To the editor:

America is facing a health care crisis caused by a combination of skyrocketing costs and an insurance system that leaves 47 million of us without any coverage. The current health care system is endangering both our economy and our health, and voters have made it clear that they want change. According to a study reported in The New England Journal of Medicine, 70 percent of Americans surveyed believe the health care system needs major changes, if not a complete overhaul.

Health care reform legislation must guarantee quality, affordable health care to all U.S. residents. It is universal coverage that will determine the humanity of our system, and all Americans must have health care coverage, including the choice of a quality, affordable public insurance plan.

Congress needs to take additional strong action to reduce the costs of health care for individuals, businesses and communities. As a nation, we are spending $1 out of every $6 we earn on health care. Legislation must provide effective cost controls, equitable distribution of services and allow for efficient and economical delivery of care. Offering everyone the choice of a government-administered health insurance plan like Medicare that would compete with private health insurance plans will be key.

Achieving this kind of comprehensive, systemwide reform will take a shared effort by citizens and Congress. We urge our senators and representatives to support real health care reform.