This letter is complete and utter bullshit. The blue dogs give a number of reasons for opposing the public option or lists of things that have to be in the final legislation before they sign on.  These things are not only (1) impossible, and (2) unnecessary, they (3) guarantee that these legislators do not want to see this legislation passed.   The "wish list" is as follows: 

• 1.  Deficit neutrality.  Seriously?  Do any of these fucking retards know what an externality is?  Further, as we all know, that will be impossible.  The point of reforming health care and the public option is that it will be cheaper for the country -overall- to have government involvement in the health-care market because it's dysfunctional.  That will cost money, and it will add to our deficits.  The policy call is that the country as a whole is better off with a public health-care option than without it.  
• 2.  Delivery system reform.  To the extent that this paragraph is not opaque, it's nonsensical. Stating that we can't "add consumers to a broken system is the bloody problem in the first place."  Thus the public plan--voila, new system.  And I have no idea what "value-based purchasing" means in the health care market, but when your kid needs stitches, you don't comparison shop.  If it means letting the gov negotiate with Pharma over drug prices, then yes, that should be in there.  But somehow I don't think that that's what they're talking about.

• 3. Small business protections.  The letter cites "high and unstable costs" for small businesses.  Single payer would be the solution to that problem.  Again, I'm sure that that's not what they mean.  And again, if there is always a public option (which will be cheaper provided that these idiots don't get ahold of the draft), how will that not drive prices down?

• 4.  Rural health equity.  See public option, supra.  I have no idea what that means, but there is going to be some disparity between rural and city hospitals.  Getting primary care doctors to those areas is a different problem, and one that costs money--another reason their first objection is so disingenuous.

• 5.  Bipartisanship. Seriously?  "Yes--let's solve the healthcare problem with one part failed ideology, and two parts batshit crazy.  We'll call it bipartisanship"  Ladies and gentlemen, your modern republican party.

Oh, man the ads write themselves.  "Congressman X has a gold-plated health plan.  Here's what he thinks you should have."