Our $2.2 trillion health care system represents 16% of our economy. While polls consistently find that health care is a top national concern, many Americans are increasingly frustrated that nothing is being done. The truth is there are many changes taking place under the radar, and not all of them are good.

In fact, one could argue that there is a concerted attempt to quietly, but inexorably, move things further down the road toward a government controlled system. Despite where you stand on reform, doesn't an issue of this magnitude require an open and honest debate so that the American people can decide?

Consider the following: In the midst of an economic crisis, Congress just approved a significant expansion of the Children's Health Insurance Program. No one objects to helping poor families find health care coverage for their children, but should we be expanding this program to include middle class families making up to $66,150 annually, many of whom already have private health coverage? And should we be doing this when we haven't enrolled all eligible poor children?

At the time of this writing, the details of the compromise stimulus bill remain unclear, but we do know that some members of Congress made a concerted effort to grow government's role in health care. There was an attempt to expand eligibility for both Medicaid and COBRA benefits, which would have imposed new costs on taxpayers and new burdens on businesses. Even if these new mandates fall short, there will still be an influx of new money into both initiatives.

It is troublesome that some of these provisions, which will have a far-reaching impact, were not the result of open dialogue. The public is also in the dark about one of the best-kept secrets in the country—the positive, affordable, proactive steps we can take right now to lower costs and improve care without resorting to a government-run program.

For example, implementing a national health care IT system is a step in the right direction. We should also emphasize wellness and chronic disease prevention; implement pay for performance standards that take medical providers to task for avoidable errors; and increase transparency about the price and quality of medical coverage and services, which would reintroduce positive market forces in health care.

The bottom line is that health care reform is serious business. With so much at stake, we need an inclusive national discussion. Otherwise, we'll never be able to build the consensus necessary to make a true reform effort successful ... and may end up with something far worse than what we already have.

February 13 - Chamber's Donohue Outlines Keys to Recovery