option with a trigger as a health care reform compromise. Alarmingly some work in the White House.

First What Ezra said

No one has ever seemed to have worked on a possible trigger as an actual provision of an actual bill. No one has sought political support for a trigger. I think that bringing up the trigger is equivalant to asking for delay. Both the trigger and delay are advocated by Senator Snowe.

Being sure that discussion of a trigger is a waste of time, I just can't resist.

I propose a trigger in which people in some state have access to a pubic option if for t = 2014 or later, fewer than f(t) % of legal residents have health insurance. To be a good policy, f(t) should rise to 100 % over time.

Aadding a trigger to the public option could be a disguised way of eliminating it. Certainly, if the Senate were required to pull the trigger, a trigger is like a no.

Adding a trigger could amount to nothing if, say, Barack Obama were the one to decide whether to pull it.

A trigger only makes sense if it is based on hard numbers and those numbers are crunched by an independent non political entity. I'm not sure how constitutional that would be, but let's assume it is pulled by the GAO or something.

Snowe is eager for a trigger pulled if people don't have access to affordable insurance. This is equivalent to no trigger, since the subsidies are designed to guarantee that all have access to affordable insurance. Snowe is not convinced that this means insurance is actually affordable, but it is declared to be affordable. Her position is just a gentle moderate sounding no to the public option.

OK so my proposal. I think it can be implemented. I mean it is not too hard to reliably estimate the number of people with insurance and the number of legal US residents in a state. It is hard to estimate the number of undocumented aliens, but everyone with power agrees that, for the purposes of health care reform, they don't count.

The point of my proposal is that an insurance company with a domminant position in a state would have a strong incentive to get people insured in order to avoid competing with a public option. This would give it incentives to chase after the uninsured *and* to charge low premia. The threat of a public option would work vaguely like a public option.

Effort to waste time completed.

But seriously Snowe is just delaying things, because when history calls she gets anxious. Go without her. Use budget reconciliation if necessary.

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