On the Health Care Front

Two stories caught my attention.  In the first, a new Urban institute report sheds new light on a triggered public option.

A new report from the Urban Institute argues that a “strong” public option — one that is triggered in the event that overall growth in national health spending exceeds a pre-determined target — may do more to control health care spending than the public option proposals offered in existing legislation:

In the absence of enough political support to pass a strong public option at this time, a “trigger” for a strong public option should be considered for inclusion in health reform legislation whether or not a weak public option is included as a political compromise. Even the threat of such a plan being triggered offers the potential to affect market dynamics between insurers and providers.

The report says that the Senate and House’s public option provisions (which require the public plan to independently negotiate rates with providers) hold little hope of lowering costs in areas of the country with high provider concentration. In areas where hospitals have “too strong a market presence to be excluded from insurer networks,” hospitals could dictate prices, stripping the public plan of its ability to negotiate cheaper rates, the report warns. According to a 2006 study, 86% “of large metropolitan areas were considered to have highly concentrated hospital markets.”

Policymakers can overcome the political challenges of enacting a strong public option — one which compels Medicare providers to participate and establishes Medicare-like reimbursement rates — by placing the plan behind a trigger mechanism which “would allow private insurers the opportunity to show that they can provide affordable coverage under the new health reform rules.”

The report recognizes that “many proponents of a strong public option oppose a compromise relying on triggers because they believe that triggers would never be pulled” and suggests that structuring the trigger around overall growth in national health spending — rather than affordability — would make it more likely that a public plan would be established in the absence of meaningful cost containment… [emphasis original] [emphasis added]

Inserted from <Think Progress>

It might not be a bad way to go if the trigger pulls itself automatically with no further Congressional input, if its provisions are stronger that the emasculated versions in the House and Senate bills, and if it would be implemented no later than the 2014 date set for the puny versions in the House and Senate bills.  Of course one of the big obstacles to reform is Traitor Joe LIEberman, which brings us to the second story.

Former DNC Chair Howard Dean called on Sen. Joseph Lieberman (I-Conn) to resign as chair of Senate Homeland Security Committee if he can't bring himself to oppose a Republican filibuster of health care reform legislation.

Appearing on "The Joe Scarborough Show" on WABC, Dean stressed that he had no problem with Lieberman opposing the bill on its philosophical merits, or lack thereof. But he insisted that it was irresponsible and unprincipled to not allow the legislation to come to an up-or-down vote.

"I think that [Lieberman] is a very complicated guy," said Dean. "He does [confuse me] because he says he's a principled guy but there's nothing principled about holding up a bill... If he was a principled guy he'd resign his chairmanship."

"If you are with a caucus you don't owe the leader any vote on any substance," Dean added. "I have no problem with him voting against the public option... You owe it to Harry Reid to allow him to run the Senate. And if you're not willing to do that the proper thing to do is to step aside."

Dean's remarks, which come after Lieberman renewed his pledge to filibuster health care reform that includes a public option, reflect an intense frustration among progressives over the ability of moderates to water down or stall legislation. They also suggest a growing demand for leadership to enforce institutional discipline...

Inserted from <Huffington Post>

If he does not resign, he should be stripped of his chairmanship, a point I have made many times,