It seems that you can't open a newspaper, turn on a television, or stop by the office water cooler without reading, hearing, or talking about the health care crisis facing our nation. Individuals, families, and employers alike are struggling to deal with this threatening problem that's getting worse, not better. New census figures show 45 million people are uninsured, and it's largely because of a decline in coverage by employer-sponsored health care plans.

In Illinois, the affordability and availability of health care have reached a breaking point. Physicians are fleeing the state in worrisome numbers, in large part because the cost of medical malpractice insurance in Illinois has become prohibitively expensive for many. The cost of practicing medicine in Illinois and the state's reputation for being politically unresponsive to the economics of medicine have become factors in the recruitment of new and replacement physicians.

Likewise, employers and unions are struggling to manage through five consecutive years of double-digit increases in their health insurance premiums without comparable growth in income, wages, or profits. As a consequence, employers and patients are rapidly losing access to care.

All of this is occurring while our state lawmakers haggle and stall over politically charged details of proposed legislation. Gov. Blagojevich's decision to champion a drug importation plan not only missed the mark, but it was a distraction. His headline-grabbing initiative generated national media but is inconsequential to the pressing issue of doctor flight.

To achieve significant impact on the current health care problems, our lawmakers must take action to control many factors that contribute to the overall cost and quality of health care in Illinois. And they must do it now.

For starters, medical liability insurance premiums are excessively high in Illinois, especially when compared to neighboring states. Some insurance companies have chosen to exit the Illinois market due to the volatility of pricing and court judgments. This must change, and there are a number of effective solutions to pursue.

Like other states with similar experiences, Illinois must cap the non-economic damage court awards. We can't expect to stabilize liability insurance premiums paid by medical providers without greater confidence in reasonableness and predictability in the courtroom. Patients who are wronged should be restricted to filing cases in the county where the alleged malpractice occurred, and the standards for determining an expert witness should be raised.

Hospitals, doctors, and other care givers must implement quality controls, adopt reporting requirements, and be held accountable for quality standards. Patients, employers, and insurers deserve access to such important consumer-focused information. Aggressive discipline procedures must be incorporated in the licensing process so the small percentage of doctors who have proven records of negligence will experience swift revocation and have full disclosure of their performance history available to both the public and potential employers. Information and accountability will help discipline the system.

Lawmakers also must pass the Health Care Choice bill sponsored by the Illinois Chamber, which would allow employers much more flexibility on the health plans they offer employees. Perennial double-digit increases in health care insurance premiums are taking a serious toll on employers and employees. This positive initiative, designed to assure that employers and their employees have access to affordable health care insurance, successfully passed the House of Representatives this spring but awaits a vote in the Senate. Similar legislation adopted last year in Texas has proven to be attractive to the previously uninsured population.

Finally, we must continue to make it obvious that each one of us must assume greater responsibility for our own health. A public-private partnership that promotes healthy lifestyles for Illinois citizens, encourages preventive care, and makes employers aware of new and innovative approaches-such as the new federal law authorizing Health Savings Accounts that took affect this year-could have lasting benefits.

The governor's recent decision to appoint former Judge Donald O'Connell as a special mediator is an encouraging sign that the administration is attentive to the issue at hand. We hope so, because the wellbeing of our state and its residents depends upon adopting aggressive reforms without further delay. IBI