You can almost see the political landscape shift these days. Once, back in the days after the election, we weren't even sure if the public health insurance option was on the table. Then, when President Obama and Congress reassured us, and now, we're arguing over whether it should be able to bargain for rates or not:

Nancy-Ann DeParle, director of the White House health reform office, said a public plan could be designed to address concerns about the federal government overreaching in its role.

"I'm very hopeful we'll be able to reach an agreement on that," DeParle said in a session with reporters at which she fielded repeated questions on the issue.

"If it's a policy disagreement, there are ways of bridging that gap," said DeParle.

For example, she said one compromise might be that the public plan pays hospitals and doctors rates similar to what private insurers pay. That would address fears that government would use its muscle to pay rock-bottom prices for medical services, allowing the public plan to charge discounted premiums that private insurers couldn't compete with.

Even if the government plan paid private-market rates to doctors and hospitals, it could still cut costs, DeParle said. A government plan wouldn't have to turn a profit, and could also save on administrative expenses.

Now, without getting into the policy argument over whether allowing the public health insurance option to bargain for rates is a good or bad thing (see Jacob Hacker for why it's a good thing), it's clear the ball is moving. We're no longer arguing over basic existential questions - the public plan will be part of the deal, the question now is just what kind of plan will it be.

This means that our pressure is working, and with more pressure, we can make sure we get a robust public health insurance option that competes strongly with private insurance to drive down prices and is a great guaranteed backup for people who for whatever reason need health insurance.