In one of several town hall meetings held this weekend, President Obama appeared to retreat a bit from his stance on forcing a “public option” for insurance, saying it is "not the entirety of health care reform."

Separating the insurance public option from its larger health care reform package appeared to calm some but not all of the more vocal opponents of the bill, now in limbo during the Senate’s summer recess.

Discussion of the public option, a new government insurance program similar to Medicare, has been both the keystone to the president’s health care reform and a provocative element for anger and opposition across the country, chiefly at town hall meetings where opponents are acting in what some call an organized uprising.

Other statements made during the weekend by the president’s staff further confirmed the shift in messaging. In a follow-on statement, spokesman Robert Gibbs said the president could be "satisfied" without it. Health and Human Services Secretary Kathleen Sebelius told CNN's "State of the Union" that a public insurance plan is "not the essential element."

But the debate, and its messaging, continues. This morning, former Democratic Party Chairman Howard Dean, a doctor and one-time presidential candidate, told NBC's "Today Show" that he believes a public option "is the entirety of health care reform; it's not the entirety of insurance reform."

Dean’s messaging efforts are blanketing the airwaves, using the greater television press, his Web site, and even an iPhone/e-book application that promotes his health care reform book.

Calling semantics into play, some question whether health care reform can occur without a firm grasp on a public option for reimbursement for health care services.
Clarification will be a necessity for any legislation to pass through the Senate, notes Democratic Sen. Kent Conrad of North Dakota, one of six Senate Finance Committee members who have been trying to hammer out the first bipartisan compromise bill.  
Conrad, who suggested that a public option “won't make it through Congress,” suggests yet another option: The creation of nonprofit health insurance cooperatives that could negotiate coverage as a collective for their members.

Health cooperatives surfaced as a popular option during the Depression—fashioned after rural electric cooperatives that strung wires to underserved parts of the nation, but the vast majority of them eventually failed. Among those that did survive—and continue to thrive—was the Group Health Cooperative of Seattle. That cooperative, after 60 years of existence, has grown to about 500,000 members. The largest private insurer in America, Wellpoint, has about 34 million.

“It would take an awful lot of Group Health Cooperatives, all of them providing uniformly lower rates, to make big insurers like that pay attention,” noted Andy Green of the Baltimore Sun.

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