The hot topic at this precise moment in time is the concept of a public option "trigger" being proposed by Maine Republican Senator Olympia Snowe.
Snowe was one of only three Republicans to vote for the February 2009 stimulus plan; without those three Republicans (one of whom, Arlen Specter, formally became a Democrat in April), the stimulus plan would not have passed in its pork-laden, misguided form.
The idea of a trigger is stupid, plain and simple. The concept of giving insurance companies a set period of time to bring down costs, under threat of having their businesses compete with the government, creates the wrong incentives. Cutting costs by rationing care is not what we need, and putting in place a trigger simply will encourage insurance companies to make arbitrary cuts.
Rather than relying on insurance companies or government, we need to move on to market reforms which will accomplish most of what people want without creating new government bureaucracies or arbitrary insurance company cutbacks. Empower hundreds of millions of people to shop for health services and products the same way they shop for other consumer goods and services, and require medical providers to compete for the business.
Cross-state insurance markets, easy to use health savings accounts, and other mechanisms which do not require government spending are the answers. Improving the markets will allow for lower cost catastrophic plans, policies which are portable, and no preexisting condition exclusions.
The current system does not encourage consumer cost consciousness or innovative insurance plans because insurance companies and government foot almost all of the health care bill, and a government plan will make this situation worse. Who cares what the MRI costs if someone else is paying. Medicare costs are out of control precisely because patients have no stake in the costs; if Medicare patients had a financial incentive (i.e., they keep some of the savings) to find lower cost providers, everyone would benefit.
If a public plan is so great, then pass a public plan. If a public plan is not so great (my view), then kill the idea once and for all and move on to what people really want, individual empowerment.
What we do not need is another Snowe job.
Follow me on Twitter and Facebook