No need to hesitate on health-care bill

It is time for the Congress to act on health care. Legislators should stiffen their spines and pass the bill. The legislation produced by Speaker Nancy Pelosi and the House leadership has many critics. Progressives are dismayed at its weak public option. Conservatives rail against paying for it with tax hikes for those earning over $500,000 a year. Many of us worry whether the health insurance that people are mandated to buy will be affordable for working families.

But the bill would represent a profound increase in security for Americans. Tens of millions of Americans who now live without health insurance would be insured. Millions more who have insurance would be protected from the predatory practices of insurance companies. We should keep our eyes on this prize. This bill would make America a more just and healthier country.

Amid all the brouhaha of tea- party protests, back-alley drug company deals and Republican obstruction, too many folks have lost track of what the bill does.

No longer could millions of Americans be excluded -- or gouged -- because they have a "pre-existing condition." No longer could insurance companies charge women more for the "pre-existing condition" of being born a woman. This is an immense change. It means that employees needn't be frozen into jobs for fear of losing their insurance.

The legislation would require insurance companies to sustain your coverage when you get sick. No longer could they invent reasons to discontinue coverage just when your bills go up.

The House bill would enable Medicare to negotiate lower prices for prescription drugs in bulk purchases. And it would erase the so-called "doughnut hole," where seniors with high drug costs suddenly find their coverage runs out. Our most vulnerable population will have far more coverage and pay lower prices for the drugs they need.

The legislation would ensure that preventive health costs -- the annual checkup, basic tests -- are covered in full. People would stop skipping preventive care because of cost, so conditions would get identified early when they are easier to treat. Lives will be saved. And we'll save money in the emergency rooms and operations that are required when early detection doesn't happen.

Many small businesses find it harder and harder to afford health care. In this bill, individuals and small businesses will be able to select policies from competitive "exchanges," enabling them to lower costs by pooling their numbers, and force insurance companies to compete. A public option will compete with private insurance companies in the exchange.

According to an academic study, "Get Sick, Get Out," by Dr. Christopher Robertson of Harvard and Dr. Michael Collins of the University of Wisconsin, a fact that runs counter to the national conversation is that medical bills are a major cause of home foreclosures. About half of all bankruptcies are due to medical bills -- and three-fourths of those who file were insured.

The real test is whether the policies are affordable. Forget about the projected 10-year costs of the program. The number that counts is whether the insurance is affordable to individuals and small businesses. Since the legislation requires people to have insurance, it must be affordable to individuals in monthly premiums.

And the second question is whether we can lower the unsustainable rise of health-care costs.

Here the legislation represents only a start. As soon as it passes, Congress will have to push harder on getting costs under control. Many of us will campaign for more progress toward single-payer health care -- say by putting everyone over 55 into Medicare and extending children's coverage to 25. But first Congress has to prove that it can overcome the opposition of the insurance lobby, the obstruction of the Republican opposition that wants Obama to fail and the timidity of blue dog Democrats and pass the most historic health-care reform since the passage of Medicare over 40 years ago. They've debated long enough. It is time to act.