Allyson Schwartz

is a Democratic congresswoman from Pennsylvania, vice chair of the House Budget Committee and member of the Ways and Means Committee

Health-care reform is the number-one issue my constituents raise with me, and a leading concern of business owners. For Democrats in Congress, health-care reform is a moral and an economic imperative.

American families are facing inadequate health coverage, mounting bills, and lack of access to care. They like their doctors and appreciate the quality of care provided by their hospitals. But, they have deep worries that their current coverage may change suddenly and limit access to their doctor or to needed benefits.

Business owners are struggling to pay for health benefits for their workers, forcing them to pass greater costs to employees or drop coverage.

Increasing costs for the federal government are neither sustainable, nor producing the health outcomes they should. Taxpayers pay 46 percent of our nation's $2.5 trillion health-care costs. And, just as in the private market, costs are skyrocketing. The share of our GDP devoted to health-care spending has doubled in the last 20 years, threatening our budget stability.

The status quo is unacceptable and unsustainable. We must do a better job to contain costs for families, businesses, and the government, and to ensure meaningful, affordable coverage for all Americans.

Can we? I believe we can by keeping what works, fixing what doesn't, and demanding quality care and greater value for our dollar.

In the first three months of this new administration, we did more to strengthen health care than in the prior decade. We expanded affordable health coverage to 11 million American children, took major steps to modernize medicine through health-information technology, invested significantly in lifesaving medical research, and ensured that U.S. workers and their families hurt hardest by this recession continue to have access to health coverage when they lose a job.

Building on these achievements, we can find a uniquely American solution to cost, coverage, and quality. This is essential if our businesses are to be economically competitive, our people healthier, and our federal budget balanced.

Here's what we should do:

First and foremost, we start with the acknowledgment that health care is a shared responsibility. Every American will be expected to get health coverage and employers will have to provide coverage or help pay to cover the cost of the uninsured.

As President Obama has said, if you have coverage, and you like it, you can keep it. This means work-based coverage for most Americans, Medicare for seniors, Medicaid for our poorest and sickest, and continued benefits for veterans.

For the nearly 50 million uninsured Americans, many of whom are working families, we will help you buy either private or public coverage. While everyone will have to pay part of their premiums, partial subsidies on a sliding scale will be established and can be used to buy either private or public insurance.

To ensure affordable, meaningful coverage, we will change the ground rules in the insurance market. Denying coverage or charging more for preexisting conditions, health status, or sex is going to stop. Insurers will have to simplify terms and procedures. And, we expect insurers to pass those savings along to their consumers.

Next, we know that in order to control costs and improve health-care outcomes, delivery of health services must be more efficient, more accountable, and better coordinated. Changes in Medicare and the new public-insurance option will create choices for patients to find primary-care providers and will mean better continuity of care for those with chronic diseases. We will gather, analyze, and disseminate information on best practices to doctors, nurses, and health providers, and then expect them to use it. And, we must have a renewed focus on primary care, encouraging future health-care providers to enter the field and working to ensure their excellence.

Third, we have to strengthen our commitment to innovation and technology. Americans have always been scientists and innovators, and we must keep investing in the next generation of medicines, technologies, devices, and cures.

Finally, without increased personal responsibility, Americans will not be healthier. We must take greater responsibility in the way we get health care and the way we take care of ourselves. If we don't, we all pay the consequences - from lost productivity, to the cost of expensive care, to personal pain and suffering.

Setting our nation toward a healthier, more economically competitive future will take fair and responsible financial investment. We are committed to covering the cost of health reform. To do so, we will consider means that are appropriate, fair, shared, and the least disruptive to economic growth and financial security for our families. The president has asked that those making under $250,000 not be burdened by higher taxes. These are the parameters; the decisions will be difficult, but ones that you have entrusted to us.

Much of the cost of health-care reform will come from savings within the system. Reducing hospitalizations, duplicative testing, and medical errors, ending the current overpayments to private insurance companies that contract with Medicare, and insisting on better prices for prescription drugs for seniors will result in hundreds of billions of dollars of savings.

Besides the significant dollars that will come from savings and new premiums paid by those currently uninsured, stakeholders in health care, including insurance companies, hospitals, doctors, pharmaceutical companies, medical-device manufacturers, have committed to reducing costs by $2 trillion over 10 years. These savings should be passed along to consumers.

There will always be naysayers who say these decisions are too hard, that health-care reform cannot be done, but I believe that today even "Harry and Louise," who helped stop reform before, would tell us reform is a necessity. If our businesses are to be economically competitive, our families healthier, and our government fiscally sound, we must find a uniquely American solution to our health-care challenges.

The time to act is now.

E-mail Allyson Schwartz at www.Schwartz.house.gov.