it is kent conrad's model something that your colleagues are taking a look at, that even has any chance of passing the house? if not, i guess given that the senate is not looking at a medicare model for the public plan, how do the two changers' bridge -- how do the two chambers bridge your differences on that point? guest: i use medicare as an example because people familiar with it. i think the people that fear a public plan are afraid that it is going to be all paid for by the federal government, it is not going to make a profit, and the federal government is going to favor it in many ways as possible so that there is not a level playing field. what we have said and what i have said is that you have to create a level playing field. for example, the public plan has to rely on premiums of the people that are purchasing it, just like a private plan. it cannot be subsidized by the federal government. you know, basically you say that whether it is advertising, whether it is subsidization, whether it is -- whether certain doctors participate, all these things are made the same between the p

. >> you wrote about one element of the emerging plan that is kent conrad ' alternative to a system run by the government. how would that work? >> it remains to be seen exactly. the senate bridge -- there is supposed to be a bridge for the plan. instead of a public plan like a government run insurance co., is essentially what the public plan would be. he is offering to help create cooperatives that are similar to credit unions. they have some rules that make it a lot easier for customers to deal with and make it more price conscious. they do not have the same business pressures as private companies in terms of profit making. they are not government entities, and would be much more fair and how they competed with private insurance companies. that is what these medical cooperatives would be theoretically. some democrats were willing to take a look at that idea. they were trying to decide how the government would run the cooperatives themselves, which are causing republicans to say that is just like having a government-run private plan. even if you call it a cooperative. we are not interes

. >> you wrote about one element of the plan and that is senator kent conrad, what alternative to a system run by the government -- how would that work? >> it remains to be seen exactly, the senate budget chairman has tried to bridge the divide of the public plan and he has offered an idea that instead of a neighbor of a plan like a government-run insurance company, which is essentially what the public plan would be, he is offering to create or help create cooperatives that are similar to credit unions. they have some rules that make them a lot easier for customers to deal with that make them more price conscious, they don't have the same pressures, business pressures as private companies in terms of profit-making but by the same token they are not government entities and therefore would be much more fair in how they competed with private insurance companies of that is what these medical cooperatives would be theoretically although some democrats who are willing to take a look at that idea are trying to design them in such a way that the government would essentially run the cooperatives th

that is why i introduced comparative act research in 2008 as mark said along with my colleague kent conrad. he and i share a passion for this. we believe it is fundamental to transforming our health system from one that is volume-driven to one that is evidence-based. there are many, many other components of moving that direction but comparative effectiveness research is clearly a part of it. this year we plan to reintroduce the bill. we've been discussing it constantly with staffs and the committee and elsewhere. we're close to coming to an agreement and that's important because i intend to include my bill that is the comparative effectiveness bill in a comprehensive health reform bill that we'll mark up in the finance committee later this month. and that brings me to my last point. the need for comprehensive health reform. the finance committee has spent many hours, many days, weeks, months laying the groundwork. you have 12 hearings last year all day summit at the library of congress we held three round table discussions outlining options for reform. totally inclusive, totally bipartisan

this debate, should there be a government sponsored health plan, should go the route of something kent conrad of north dakota has talked about a co-op idea and again for a regional or state based and federal seed money and a lot operate and nonprofit level at that level. i think this is just a huge discussion point, did you have a government plan, do you need a government plan, would it be an unfair competitor or a fair competitor -- that is into the payment rates and all sorts of things and as people follow the debates they need to be reading and thinking about that. >> host: talk about one of the ways of paying by taxing employer health-care benefits. explain that. >> guest: right now you get health insurance from your employer and it is not taxed, and it is an expense for the employer so they don't have to pay taxes and you don't have to pay taxes as part of taxable income in the idea is that costs the federal treasury billions a year. so if they looked at the level a bit of those benefits and decided to tax at a certain level or decided to tax people of a certain income tax on the health