Modern Healthcare Illustration / Getty Images An effective public option that has lower premiums than private plans and saves consumers money would need to pay providers less, according to two analyses published this week, a fact that presents political challenges for a Congress that often fails to take on the healthcare industry. The public option would need to set provider rates—like Medicare does—and require provider participation, argues an analysis by Matthew Fiedler, a fellow in economic studies at the USC-Brookings Schaeffer Initiative for Health Policy. "The main way a public option could reduce premiums is by paying providers less," Fiedler said. "It's absolutely true that paying providers less is politically controversial but it's also unavailable if the goal is to spend less on healthcare."