In the absence of any discussion of single payer, a robust public option is the only significant reform that is on the table. It is also, coincidentally, the one part of the discussion that health insurance companies violently oppose (which is why they're still ostensibly playing ball with Obama). I've been doing the same Debbie Downer routine since Obama first settled on a date for dealing with health care: there is no way in Hell that he will pass a robust public option. It's not a criticism of the president's will or abilities; rather, it's an appraisal of the forces allied against him.
Let's face it, kids: not even Johnson got health care for all.
Nevertheless, I imagine the Democrats will insist on passing something, so what we'll almost certainly see is a health bill sans the public option, or perhaps with a public option so weak and disfigured that it could never compete with private insurance. What I think we're also very likely to see is a mandate for purchasing health insurance, with an accompanying tax break if there is no public option.
In other words, taxpayer subsidized profits for Cigna and Blue Cross, and a new captive market, to boot. I hope you like your insurance company, because most of you will be paying them twice.
On the other hand, there may be some around-the-edges improvements buried in the bill, money for better record-keeping and such. It won't be much, though.
The question I hope some people are preparing to deal with is what to do when the only two options left are 1) passing a bill that tells people health care is "fixed" when it isn't even improved in any substantial way (and further empowers the enemies of health care reform, at that), and 2) passing nothing.