The public option in the proposed overhaul of the nation's healthcare system was considered a poison pill that would kill serious reform. Now a hybrid proposal has surfaced that merits attention.

There's good reason to support it -- no significant reform can be accomplished without some version of a public option.

The measure that Speaker Nancy Pelosi and House Democratic leaders unveiled last week will not please the most ardent advocates of a ``Medicare for all'' single-payer system. It offers a milder version that would let states opt out. Instead of linking payment rates to those set by Medicare, it would negotiate those rates with health providers and pharmaceutical companies.

That would still offer consumers a far better deal than what the system offers today.

48 million uninsured

Private insurers don't make a profit by insuring people likely to need coverage -- it makes no business sense -- so another path for coverage must be provided for those who are most in need. That's why a public option is needed.

According to the Congressional Budget Office, some 96 percent of legal residents who are not covered already by Medicare or Medicaid would get health insurance under the House proposal. That's not literally universal coverage, but it's better than having 16 percent -- about 48 million Americans -- without coverage as we do now.

It's encouraging that Democratic Sen. Bill Nelson, who was once not enthusiastic about a public option, now says he will support a version that Majority Leader Harry Reid plans to bring to the floor. ``I've told him I'd prefer not letting states and insurers be able to opt out in the very beginning,'' he added. ``You need time for the plan to work.''

Engage moderates

Either way, it's a step in the right direction. Mr. Nelson, a veteran lawmaker who served as Florida's insurance commissioner, has an opportunity to bring more moderates to the reform table.

Opponents say the costs of the proposals would bankrupt the country. Proponents point to estimates that it would reduce the deficit by $100 billion over a decade. More likely, the supposed savings are fanciful -- projecting costs 10 years out is an educated guess, at best.

But it is fundamentally dishonest to rail about the cost of reform without taking into account how much the failure to make substantial change has cost the nation already. The $5,800 individual cost of employer-provided family health insurance in 1999 has risen to $13,375 today. That's several times greater than the rise of inflation. By 2020 -- if projections are right -- they'll increase to $24,000.

The public option is designed to address this problem, along with other glaring flaws in the current system like the inability to obtain coverage for pre-existing conditions. It would also offer more choices.

No doubt the coming debates on the floor of the House and Senate will feature a lot of buzzwords designed to scare the public -- socialization, government takeover, rationing. Don't be misled.

The U.S. healthcare system is overdue for reform.

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