It's not hard to understand why President Obama has made reforming the busted American health-care system a top priority. The United States has by far the most expensive health-care apparatus in the world, and yet it fails to care for 47 million Americans who lack health insurance. That alone should be enough of an indictment, but there's more: The high cost of individual health care (even for those with insurance) is one of the leading causes of personal bankruptcy in this country, and the high cost to businesses that provide health insurance is a drag on an already-struggling economy.

What to do? It's a question people in D.C. have been trying to answer for decades, and one they dramatically failed to answer in 1993 when the last Democratic president to try to overhaul health care, Bill Clinton, failed. Now, prodded by Obama, Congress is taking up the issue again, and all the usual interest groups—doctors, patients, malpractice lawyers, insurance companies, pharmaceutical manufacturers—are gearing up for a huge battle ahead of an expected vote on a reform package later this summer.

The biggest fight is going to be over the so-called public option, which is shorthand for the idea that a government-run health-insurance plan should be created as a way of expanding coverage to more Americans, increasing the competition faced by private health-insurance providers, and ultimately lowering costs to consumers and businesses. For conservatives, this is the dreaded "socialized medicine," but for most Democrats—and for many familiar with the way most other industrialized nations do health care (hint: It involves even greater government intervention than the proposed public option)—this is a no-brainer.

"There is going to be a public option," liberal Seattle congressman Jim McDermott told The Stranger on June 16, speaking by cell phone as he headed into a D.C. meeting on health-care reform. It's easy for him to say, since he casts his votes in the House of Representatives, which Democrats control by a wide margin. Over in the Senate, where Democrats don't quite have the 60-vote majority needed to easily pass legislation, things get a bit more tricky.

Washington's two Democratic senators, Maria Cantwell and Patty Murray, both sit on committees that are currently drafting their chamber's health-care proposals, and both favor a public option—though with varying degrees of rhetorical force. Murray spokesperson Alex Glass said her boss "is in favor of a strong public option." Cantwell spokesperson Ciaran Clayton said her boss is "looking at all the proposals for the public option, but she wants to make sure any proposal allows for competition."

Perhaps most important: Neither Cantwell, Murray, nor McDermott voiced opposition to Democrats using a controversial maneuver known as reconciliation to ram through a public option if they can't get 60 votes in favor of it in the Senate. "It would be better if we can move forward with some consensus on this," Glass, Murray's spokesperson, said. "If we can't, reconciliation remains an option."