The NYT reports there is a critical healthcare reform meeting at the White House today, in which the Administration will confer with key Senators debating whether reform will include a public health insurance option that consumers can freely choose in lieu of private insurance plans.

Digby reminds us that Congressional Progressives have been pushing strongly for a public health insurance option and need our support in arguing against the industry and centrists who seem perfectly willing to sabotage reform by putting off, perhaps forever, any meaningful public option. You can support the progressives’ efforts by calling members of the Congressional Progressive Caucus — the phone numbers are here.

The private insurance companies and Big Pharma have tried to kill the public option. And failing that, they’re arguing that a public option should only be considered at some future date, following a set of "triggers" that would, as Mike Lux predicts, be designed to effectively kill the concept. We’ve seen this before, in the Medicare Part D drug legislation, which allowed a public option for drug provision only if certain unlikely triggering events occurred.

Just to recap where we are on the continuum, the various views are:

0. Don’t allow any public insurance plan option — that’s the private insurance industry’s and Big Pharma’s preferred position, so they’ve been running ads disparaging the public option as akin the (misrepresented) evils of Canada’s single-payer system and railing against some imagined government interference in between you and your doctor. They’re backed strongly by most Republicans, who are closely following Republican strategist Frank Luntz’ deceptive talking points. More on Luntz here, here and here.

1. Allow a public insurance plan option only after some triggering event (e.g., the failure of the industry to meet its cost-reduction goals which it sort-of promised to Obama). That’s industry’s fallback position, and it’s supported by (apparently) Sen. Baucus and other centrists, and is being pushed by Sens. Grassley and Snowe. HuffPo’s Ryan Grim reports that Baucus’ aides recently got hammered at hometown meetings in Montana over his refusing to allow single-payer advocates from participating and for fronting for industry proposals.

2. If a public insurance plan option is allowed, hobble it: limit who can get access to it, how it’s financed, when/how it’s allowed to compete against private insurance plans. There are many possible variations of this, and one was proposed by Sen. Schumer last month. The rhetorical idea is, let’s have "fair competition" so that the private plans won’t be unduly disdvantaged by whatever administration cost advantages a public plan might have. Key limits would be forcing the public plan to survive on premiums with no access to federal funding (except possibly for startup funding?).

3. Allow a public insurance plan option that looks/works like Medicare, but is separate from Medicare; also broaden eligibility for more people to get Medicare directly. Sen. Kennedy’s Health, Education, Labor and Pensions Committee (HELP) has proposed a concept along these lines, and his Committee will have an alternative proposal to the one likely to emerge from Sen. Baucus/Grassley Finance Committee.

4. Make Medicare the public option and open it up to everyone who wants it, but not make it mandatory. (In all public insurance option plans, people could keep whatever they have now, but they could choose the public option if/when they lost their coverage or, in the most open proposals, at any time). Consumers would be free to choose public or private options.

[I should add:] 5. A full single-payer type approach, which has widespread public support. This might replace/restrict or exclude the choice of private options.

There are many possibilities within/between these alternatives, and this week, or next, the Senate will be moving towards some definition.

This isn’t the only major decision point; they still have to decide how to fund whatever they do. For example, the proposal to begin taxing the value of employer-provided benefits, at least for the wealthiest employees or most expensive plans, is on the table, even though Obama opposed McCain’s version of this during the campaign.

And reforms will/must also include other measures to control costs. On that point, this New Yorker article, The Cost Conundrum, by Atul Gawande is well worth reading.

Again, phone numbers for the Congressional Progressive Caucus members are here. Let them know what you think.

More from Sam Stein, quoting Schumer on the deception behind the trigger concept:

Senator Chuck Schumer has insisted that, if anything, "reasonable criteria for triggering a public plan has already been met."

"Premiums are high," the New York Democrat said, "and either one or two insurers dominate the market. As we’ve seen with Medicare part D, a trigger option has so far meant no public option at all."