I think what it really means if you think about it is this ...
Private health insurance companies cannot compete with the government who can afford to lose billions of dollars for years without end ... So, in fact, if there is a public option and a private option, the private option is dead in just a few short years, if any single piece of legislation makes it through that provides government health care, then we are all on it a few short years, and from all appearances, the bills they are pushing through now will do just that.
Yes. The current plan is expected to take effect in 2013 — it begins AFTER the next presidential election. Then it does its magic for 4 years, likely without interruption. Perhaps by 2016 people will wish that government didn’t control so much of healthcare, but by then so many private insurers will have been driven out of business, that there will be no going back.