President Obama says he wants Americans to "have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest."

A public plan that would not have to turn a profit or pay taxes should be able to offer insurance that is more affordable than private plans. But neither the president nor the other Democrats who support the so-called "public option" have supplied many details.

However, that hasn't stopped the insurance industry and the American Medical Association, which represents doctors, from declaring war on the public option.

The insurers complain that a public option would run them out of business. According to this thinking, the United States soon would have government-sponsored, single-payer insurance, because everyone would flock to the government plan.

Critics of single-payer rant about "socialized medicine," but they rarely point out that the United States already has a single-payer plan for the elderly. It's called Medicare and it works pretty well. Including Medicare, Medicaid and the Children's Health Insurance Program, the government already pays about half of the nation's health care bills.

The AMA says it's against the idea that doctors who accept Medicare patients would be obliged to accept patients insured by the new government option. Because Medicare dictates what

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it will pay for services, the doctors fear government deciding what it would pay for other insureds as well.

However, we would ask the private insurers and the doctors how they propose to control costs without a public option.

Some Democrats have suggested the formation of private cooperatives, modeled on agricultural and utilities co-ops, as the public option. They could receive government funding but would not be government-run. Beyond that, there are few details about how they would work.

Obama and many congressional Democrats say they don't want a single-payer plan; they want to keep private insurance in the mix. They must explain, then, how the public option will not become the only option.

The Republicans, by contrast, together with the doctors and the for-profit insurance companies, must explain how reform without a public option would be anything more than putting a Band-Aid on a broken, discredited system whose unsustainable cost increases threaten to bankrupt the country.