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The public option is gone. Expansion of Medicare is no more, but an intense fight continues over a crucial issue in the proposed health care overhaul. Called exchanges inn the federal health bills and modeled on the Massachusetts Health Connector, they would enable people to compare and purchase insurance as easily as they shop for airline ticket at an all-in-one travel website. The concept of such comparison shopping is generally supported by insurance firms, but exchanges are also controversial because Democrats in Congress want to use them to impose greater oversight and cost controls on insurance companies, requiting them to provide certain levels of coverage at lower profit margins. The debate over the exchanges is more urgent now that the senate has purged a government insurance plan from the bill and killed the idea of expanding Medicare eligibility. If the senate approves its health care bill, how the exchange will work in the historic insurance coverage expansion will be a central element of negotiations to meld the House and senate bills next month. Insurance companies want fewer hard rules in the exchanges, contending that greater restrictions will reduce the number of providers willing to participate in the program and limit consumer choice.