After a full year of debate, it's time to do something about health care reform. Everything, indeed, has been said, by just about everybody. Our present “system” is untenable. It is killing 45,000 people a year (because they have no insurance), driving those who survive into bankruptcy and sending our national deficit into the stratosphere. Is this really what Republicans want? The president has invited the opposing party to give their all, and their response has been little more than “No, no, no,” accompanied by talking points full of lies. Let's get a few things straight. We are the only industrialized, western society that doesn't have universal health care ' known here as the public option. Most medical professionals agree that the only way to have a healthier society (while, by the way, creating huge efficiencies) is by pooling risk in a national health care plan. Republicans say they are worried about the deficit ' as they should be, having driven it through the roof with billions lost to an insane Iraq war and the $1.8 trillion deficit created by their tax cuts for the very rich. But there's another kind of waste they should be concerned about ' the nearly 2,000 daily health care-related personal bankruptcies, the more than 25 percent that insurance companies spend on administration (including huge bonuses for their CEOs), as opposed to Medicare's 6 percent, not to mention the skyrocketing rate hikes private insurance companies are imposing yearly on their beleaguered customers (and the businesses that can no longer hire people because of the spiking costs of health insurance). In my youth, before I turned 65 three years ago, I was afflicted with crippling arthritis in my hip. I could hardly walk. Self-employed, I bought my own health insurance. The plan I could afford was Anthem's, which cost $389 a month and carried with it a $15,000 annual deductible. There was no way I could afford to get my hip fixed. I'd never imagined I'd be so thrilled to turn 65, but I was, because Medicare would make it possible for me to walk again. In 2009, our worst economic year since the Great Depression, our top five insurance companies, whose CEOs' salaries were in the multimillions, still managed to raise their profits by 56 percent. What are they doing with this excess money? Spending $1.4 million a day on lobbyists hellbent on defeating a health care reform bill that would help people and begin to bring this country into parity with the rest of the civilized world. So, why not Medicare for everybody? It is way more efficient than private insurance, and it's accountable to us, the people it serves. Rapacious private health insurance companies are, apparently, accountable to few others than their shareholders (who, in turn, subsidize their bonus-rich CEOs). It is an outrage that health insurance is such a hugely profit-making industry. Republicans' fearmongering talk of a “government takeover” of health care is nonsense. What we're talking about is the choice of a public option versus private insurers. Didn't Republicans used to want choice? Besides, government is already administering almost half of our health care, through Medicare and Medicaid, and is doing it far more efficiently than the private sector. But, we're told the public option is gone. The choice of a public option would have given us an opportunity to reduce the deficit, provide health insurance to the 47 million Americans who have none and make us a healthier nation. That was what the people wanted, but the insurance industry's money and power over our elected representatives had far more sway than we possibly could have. How very sad. The naysaying obstructionists have so poisoned the air that the bill that will now go to a reconciliation vote is less than it should be, but far, far better than nothing at all, and it can be a foundation for future improvements. Doing nothing would be catastrophic. Susan Goodwillie Stedman of Westport Island worked for the United Nations and Ford Foundation on international development issues and was the first executive director of Refugees International.