The "Public Option" is just an element of providing greater access to care. In concept, it is a government program similar in concept to Medicare/Medicaid.  Opponents of the process believe there are better alternatives to a new governmental program, such as adding mandatory/enhanced provisions to existing commercial plans, e.g. employer play or pay, individual mandates, financial subsidies for premiums, restrictions on underwriting and pre-existing conditions, all of which will be the subject of a later post.

Chief among the opponents of the public option are the existing third party players (collectively as an industry) who understandably would prefer to see the currently uninsured, specially the relatively healthy voluntarily uninsured, mandated or at least encouraged to buy health insurance. America’s Health Insurance Plans trade group has described the public option (which would essentially be a government run program competing with private insurers) as a plan "which would underpay doctors and hospitals, rather than drive real reform."

The original Baucus bill contained no public option, but it is now being considered by Senate Majority Leader, Harry Reid — and is being "renamed" "newly presented" as a consumer option. However, this revised public option includes consideration of a provision allowing states to "op-out," although there is little detail yet as to how those particular states’ citizens would be assured coverage. 

In the final analysis, America’s healthcare insurance system does not cover enough people and the current government funding (tax dollars and Social Security premiums) does not cover the cost. We clearly cannot pay for greater public coverage using the same financing. We must either increase taxes or find what the trade groups called "real reform," i.e. a delivery system that is designed to incentivize improved and more efficient care (no small task) which simultaneously improving/stabilizing reimbursement and managing taxpayer cost. Doing all of that seems impossible — so I wouldn’t expect that reform, regardless of the design, will cost less.