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The "Trigger Mechanism"

by: David Sirota, t r u t h o u t | Perspective

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(Photo: SXC)

    After a summer of politics marked by esoteric phrases like "co-ops" and "insurance exchanges," the newest kernel of ubiquitous arcana is the term "trigger mechanism."

    This proposal, which is gaining momentum after President Obama's speech to Congress, would have any national health legislation include provisions only allowing a government-run "public option" if certain future conditions are met. "It's an obscure policy tool that isn't even written," reported the news service TalkingPointsMemo.com, "But somehow, a 'trigger-mechanism' is the talk of Washington right now. How did that happen?"

    Such shock is widespread. Pundits, reporters and activists are stunned that an abstruse scheme to halt reform has become a focal point of the health care debate. Yet, considering recent history, the only surprise is that Washington waited so long to again force this legislative cyanide down America's throat.

    Recall that over the last decade, a maverick group of progressive and conservative lawmakers pushed bills to let Americans purchase cheaper, FDA-approved prescription drugs from other industrialized nations. It was (and is) a commonsense idea - other countries allow importation, and the practice helps lower health costs by permitting consumers to buy medicines at the lowest world market price, not just at an artificially inflated domestic premium.

    As with today's public option surveys, polls on importation showed strong national support for the concept. So rather than murder the drug legislation outright, congressional leaders joined the Clinton and Bush administrations in backing a "compromise": Importation bills were passed, but only those that gave the secretary of Health and Human Services the power to trigger - or not trigger - final implementation.

    Specifically, the secretary would have to first certify that imported medicines were "safe" (drug companies promote the lie that Canadian medicine is mortally dangerous - prompting Republican Gov. Tim Pawlenty, an importation proponent, to ask, "Where are the dead Canadians"?).

    This trigger provision, of course, was lobbyists' poison pill - and it worked as they planned. Importation has never been implemented, as no HHS secretary has pulled the trigger. Hence, Americans are still barred from wholesale importation of lower-priced medicine - and pharmaceutical industry profiteering continues.

    The moral of the story is that triggers are just another version of the old Blue Ribbon Commission trick. They are designed not as good public policy, but as devious political tactics to help dishonest lawmakers look like they support popular measures - all while guaranteeing those measures never become reality.

    On importation, triggers gave corporatist politicians a way to seem like they were remaining true to their pro-consumer platitudes and "free trade" dogma at the same time they were strengthening an extreme form of anti-consumer protectionism for pharmaceutical companies.

    On health reform, a trigger will let those same legislators look as if they support a public option that increases insurance competition, reduces costs and therefore delivers on promises to decrease the deficit. But if/when the bill's final language is inevitably designed to make pulling any trigger impossible, it will preclude a public option from ever existing.

    If there is any mystery about the trigger subterfuge, it is how anyone can wonder where the idea came from or why it is suddenly so prominent. After all, the same lawmakers and lobbyists who used it to kill importation are currently working to destroy health reform.

    As just one example, Rahm Emanuel, the White House chief of staff pushing a trigger, was previously one of the key congresspeople who portrayed sham importation bills as real progress (he was also - not coincidentally - a huge recipient of health industry cash).

    "The past is never dead," wrote William Faulkner. "It's not even past." As today's trigger proposal shows, that's particularly true when a "change" election preserves the same corrupt forces, cynical tactics and bedeviled details.

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    David Sirota is the author of the best-selling books "Hostile Takeover" and "The Uprising." He hosts the morning show on AM760 in Colorado and blogs at OpenLeft.com. E-mail him at ds@davidsirota.com.

    Copyright 2009 Creators.com

  

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Comments

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Well, this is what you get

Well, this is what you get for trying to work with corporate America. Corporate America, or American fascism, has only one singular purpose, and that is to make profits without regard to anybody's welfare except the tycoons at the top. Unfortunately, Jefferson's regrets about failing to get his amendment included in the Bill of Rights, that would have provided a better constitutional basis from which to control corporate power, has proved visionary. I'm still disappointed that Campaign for America's Future, Moveon, etc, did not choose to engage in a knock down, drag out fight for single payer. If Americans ever wake up, I hope they will destroy the health insurance industry, as they should, by enacting single-payer. However, Obama, who got so much help from Wall St during the campaign, is not likely to contribute much to anything like that.

So who are the people who

So who are the people who can afford to go to Washington to protest health care reform? Not the folks who need it, only the folks who can financially afford to fly, drive, take time off from work (if they have it), or not work because they are retired and eligible for (gasp) socialized medicine in the form of Medicaide. We need a single payer public option. We cannot afford to wait. For those who want to pay full price in the free market where the invisible hand of the consumer drives the market, go for it. Keep your existing system. And for the rest of the Americans, we need a cradle to grave health care system that benefits ALL Americans and makes a more level international playing field with businesses. Other industrial nations who have nationalized health care, not illness care, focus on keeping their citizens / workers healthy so that the cost of doing business is lower for all their nations employers. Wake up America! The time is now! We need the same quality of care that is paid for by tax dollars for Congress! We can do it. Yes we can.

What started out as reform

What started out as reform has been transformed into a scheme to give the health insurance and pharmacutical industries an ever-increasing share of consumer's steadily declining real income, via the purchase mandate. We need serious cost controls. That will only happen by eliminating the 30% insurance industry profit, and by allowing negotiated drug prices. Any bill without a viable public option should be defeated.

The trigger = deception.

The trigger = deception. Pretend that you could support change to the health care system while continuing the disastrous status quo. We have had 60 years of waiting for the trigger. Vote out any Dem or Repug that does not support Single-Payer Health Care now.

Yes to all of the above. My

Yes to all of the above. My Canadian half says that the trigger already happened in the US over 100 years ago when Teddy Roosevelt first proposed health care reform. Today, with 18,000 dying each year from lack of any health care, each death is a trigger. How many more triggers are required before people realize that health is a basic moral right of each individual - not reserved for people who can afford the best insurance? Canada got the message and having experienced their health care for 30 years, I can't really imagine why anyone is dumb enough to oppose it.

Thank you David Sirota,

Thank you David Sirota, again. There has never been a more appropriate wake-up call, for these devious political tactics being employed in this go-around of Healthcare 101. It seems obvious where this is going. Was it intended to go this way all along after a not-very-convincing dog-and-pony show, funded by taxpayers, on behalf of the corporate owners of our representational government? Thank you Senator Harry Reid for the last minute peep of support for healthcare reform, they couldn't have done it without ya. Who's afraid of affordable heathcare (besides the insurance industry)? Our public education system, and many mindless distractions, have served the corporate elites well, and thus they reap the rewards of what they've sown in citizen apathy and poor cognition.

The respondents here are

The respondents here are missing an important connection. Consigning patients to their deaths by denying payment for medical services -- death panels? -- is the right-wing's version of population control. We can't allow abortion or even contraception, but we can let Granny or Auntie (or Gramps or Uncle) die because of refused procedures. By the time an ailment is diagnosed, the condition found is guaranteed to be "pre-existing". The family goes to the funeral -- the insurance company goes to the bank. The shareholders are pleased and vote the board to another term.

Documented deaths from

Documented deaths from treatment complications are 225,000 to 250,000 (Starfield, Leape, search with iatrogenic). If deaths from not treating are 18,000, there are issues here to be explored. Also, I am interested to know whether the HHS Secretary now could simply order that less expensive medicines from Canada be allowed? Is it a consensus at truthout that cooperative is now a logos non grata? Would that mean coercive or mandatory are considered welcome words? Is sweat equity a bad word? I attended a media panel for activists yesterday, and one of the speakers, from the news side of the business, said they like to "rogue" (Rogue of the Week) advertisers, and when they do, the people on the sales side of the business sometimes groan. He said the news side feels that it's good for their credibility to do this. It is in this spirit that I offer questions that will not come to you from the choir. I put coercion in the same category as torture, possibly serviceable to a culture of treatment, but not to a culture of care.