Why we're breaking with the Blue Dogs on the public option (Rep. Jane Harman and Rep. Loretta Sanchez)

Throughout the congressional health care debate, considerable attention has focused on the Blue Dog Coalition - a group of House Democrats committed to fiscal responsibility and budget discipline.

We're Blue Dogs, too, and we believe in the group's core principles. But we've broken with our Blue Dog sisters and brothers over their lukewarm support for the public insurance option a concept we think must be part of a successful health care reform package.

Far from being an option of last resort or a government-funded takeover of the country's health care system, we see the public option as a critical market mechanism that will drive down costs, foster competition and expand Americans' insurance choices.

This is not just smart health care policy, it is smart economic policy.

A Gallup-Healthways survey has identified more than 290,000 uninsured people in our congressional districts alone. This is astonishing, and, according to the Centers for Medicare and Medicaid Services, their medical care cost local hospitals and other health care providers $65 million last year.

How can providers stay afloat in the face of such expenditures? By charging people who have insurance more. A recent study by the Center for American Progress found that more than 10 percent of the average Californian's premiums, approximately $500 each year, goes to covering the cost of caring for the uninsured.

Expanding coverage will greatly reduce the costs of uncompensated care and alleviate a major drag on the state and national economies. A public option is necessary to reach that goal.

If private insurers were already providing affordable coverage, there would be no need for this debate. But they are not. In fact, the profit motive has routinely trumped a customer's health and well-being. They set premiums at artificially high rates to compensate for the costs of the uninsured, drop people from their plans when they become sick, or use fine print to deny expensive but medically necessary treatments.

We understand the fear of many insured Californians that health care reform will take away their current doctors and coverage. However, the grim reality is that many more insured people will lose their coverage without reform.

In August it happened to Rep. Harman's 27-year-old son, who was dropped from his insurance after suffering a torn eardrum.

He's not alone. According to a recent report by the Treasury Department, without health care reform, nearly half of all Americans under 65 will lose their coverage at some point over the next 10 years. Additionally, health care spending in the United States will go from $1 out of every $6 spent to $1 of every $5 in the next decade.

Ultimately, our country and our constituents can't afford to wait for health care reform. Doing nothing means Californians will pay twice as much in premiums and out-of-pocket costs in the coming years and insurance companies will still call the shots, denying care to people with pre-existing conditions and walking away from families that need coverage the most.

The Congressional Budget Office estimates that 97 percent of all Americans would have insurance coverage if legislation that includes a public option becomes law. If this benchmark is reached, in our districts, more than 250,000 additional people would be able to count on quality, affordable health care coverage. Whether people choose a private insurer or the public option, all could count on a guaranteed standard and comprehensive set of benefits to ensure access to quality, affordable health care.

The health care debate in Congress will continue through the end of the year. The recent Senate Finance Committee defeat of two amendments to include a public insurance option in its health care reform bill is a disappointing setback.

Nevertheless, we remain hopeful that at the end of its process, Congress will have succeeded in passing a fiscally responsible health care bill that includes a robust public option.

This is our best bet to ensure Californians have access to quality, affordable health care without burdening future generations.

Cross-posted from an Op-Ed in the Sacramento Bee.