"It's an obscure policy tool that isn't evenwritten," reported the news service TalkingPointsMemo.com, "Butsomehow, a 'trigger-mechanism' is the talk of Washington right now. How did thathappen?"
Such shock is widespread. Pundits, reporters andactivists are stunned that an abstruse scheme to halt reform has become a focalpoint of the health care debate. Yet, considering recent history, the onlysurprise is that Washington waited so long toagain force this legislative cyanide down America's throat.
Recall that over the last decade, a maverick groupof progressive and conservative lawmakers pushed bills to let Americanspurchase cheaper, FDA-approved prescription drugs from other industrializednations. It was (and is) a commonsense ideaother countries allow importation,and the practice helps lower health costs by permitting consumers to buymedicines at the lowest world market price, not just at an artificiallyinflated domestic premium.
As with today's public option surveys, polls onimportation showed strong national support for the concept. So rather thanmurder the drug legislation outright, congressional leaders joined the Clintonand Bush administrations in backing a "compromise": Importation billswere passed, but only those that gave the secretary of Health and HumanServices the power to triggeror not triggerinal implementation. Specifically,the secretary would have to first certify that imported medicines were"safe" (drug companies promote the lie that Canadian medicine ismortally dangerousprompting Republican Gov. Tim Pawlenty, an importationproponent, to ask, "Where are the dead Canadians"?).
This trigger provision, of course, was lobbyists'poison pilland it worked as they planned. Importation has never beenimplemented, as no HHS secretary has pulled the trigger. Hence, Americans arestill barred from wholesale importation of lower-priced medicineandpharmaceutical industry profiteering continues.
The TriggerGuarantees Reform Won't Happen
The moral of the story is that triggers are justanother version of the old Blue Ribbon Commission trick. They are designed notas good public policy, but as devious political tactics to help dishonestlawmakers look like they support popular measuresall while guaranteeing thosemeasures never become reality.
On importation, triggers gave corporatistpoliticians a way to seem like they were remaining true to their pro-consumerplatitudes and "free trade" dogma at the same time they werestrengthening an extreme form of anti-consumer protectionism for pharmaceuticalcompanies.
On health reform, a trigger will let those samelegislators look as if they support a public option that increases insurancecompetition, reduces costs and therefore delivers on promises to decrease thedeficit. But if/when the bill's final language is inevitably designed to makepulling any trigger impossible, it will preclude a public option from everexisting.
If there is any mystery about the triggersubterfuge, it is how anyone can wonder where the idea came from or why it issuddenly so prominent. After all, the same lawmakers and lobbyists who used itto kill importation are currently working to destroy health reform. As just oneexample, Rahm Emanuel, the White House chief of staff pushing a trigger, waspreviously one of the key congresspeople who portrayed sham importation billsas real progress (he was alsonot coincidentallya huge recipient of healthindustry cash).
"The past is never dead," wrote WilliamFaulkner. "It's not even past." As today's trigger proposal shows,that's particularly true when a "change" election preserves the samecorrupt forces, cynical tactics and bedeviled details.
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