Consider your local farmers' market -- that collection of licensed vendors who offer fresh fruit and vegetables, unprocessed meats, baked goods and flowers for sale to the public. If you're like me, it's one of your favorite places to shop. So what would you say: Is this something liberals dreamed up or should conservatives get the credit?

Silly question? Then why -- when the subject is health-care reform -- do we apply such terms to the proposal that we establish an insurance exchange? It is no more a liberal (or conservative) idea than a farmers' market.

An exchange isn't a new idea, nor one that belongs to any political point of view. It's simply a venue that brings together sellers who offer health plans and buyers interested in purchasing coverage. To win the right to compete for customers, sellers would agree to meet certain quality standards. By showing up, prospective buyers get the benefit of transparency and clear information about competitive products, prices and vendors.

So why are we talking about it now? Because small employers, the self-employed and the uninsured have a terrible time finding affordable coverage.

Yes, large organizations also are stressed by rising insurance costs but the problem is most acute among those lacking volume-based bargaining power. Small businesses pay 18 percent more than large companies for comparable coverage, according to a Commonwealth Fund study. Many individuals who have chronic conditions are priced out of the market entirely.

If we want everyone to have quality coverage at an affordable price, then we need to create a way for individuals and small employers to combine their buying power and benefit from volume purchasing. That is one thing an insurance exchange is set up to do.

At the farmers' market where I shop, some customers use public funds to subsidize a part of the cost of their food purchases. Others use only private funds. In either case, sales are between private parties; the government isn't directly involved.

For the most part, that's how it would work in an insurance exchange. Private insurance companies would sell their wares; small employers, the self-employed and the uninsured would be shopping for coverage, in some cases using public subsidies to lower their premium costs.

In town hall meetings I attended this past summer, two of the most frequently voiced sentiments from critics of President Barack Obama's health-reform proposals were 1) we want access to a health plan like members of Congress have, and 2) we want insurance companies to be allowed to sell across state lines so there is more competition and lower premiums. Both of these concerns could be addressed by an exchange.

Members of Congress currently buy coverage through an exchange known as the Federal Employees Health Benefits Program, which offers a wide range of insurance plans. Current legislative proposals to establish a national insurance exchange are modeled after that program.

And an exchange could make it easier for insurers to enter the market and compete in larger regions of the country. This would create more choices for us as consumers and more price competition among insurers.

Yes, an insurance exchange involves some contested terrain where conservatives and liberals may diverge. Should the government be permitted to function as a seller in an exchange -- perhaps through a contracted vendor? How comprehensive should a health plan be in order to qualify for sale at an exchange? Do we want a national exchange, regional exchanges or an exchange in every state?

These are important issues, to be sure, and in a matter of weeks, Congress will face decisive votes about how to resolve them. The debate will intensify and our philosophical biases will engage.

But before that begins, let's pause and remember that we mostly agree on the need for everyone to have quality, affordable coverage. We mostly agree on the need for an insurance exchange to bring down the cost of coverage for small employers, the self-employed and the uninsured. That still leaves a lot to be decided, but it's a good start.

Cartoonist Rob Rogers does "Rob's Rough," an early look at his work and his creative process, exclusively at PG+, a members-only web site of the Pittsburgh Post-Gazette. Our introduction to PG+ gives you all the details.