October 14, 2009

h/t David E.

Olympia Snowe claims that the trigger option which was included in Medicare Part D was never needed because there was so much competition. Little surprise since it worked out so wonderfully for big Pharma.

Rahm Talks of Triggers in Healthcare Reform, But Doesn't Anyone Remember Medicare Part D?:


by Meg White

In examining and crafting policy, it is helpful to look at the recent past. The favorite comparison for our current efforts to reform healthcare is known as Hillarycare, the failed attempt at universal healthcare during the Clinton Administration.

But there may be a much more timely (and ominous) yardstick to hold up to this current legislative process: President Bush's Medicare Part D prescription drug program for seniors.

I know 2003 was forever ago, but does anyone remember how we ended up with Medicare Part D?

It was promised as a mechanism to bring down prescription costs for seniors. The problem is, the legislation itself was basically written by Big Pharma. The drug companies ingeniously decided they wouldn't have to negotiate with the federal government on Medicare prescription drug prices, as they must do with other programs such as the Veterans Health Administration, so they could charge taxpayers whatever they wanted.

And that they did.

After all that, the program still didn't help a large minority of the senior population deal with drug costs because of the massive "doughnut hole" problem. There are millions of seniors caught in the so-called doughnut hole, where thousands of dollars in annual prescription drug costs must come directly from their individual pocketbooks, or they will go without the often life-saving medications.

The legislation had a "trigger" built in to supposedly protect consumers and taxpayers against huge cost increases in the program. If the bills became too large, a "public option" would kick in and tell Big Pharma what's what. Unsurprisingly, that threshold has not yet been reached.

As a result, Big Pharma got a big windfall (a whopping $3.7 billion in the first two years alone) from Medicare Part D. But hey, that's what happens when you let lobbyists for the industry you're trying to reform write the legislation that does the reforming.


But the peep from Emanuel was telling. He says a "public plan" is only necessary if hospital bills balloon too large. That will set off a "trigger mechanism" like we were told would be available for the Medicare prescription drug program. You remember, that one which we haven't yet seen?

Now the House is using healthcare reform as an impetus to argue over ways to fix the doughnut hole problem, but they don't see the trigger pointed right in their faces.

Instead, Blue Dog Democrats are saying they want to work with industry to institute reforms. The insist that the American Hospital Association is ready to help cut costs. Right. Just like Big Pharma promised to do for seniors with the failed prescription drug program we're trying to clean up now, just three years after it went into effect.

Lawmakers need only look back a few years in the past to see that trusting industry to institute a fair trigger guarantees yet another program blowing up in our faces.

From CNN's American Morning. Good grief. She's on Hardball repeating the same nonsense right now. Transcript below the fold.

CHETRY: Well, back to our top story this morning. Health care reform clears a major hurdle in the Senate. Entering a whole new level today. The Senate Finance Committee approved a broad 10-year $829 billion bill to remake the nation's health care system. But even some members who voted for it say it is far from perfect. In fact, the only Republican to vote in favor of the measure, Olympia Snowe of Maine, joins us now live from Capitol Hill with more on why she decided to vote this way. Welcome, Senator.

SEN. OLYMPIA SNOWE (R), MAINE: You're welcome. Good morning.

CHETRY: You certainly have become a household name during this entire health care debate. They're calling you the "it" senator right now on the hill. But tell us a little bit about what it's been like for you? So many people courting your vote and watching how you voted on this measure.

SNOWE: Well, you know, I didn't consciously set out to be the only Republican who interestingly enough, it all developed as part of the bipartisan group that the chairman of the Senate Finance Committee Senator Baucus had convened four months ago to build bipartisan support for a bill and it turned out that I was the one that - the remaining along with the Democrats, but that doesn't mean to say that Republicans don't have some good ideas that should be incorporated in this legislation.

So I believe in solving problems, in trying to work through the legislative process to get it done. It's a monumental issue. It's very complex. It takes time. It should take time. That's what the American people expect. So we've just got to give it the time and the patience that it deserves to work through the legislative process to get this, to get this to be in the best place for the best policy possible on such an issue that affects every American.

CHETRY: It seems that's going to be a hard bar to meet, to pick the best possible, because there are so many groups out there who have their one issue that's make or break. I mean, take a look at even in the way these bills came down. The Senate Finance Committee is the only one that does not include a public option, and there are many in the House. All three of their bills do include it and there are many who say it's a public option or bust. Where do you stand on that?

SNOWE: Well, you know, I'm opposed to a public option, because I think the government has an inherent disadvantage, and disproportionate advantage at that against the private sector, and I think that we should leverage the private sector to perform by prohibiting egregious practices on the part of the insurance industry of the past and denying people coverage on so many levels.

We're going to end all of those practices, at the same time we're going to provide tax credits and subsidies and then we're going to make a transparent marketplace through these exchanges for individuals and small businesses and to provide affordable health insurance. I think that's the preferable rule. I would support a trigger as a fallback in the event affordable plans do not materialize in any given region of the country as we did with the prescription drug program.

We never had to utilize it. It was so much competition, that it was never triggered. I think that's the preferable way to go in that regard. I'm surprised that the insurance industry, frankly, you know, in trying to engineer such opposition, because our bill did not include the public option and provides tax credits and subsidies of almost $500 billion of the purchasing insurance products.

That certainly should help their business and with almost 30 million new customers. So I think that hopefully they should reconsider in a way that they've gone about trying to provide opposition to this legislation.

CHETRY: It's not just the insurance companies lobby there. The latest ones that have down, but there's also some opposition from labor unions. In fact, they're planning on coming out again as well, because they do not like two of the measures in this bill.

Part of it they don't like is the tax on high cost insurance policies. They also would like to see a public option. You know, what do you do when there are a lot of competing voices out there who are not going to be happy with whatever it is that you guys will ultimately decide on?

SNOWE: Well, you know, that's the challenge. And I've said the last century was riddled with failed attempts, but we're going to have to overcome the difficulties. Just because it's a tough issue doesn't mean that it obviates our responsibility to make it happen. This is not a solution searching for a problem.

With that rising health care costs is going to devastate the health care system very shortly. I think it's undeniable in seeing what's manifested in the health care premiums that have risen 131 percent over this last decade. Wages have only gone up 38 percent. Inflation is only 28 percent. So that gives you an idea.

CHETRY: Right.

SNOWE: Of how dramatic the costs are in health care. So we have to reconcile those differences. Everybody has to pitch in. The insurance industry has made 500 percent gross in their profits over the last decade. As far as labor unions are concerned, they are talking about that excise tax on high cost insurance plans. And we have a lot of built-in mechanisms, that we're talking about plans over $21,000 or $27,000.


CHETRY: And the labor unions don't like that either though. Some of the members say they've gave up higher wages in an effort to get better benefits. So they don't like that. I know there's a lot of challenges, but you know, the thing that was fascinating to me is that besides you, Republicans seemed to be sidelined on this health care reform debate.

You said yesterday, the consequences of inaction dictate the urgency of Congress, and that they need to take every opportunity to show the capacity to solve this issue. But are your fellow Republicans then making a major error by sitting this one out?

SNOWE: I don't know that they're sitting it out. They had offered a lot of amendments and I think, have very good ideas that I supported.

CHETRY: But in the end, you're the only one who voted yes. Everyone else voted no.

SNOWE: Yes, that's true.

CHETRY: They're not really taking part in anything that...

SNOWE: Right.

CHETRY: That would ultimately become law.

SNOWE: Right, but hopefully, that that could change, and I think that's where I think the Democratic leadership and the president has to begin to build those bridges and see what can happen. Among Democratic senators, I'll be working to collaborate on different issues in providing significant improvements to the bill along with Republicans and seeing what we can do to make this better, because that's what it's all about. It's understanding these differences.

You're right to underscore the real challenge here. There are so many different facets to it that it's easy to attack one facet and yet it's all integrated and interrelated. I think we can work that out. But we just have to give this a reasonable period of time to do it, and that's why I think Chairman Baucus and the Senate Finance Committee was right in undertaking this process of convening this group of six - the three Democrats, three Republicans more than four months ago.

We were involved in very intensive discussions on these issues and I think it's reflected how much time this issue takes and we should give it the time that it deserved to get it right, and to address people's concerns and to allay their fears. That's the only way I think that optimally we can get this done.

CHETRY: And I know that you guys have had very civil discussions. But when we had Senator Grassley on the show yesterday, he said that the reason he changed his mind and then felt that he couldn't support this is because he heard from his constituents who were very upset about some aspects of this including the mandate that everybody has to either buy insurance or face a fine.

SNOWE: Right.

CHETRY: He's saying that he was just listening to his constituents and not everybody wants health care reform. What about your fellow GOPers who are doing what their districts want them to do?

SNOWE: Well, I don't disagree with that. I oppose the individual mandate and I have made changes in the committee with Senator Schumer and I hope we revisit that issue as I said yesterday on the floor. It's not about punishing and penalizing people, it's about our responsibility to deliver affordable health care.

But that doesn't mean to say that there isn't a problem. It's the rising health care costs. And that's why I drew the analogy to the "Titanic" and it really is similar to turning the "Titanic" around before it hits an iceberg. We have an iceberg out there. If today's average employer family plan is $13,300. In a decade from now, it's $30,800, we have a problem.

CHETRY: Right.

SNOWE: We're expected to spend $33 trillion in health care over the next decade. We cannot reorder $829 billion within the health care system to make it work for everybody. I think we can if we put our mind to it. And if we don't, it's going to overtake us, it's going to have a crisis and then it's going to be really difficult to turn this around on a dime.

CHETRY: Well, Senator Olympia Snowe, very great to the have you on the show today. Thanks for giving us your input.

SNOWE: Thank you. Thank you.

Can you help us out?

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