Excerpt: The prospect of universal health care -- or in the shorter term, an expansion of children's health care and changes in Medicare and Medicaid purchasing -- will create new winners and losers. Democratic lawmakers have made it clear that payments to private insurers for Medicare plans are a big bull's eye in any health-care overhaul. Currently, private insurers receive more per beneficiary than the government would spend if it covered people directly. But insurers could benefit from a health-system overhaul. Aetna Inc.'s chief executive, Ron Williams, supports requiring people to buy health insurance. Some of Aetna's rivals oppose that position, but Mr. Williams says that without such a requirement, healthy people would opt out of the collective insurance risk pool and costs would spiral.

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