Saturday, June 6, 2009

The Public Option Overton Window

On one side, Ted Kennedy's HELP committee puts out a health care bill with an extremely robust public option. On the other side, the insurance and drug companies are trying to find a public-option-in-name only that will leave incumbent firms with all the bargaining power. In the middle we've got ideas Chuck Schumer's public-but-self-sustaining plan, and Olympia Snowe's "trigger" proposal. As Robert Reich points out, any sort of "trigger" mechanism will be met with endless delays as the insurance industry extracts additional concessions or begs for more time to meet coverage goals—just look at the digital TV transition to see how this will play out. Thus, unless Ben Nelson, Arlen Specter, and their fellow travelers suddely warm to the Kennedy approach, the goal of the next few months should be to make sure the final bill looks more like Schumer's proposal and less like Snowe's.

It's also somewhat ironic that Olympia Snowe (R-ME) is concerned about the prospects of a public health care plan introducing unhealthy competition. Currently Maine has exactly one major private health insurance provider: the state's Blue Cross/Blue Shield affiliate. It's also a state with relatively high health care costs. Under those circumstances, you would expect politicians from such a state to be eager to introduce alternative health insurers into their market.
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