Health Reform May Hinge on Public Plan Option

In the Senate, an approach getting a lot of attention is to create not a public plan but rather a federally chartered, nonprofit cooperative plan, Ms. Stoll said. This proposal is seen by many as a compromise between a government-run plan and no public plan at all.

Overall, the discussion on a public plan is heading in a direction that is positive for physicians, said Elizabeth Carpenter, associate policy director for the Health Policy Program at the New America Foundation, a nonpartisan think tank.

At the beginning of discussions on health care reform, the thinking was that a public plan would use Medicare rates in paying physicians and other providers. Now that idea seems to be losing support, Ms. Carpenter said. Instead, in those cases where reform proposals are referencing Medicare rates, those rates are intended only as a starting point, she said.