Rahm To Public Option Supporters: Trust Us! This Isn't Bait And Switch, Honest

All these gyrations and negotiations to avoid even the possibility of a truly robust public plan! Ah well, there's probably some 11-dimensional ches

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All these gyrations and negotiations to avoid even the possibility of a truly robust public plan! Ah well, there's probably some 11-dimensional chess going on here that I can't see. But I'll tell you what I can see: That everybody's represented at this particular table except us:

WASHINGTON -- It is more important that health-care legislation inject stiff competition among insurance plans than it is for Congress to create a pure government-run option, White House Chief of Staff Rahm Emanuel said Monday.

I guess it all depends on what you mean by "stiff." Somehow, this statement has a whiff of Viagra spam about it: "Your instrument will be like a mighty oak." Uh huh.

"The goal is to have a means and a mechanism to keep the private insurers honest," he said in an interview. "The goal is non-negotiable; the path is" negotiable.

His comments came as the Senate Finance Committee pushed for a bipartisan deal. To help pay for the package, the committee planned to announce an agreement Wednesday with hospitals and the White House for $155 billion over a decade in reductions to Medicare and charity-care payments for hospitals, according to a person familiar with the agreement. That will help pay for the legislation, expected to cost at least $1 trillion over 10 years.

One of the most contentious issues is whether to create a public health-insurance plan to compete with private companies.

Mr. Emanuel said one of several ways to meet President Barack Obama's goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect.

Are you kidding me, Rahm? Plan D is a piece of crap, a fact that is well-known to the people who actually rely on it. Oh, I forgot - to you, a success has more to do with "getting the job done" in Congress than in actually fixing the problem. Solution-esque, as it were. This is your template? Dear God, we're screwed. Because that trigger mechanism was designed to never be triggered.

Mr. Obama has pushed hard for a vigorous public option. But he has also said he won't draw a "line in the sand" over this point.

Will this man draw a line in the sand over anything? Is nothing non-negotiable with President Obama? Oh, right: Banking bailouts.

The deal with the hospitals follows a similar agreement with brand-name drug companies. And insurance companies were talking to Senate negotiators about cuts worth at least $100 billion over 10 years, according to two officials with knowledge of the negotiations.

Congressional negotiators and the White House hope to lock in support from the industry groups, which are backing a health bill in general terms but have opposed past efforts.

But this time, they're really, really, really operating in good faith. Honest! (Charlie Brown, meet football.)

Hospitals and insurers hope to gain some degree of control over cuts to their federal payments. In principle, a health-care overhaul could benefit both groups by raising the number of Americans who buy and have health insurance.

"They've made an assessment reform is going to happen, so it's better to be part of that than not," Mr. Emanuel said.

However, insurers, and most Republicans, strongly oppose creation of a government-run insurance option, saying it would ultimately drive them out of business. Most Democrats support a public option.

The president and his aides already have signaled a willingness to consider an alternative to a public plan under which a network of nonprofit cooperatives would compete with for-profit insurance companies. That is the leading idea in the Senate Finance Committee.

You know what? All this co-op idea would do is Balkanize and weaken whatever clout we had against the insurance companies.

The Senate Health, Education, Labor and Pensions Committee, meanwhile, has put forward its own version of a government-run plan, closer to what most liberals and the White House favor.

On Monday, Mr. Emanuel said the trigger mechanism would also accomplish the White House's goals. Under this scenario, a public plan would kick in under certain circumstances when competition was judged to be lacking. Exactly what circumstances would trigger the option would have to be worked out.

Again, horse feathers. Just like with Plan D, they will design a trigger for which the conditions will never, ever be met. Insurance companies have shown again and again they don't operate in good faith. All this talk about "triggers" means the one on the gun held to our heads.

Some Democrats pushing for a vigorous public plan say the trigger idea isn't good enough. Sen. Charles Schumer (D., N.Y.) said in an interview, "If it's not there on day one, those of us who support a public option have a real problem with it."

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