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Was single payer ever on the table? The difference between the public (government run option) and Co-op is the management control. Public is completely under government control, co-op is managed by a non-government NPO that is held under federal regulation, garners subsidies instead of interoffice funding. It will function in the same manner as the public option except for its structure which isn't really a big deal either way, so it isn't a huge change if this is what is going on.