Kent Pitman

Kent Pitman
Location
New England, USA
Title
Philosopher, Technologist, Writer
Bio
I've been using the net in various roles—technical, social, and political—for the last 30 years. I'm disappointed that most forums don't pay for good writing and I'm ever in search of forums that do. (I've not seen any Tippem money, that's for sure.) And I worry some that our posting here for free could one day put paid writers in Closed Salon out of work. See my personal home page for more about me.

MY RECENT POSTS

NOVEMBER 25, 2009 12:09AM

Whoa There, Trigger!

Rate: 13 Flag

I've been quite busy the last couple of weeks and haven't had time to write about everything commentworthy that I see going by on the news. But tonight I had a few free minutes and wanted to make some observations about this silly “trigger” idea I've seen floated as an alleged compromise on health care.

First, on the notion that we should give insurance companies a chance to fix things on their own and only if they fail should we act: Absolutely. But I want “credit for time served.” They've had this chance for decades now and have abused the privilege of being allowed time to show the market could work. Even with a delay to allow insurance companies a chance, if you set the start time appropriately—several decades ago—our trigger alarm has not only been ringing too long, but the snooze button is at risk of wearing out from being hit too many times.

Second, it's worth closely scrutinizing any delay that moves responsibility to a different political term. That's sometimes necessary, but at other times it's done for cynical reasons.

I once worked for a company that laid off a great many of its employees, but on a six week delay. “Finish up soon,” the company urged, “because we need those products in good shape when you're gone.” What a surprise that those employees, who were no longer worried about losing their job, found themselves unable to focus clearly on finishing those products and instead consumed with discussing how to get a new company president who better understood what it would take to move the company ahead. That “worked,” by the way: The layoff was canceled in time, and the soon-to-be-laid-off employees were rescued by the new president, who canceled that layoff.

So you can understand why I might think when I hear someone say “give us some time,” and when I know that they have elaborate resources for influencing politics, that there might be some chance that instead of directing resources to cleaning up their act in the marketplace, they'll direct their precious resources even more heavily than usual into influencing the next election, just possibly asking that the candidates they support for Congress be ones who support canceling the trigger.

And finally I'll leave you with a metaphor to contemplate. A lot of our present economic woes came from the handling of mortgages. Among the tools for that was the Adjustable Rate Mortgage (ARM). Superficially, you might think my metaphor is going to be about rates and costs, but let's step up a level and think of an ARM not in terms of “paying” but in terms of “perceiving truth.” The hurtful thing about ARMs for many people wasn't the money, it was the delaying of the perception of reality. Years passed when something could have been done but wasn't, and by the time the reality caught up, it was even harder to deal with.

That's what a trigger is offering us. It seeks to say to people “things are ok now, wait a while and you can choose something better later if you need it.” Both of those statements are false and we need to start thinking in the present. Things are not ok now. Things may be ok for some people, but not for all. And if you're deciding whether your health care is ok based on having recently submitted a bill and having it paid, you're ignoring the many stories that say others have found this can change suddenly, without notice. Moreover, the trigger deceptively suggests you'll be able to change later. But just like holders of ARMs found out the hard way, the situation can change in unexpected ways. Our political situation could change, too. We have a lot of legislators poised to support health care reform just now. That could change. We must act now or may not have the chance later.


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Comments

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Eliminate the entire health "insurance" industry. That would be a good start. It's a contradiction in terms anyway, there's nothing healthy about it, and paying premiums certainly did not insure one's health.
Karin, I think Obama's approval rating is having problems because he's so hands off on these really critical issues. This is just one of them. He's being a lot like a senator, building consensus. He doesn't understand that an executive is expected to do more. He has to lead, and he's not doing as much of it as I expect of him.
Ablonde, I'm with ya on the question of premiums. They're already collecting our taxes. How much more efficient could it be to get money from everyone, given that this is an expense everyone should have. “From each person according to their ability” is not some sinister plot to nefariously change the government, it's the truth about what people can pay on an issue where everyone needs to chip in. People need to pay when they can just in case. And if some are lucky enough to never get seriously ill, that's already something cool they got that others didn't. They don't need more reward than that. The cost savings comes from an economy of scale, and the opponents of health care reform are trying to destroy that scaling factor so the expected returns are not seen.
Earthlings are funny…

Earthling - 1: "I was given the mandate, so now I am going to do XYZ"
Earthling - 2: "Don’t do it! Because of "A" things will be very bad!"
Earthling - 1: "A" will cause no problems" [he spends a year to prove it]
Earthling - 2: "Well then "B" will cause problems, so don't do it!"
Earthling - 1: "B" will cause no problems" [he spends a year to prove it]
Earthling - 2: "Well then "C" will cause problems, so don't do it!"
Earthling - 1: "C" will cause no problems" [he spends a year to prove it]
Earthling - 2: "Well then "D" will cause problems, so don't do it!"
Earthling - 1: "D" will cause no problems" [he spends a year to prove it]
Earthling - 2: WELL, YOUR TIME IS UP! Now it is my turn …No XYZ!

In a Galaxy far away:

Alien - 1: "I was given the mandate, so now I am going to do XYZ"
Alien - 2: "Don’t do it! Because of "A" things will be very bad!
Alien - 1: "Pick up your stinking red herring and go back to your room! [He does XYZ and some time later they can't even imagine how they managed to live without XYZ]
G-Man, I was expecting there to be the sound(?) of rayguns in there somewhere in that far away galaxy. I guess they have a bit to learn still about true efficiency.
I really thought "Trigger" the horse of gunslinging western fame would be here. Instead, what do I find but this serious and well written piece on healthcare.
Damn you to hell for tricking me.

Oh and Rated.
Andy, I'm sorry for horsing around with your emotions that way. In the future I'll try to rein it in better and come up with a different way to lasso an audience...
And for anyone who doesn't know, Andy is referring to the horse named Trigger belonging to Roy Rogers. If you want a picture, click here.
Missed you Kent, I been away too long!

I have to admit there is so much smoke and mirrors in this bill that I am beginning to wonder if the bill itself is still visable. The trigger clause is a good example. I can't understand why it is needed. Just make healthcare for us all, kick out the healthcare industry, and make it like public education.
Good thought provoking piece, and I expect no less from you my friend.
My main concern about the trigger is the question of where the gun is pointing . . . .
Ok Kent, you have now redeemed yourself. I hated Roy but loved Dale Evans. Trigger was the best actor among them. No matter what one's opinion of the show, you have to admit Dale had some good pipes for "Happy Trails."
Thanks for the links and the multiple references to cowboy westerns, the greatest era in television history, now lost forever to shows like Dancing With the Morons.
Mission, I don't think the trigger clause is needed. I think it is a cynical ploy by people who, unable to defeat the legislation, would rather postpone what they see as its dire effects for as long as possible (both to not bear the cost while it's postponed and to allow themselves more time to figure out how to make it never happen).

What I really don't understand is why the people suggesting this are not laughed out of the room. We can disagree on many things, but it should be accepted as objective fact that there is some health care problem to be solved. Politicians didn't turn to this admidst a zillion other things because they had nothing better to do. And if that's so, the idea that we should wait and see seems nonsensical. It's like going to the Katrina victims and saying, “Your need is not clearly demonstrated. Why don't we just agree to wait ten years and then if it's really clear that you haven't gotten by on your own, we'll talk.” It neglects the so-called elephant in the room which is “why are we having this conversation in the first place?” Need is demonstrated or there would not be a desperate public outcry.

What's actually happening is that our representatives, people whose health care is not presently failing, are having Jedi mind tricks played on them and being caused to doubt whether the problem all around them is really happening. And the mind tricks are succeeding. I don't know if that suggests they're weak-minded or that the mind tricks are very strong. But either way, we need to get past that.
Pilgrim, the gun is already pointed at ourselves in a game of Russian roulette. The word “trigger” seems a misnomer. It's more like a suggestion that we not engage the safety for a game already in progress.
I so agree with you Kent. I so much agree here and I thank you.
Kent,
Thank you so much for this piece. I love the way you rationally approach subjects and probe the areas of weakness with questions and reasoned responses.

I am not in favor of giving Insurance companies a chance to “fix” things on their own. I feel that’s tantamount to giving a thief time to tidy up the house after he’s plundered you to bankruptcy so he can say, “See? I was pretty considerate after all.”

No to the Trigger. Yes to a Robust Public Option. No to “affordable insurance.” Yes to major sweeping affordable health care reform.

Rated and appreciated.
Dennis, good analogy. It really is just like that.
I'm in agreement with Ablonde. Third party payers (government included) are the reason health care is so expensive! They shouldn't be given a chance to "fix things"...they are the problem!

The only REAL solution is to eliminate third party payers entirely and run an actual free-market (this already happens to some degree with plastic surgery and contact lenses at Walmart). Of course, that will NEVER happen because insurance companies and Big Pharma and Doctors have to cash their big checks!

So, for that reason, I am in agreement with Dennis Knight...the best we can hope for is a robust Public Option. But giving third parties a chance to correct this problem? Wow.

Rated.
David, I just don't think a free market system for health insurance could work, at least not without more regulation than the health insurance industry seems to want to bear. (Heck, they think it's an unreasonable imposition to be subject even to antitrust legislation!) So, yeah, we come from apparently different points of view on this and yet arrive at the same place: a robust public option. And I think the fact that so much energy from the health insurance industries is going into keeping it from happening is probably evidence that the suggestion is on the right track.