This June 2009 Commonwealth Fund report examines health care reform options and their implications. 

From the Commonwealth Fund:

A controversial part of the health reform debate is whether a new public insurance plan choice should be offered to the under-65 population. This report analyzes alternative paths to reform and presents estimates of impacts on health spending. The approaches include: 1) a public health plan paying providers at Medicare rates, offered alongside private plans in a national health insurance exchange; 2) a public plan paying providers at rates set midway between Medicare and private plan rates, offered alongside private plans in an insurance exchange; and 3) no public plan, with only private plans offered to employers and individuals through an insurance exchange. All three approaches, if combined with Medicare payment and system reform, would produce substantial savings over time, but option 1 would yield the most—$3.0 trillion in cumulative health system savings over 2010 to 2020, compared with $2.0 trillion (option 2) and $1.2 trillion (option 3).

Full Report: Alternative Paths to a High Performance U.S. Health System (PDF | 272 KB)   

The Commonwealth Fund. (2009). Fork in the road: Alternative paths to a high performance U.S. health system. Schoen, C., Davis, K., Guterman, S., and Stremikis, K.