The only trigger I would accept:

[Zynx]

If over the next four years health insurance premiums have not DECLINED at least 5% on average with coverage rates exceeding 99% of Americans, a public option shall be made available by the federal government.

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Coming up with how that average for premiums is calculated would be tricky. I'm sure the insurance companies could figure out a way to game it or increase co-pays while reducing premiums. That's part of the reason I don't support a trigger, but if there has to be one, let's make sure it has some teeth in it.

I would also map out a very low maximum level for premiums over the next twenty years that if breeched would also trigger a public option.

I haven't put that much thought into this, so if anyone has some suggestions, that would be cool. Once again, I don't even support the concept of a trigger.

[DJ13]

1. I wouldnt give them ANY trigger unless it triggers full universal coverage

The public option is ALREADY a compromise, so if they cant accept that without a trigger the trigger should be punitive, which a universal system would be to the insurers.

[LuvNewcastle]

2. Premiums would have to be

half of what they are now within two years. I might accept that.

[customerserviceguy]

3. That's simply not going to happen

You cannot simultaneously cover more people for more conditions and have it cost less money. Universal healthcare should be provided because it is the right thing to do, not because it might be cost-effective or some nonsense like that. The only way to bring the costs down is squeeze the doctors and the hospitals even more than they have been.

[drm604]

6. That's not really correct.

You can cut costs by eliminating the profit margins and CEO salaries and paperwork redundancy of private insurance. You can also cut costs by having people getting their routine care in a doctor's office rather than the ER. You can also cut costs through preventative care and by catching problems early while they can be more easily and more inexpensively treated.

None of that involves squeezing doctors or hospitals.

[customerserviceguy]

8. There isn't that much money in profit margins and CEO salaries

sorry. And if you think paperwork redundancy will go down, you're dreaming. Every piece of paper I have to file with government or a quasi-governmental agency is way more complicated than it needs to be. The bureaucracy will just move from private insurance companies to either a single-payer entity or to a public option entity that just absorbs all the people the private companies find too expensive to cover.

Preventative care only shifts the costs of end-of-life care out there a few more years. An 80 year old dying of a heart attack costs us just as much as as a 70 year old dying of a heart attack, it just happens ten years later. And even modest inflation in medical costs make the octagenarian's heart attack cost more than it did if the guy died at 70. Plus, you have all the health costs of non-lethal illnesses for that extra ten years. Let people decide on their own preventative care, if they so choose to.

Universal healthcare that is meaningful is going to cost a lot of money, I have no illusions about that. Universal community college costs a lot of money, too, but we justify that because we think we're going to get some sort of return on that investment, even though you have associate degree holders jerking espressos while paying off sizable student loans.

We need single-payer universal healthcare because it is the right thing that a civilized country does, not because there is some magical cost savings.

[Skink]

4. If they could get that they'd make sure to put a republican in the white house in 2012

[drm604]

5. It would also have to include something about minimum coverage,

and not allow denial of anything medically necessary, and it would have to have a method of determining medical necessity that insurance companies couldn't weasel out of. And there would have to be some kind of monitoring in place to ensure that all of them were meeting all of the requirements needed to prevent the triggering of the option.

To me, that sounds a lot more like government intrusion and control than simply instituting a public option with which they would have to successfully compete in order to stay in business. The only thing heavily controlled by the government would be the government run public option. The market, rather than the government, would then force the private companies to adopt at least the standards of the public option if they wanted to stay in business.

[valerief]

7. Does that include only a 1% rate of claim rejections? nt

[damntexdem]

9. The only Trigger I would have accepted ...

was a horse. ;-)