Five Democrats joined all Republicans on the Senate Finance Committee on Tuesday in defeating one version of a public option, or government-run insurance.

Sen. Jay Rockefeller, D-WV, sponsored an amendment that would have created a plan, run by the federal government, modeled on Medicare.   But too many of his Democratic colleagues voiced concern that low level reimbursement rates in some states, though they would be in effect for only two years, could bankrupt hospitals that don't get much from the federal government.

Democrats also voiced varying levels of concern that doctors, for two years, would be required to offer a public option if they want to continue to serve Medicare beneficiaries, a point that came courtesy of committee Republican John Ensign of Nevada.

It appeared that Democrats were fighting mostly amongst themselves.  Republicans, who have dominated the discussion on other days, did not speak nearly as much on Tuesday.  

By and large, GOP committee members hewed to an oft-repeated position that expert studies predict an end to competition, with a plan like Rockefeller's crushing the private market.

Rockefeller, a former VISTA volunteer fighting for affordable healthcare for uninsured children in his early career, made a passionate case to his colleagues, before the defeat, trying to turn the Republican argument on its head.

"Public option is on the march and if you want the single payer system or government-controlled health care system, do exactly what my GOP colleagues say...do nothing," Rockefeller charged, adding, "It's a moral decision. It's an ethical decision...It's a human decision...It's writ large in our legacies."

Sen. Kent Conrad, D-ND, author of a competing plan that would set up a system of nonprofit cooperatives (a plan that Baucus included in his draft legislation), said of the Rockefeller plan, "The devil is in the details," saying that his state would be adversely impacted, hobbling hospitals that receive among the lowest level of Medicare reimbursement in the nation.

The five Democrats who helped defeat the Rockefeller measure:  Max Baucus, D-MT, Kent Conrad, D-ND, Bill Nelson, D-FL, Tom Carper, D-DE, and Blanche Lincoln, D-AR.

Finance Committee Chairman Max Baucus, D-MT, appeared pained at having to oppose the Rockefeller amendment, and tried to explain his 'no' vote, on a day when liberal groups hit him with negative ads for his opposition.

 

" There is a lot to like in public option. I included public option in a white paper I released earlier this year...But my first job is to get this bill across the finish line," Baucus said, repeating a line he has voiced for months that there are n0t 60 votes in the Senate to defeat a filibuster against public option.

 "There is a lot in this bill that will control costs. There is a lot in this bill that will expand coverage...Those things have to be my priority," Baucus, a moderate Democrat, reminded his colleagues, adding, "Rome wasnt built in a day."