WASHINGTON — Senate Democrats debating how to overhaul America's healthcare system are moving toward a showdown over whether to create a government-run insurance program or set up a system of cooperatives instead.
A government plan, an idea President Obama endorses, is a centerpiece of the legislation being developed by Sen. Edward M. Kennedy (D-Mass.) and fellow liberals. Many Democrats have indicated they would settle for nothing less, arguing that only a federal plan can compete effectively and offer a real alternative to the private insurers that many blame for denying people coverage and driving up costs.
But a bipartisan group of centrists on the Senate Finance Committee is leaning toward cooperatives, saying that alternative could offer customers more choice without enlarging the government's role in the healthcare market -- something many Republicans fear.
Generally, cooperatives are owned by their members, are structured as nonprofits and either offer a system of healthcare providers or contract out for their members' medical services.
Seeking consensus
The bipartisan group, led by finance committee Chairman Sen. Max Baucus (D-Mont.), is planning to present its proposed bill by the end of next week, before the August congressional recess. Senate leaders plan to merge the proposals from Baucus' panel and Kennedy's health committee and bring a bill to the Senate floor for debate in the fall.
Baucus and others in his group, including Sens. Charles E. Grassley (R-Iowa) and Kent Conrad (D-N.D.), have argued that their healthcare plan offers the only hope for achieving the kind of consensus that could prevent a GOP-led filibuster.
"Every single Republican is opposed to a public plan," Conrad said in a recent interview. "If one just does the numbers, it's very clear to get the votes, you've got to find some compromise here."
Conrad is the leading champion of insurance co-ops, which he has said would be controlled by consumers rather than the government or profit-driven companies that have to answer to their shareholders.
Under his proposal, the federal government would provide "seed money" to help set up the cooperatives, but would require them to sustain themselves with the premiums they charge customers.
Current models
Though once much more popular, several insurance cooperatives exist nationwide in various forms.
