House Democrats on Wednesday dove into one of the thorniest issues remaining in the health care debate a public insurance option but emerged from a closed-door Caucus meeting without a clear signal of how they intend to handle it. Speaker Nancy Pelosi (D-Calif.) described lawmakers as going around the bend, though not yet in the stretch in their drive to overhaul health care. Democrats discussed at least three approaches to the provision, according to Rep. Bart Stupak (D-Mich.): Pegging reimbursement rates in the program to those in Medicare, allowing the federal government to negotiate rates with health care providers and authorizing the provision only as a fallback option. While tying the public insurance option to Medicare would save an estimated $85 billion over using negotiated rates, moderate Blue Dog Democrats have voiced strong opposition to that approach, arguing it would short-change already strapped hospitals in their districts. And they contend the approach is a nonstarter in the Senate, meaning a push by liberals to include it in the House bill amounts to an attempt to gain leverage heading into conference negotiations at the expense of vulnerable House Democrats. I have talked to many members of the Blue Dog Coalition and those outside the coalition that feel very strongly that our leadership in respective chambers and the White House need to come together to find out whats possible, Blue Dog Co-Chairwoman Rep. Stephanie Herseth Sandlin (D-S.D.) said after the Caucus meeting. And this idea of trying to get bargaining position really falls on deaf ears for a lot of us because this is about whats doable in both chambers, not about getting bargaining position in a conference.She called the huddle one of the lesser productive caucuses Ive been to, pointing to other major issues of concern to her group that have not been resolved, including regional disparities, the overall cost of the bill and holding down health care costs long-term.