As the Senate plunged Monday into a colossal debate on health care reform, a key question is blaring louder than ever: whether national proposals would do much to control health care costs.

At the heart of a health system overhaul is adding some 47 million uninsured Americans to the rolls of the insured — a major feat to accomplish without adding to the national deficit.

Requiring nearly everyone to buy insurance — pushing Americans toward preventive care at doctors' offices instead of more expensive care at emergency rooms — would cut costs long term, some argue. But whether there is much else in the national legislation to rein in the soaring cost of medical treatment is a major point of contention.

"There is almost nothing in the bill that would help to contain costs," said Devon Herrick, senior health economist for the free-market National Center for Policy Analysis in Dallas.

On the other side, reform advocates argue there is lots — and insist the "cost of doing nothing" is out of control. The average Colorado family spends an extra $1,100 per year in premiums to chip in for the health care of fellow state residents without insurance, according to the Center for American Progress. And by 2016, an estimated 40 percent of a Colorado family's income will go toward health coverage, according to SEIU service employees union data.

Here are five key reforms some argue would chip away at health care costs.

The Public Option

Advocates of a government-run health plan argue it would increase competition, forcing private insurance companies to lower their rates. A nationwide public option — as proposed in House legislation — would bring millions of people into the same risk pool, increasing efficiency and driving down costs, they say.

For many, a public option gets to the center of the reform debate by providing coverage to the uninsured, who often seek medical care at emergency rooms. Hospitals pass on the cost of treating the uninsured to private insurance companies, which tack it onto premiums.

Many of those opposed to a public option advocate instead for allowing people to shop for insurance across state lines, not limiting them to the handful of companies that do business in their state.

"The notion that a public option would control costs is laughable," said Jeff Crank, state director for Americans for Prosperity. "What would control costs is actual competition in health care."

Besides, critics of a public option argue, government bureaucracy is hardly the model of efficiency. Otherwise, Medicare would have held down the cost of private insurance.

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