WASHINGTON -- A commission working to secure Medicare's future spent hours debating everything from economic assumptions to justice for the poorest Americans. But at the end of the day, members seemed to be reaching agreement on at least one fundamental restructuring of the program.

The idea is to inject private companies more deeply into Medicare, allowing senior citizens to choose from an array of private health plans -- paying extra if they want more generous benefits."There's a significant amount of support for that concept," said Rep. Bill Thomas, R-Calif., the panel's administrative chairman.

With less than three months until the panel must report recommendations, it has made no final decisions about this approach. Many other options remain on the table.

Underscoring the difficulty of its work, even if the commission adopted every cost-cutting option it is considering, it would not be enough to pull the massive program out of the red in 2030, when Medicare will face its most intense financial pressures.

After months of testimony from experts, Wednesday's meeting was the commission's first opportunity to debate the various proposals.

Much of the debate revolved around creation of a new system modeled after health coverage for federal employees, which would give Medicare beneficiaries the opportunity to enroll in an array of health plans offered by private insurance companies.

Private companies would offer health plans for Medicare beneficiaries, with federal payments based on the average cost of plans. Beneficiaries who want to pick a plan that is more generous -- and therefore more expensive -- would pay most of the difference.

This idea has generally found support among Republicans who like its reliance on the private marketplace. Supporters argue that competition among many private companies will squeeze out savings that the government has been unable to realize on its own.

Still, some Democrats warned that crucial issues must be addressed before they would support this sort of restructuring.

Most importantly, they want to be sure that all of Medicare's 38 million beneficiaries are guaranteed certain basic benefits.

Sen. Jay Rockefeller, D-W.Va., said he is concerned there won't be enough choices available in rural areas. And if all the healthy senior citizens choose private plans, he asked, what will be left of the traditional Medicare system for those who remain?

"We have to protect people who have absolutely no margin for error," he said, noting that the average senior citizen in West Virginia has an annual income of less than $11,000.

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Part of the problem, he said, is he just doesn't trust the Republicans on the commission.

"The people who get the tax cuts are always people like me," said Rockefeller, whose family amassed one of the nation's most legendary fortunes. "What if that carries over into Medicare?"

At least 11 of the commission's 17 members must agree for any idea to become a formal recommendation.

The panel came to no consensus on an array of other issues, including adding prescription drug coverage and catastrophic coverage to the program; raising the eligibility age for the program to 67; and removing subsidies for graduate education and hospitals that serve poor people, forcing them to compete with other government spending.

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