Rachel Maddow talks to David Sirota about why including a "trigger" in the health care bill is a poison pill that assures we won't have any real reform. David reiterates what he wrote in his op-ed The Trigger Mechanism:

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.