The clock is running on health care reform for you, your family and your friends. If we do not act soon, health care costs coupled with our broken health care delivery system will compound and increasingly burden our families, businesses and the wellness of our nation.

Unfortunately today, Hawai'i may no longer be able to claim that it is the Health State. The cost of family health insurance is $13,000 a year here and will rise to $20,000 by 2018. The average amount that Hawai'i's employers paid for worker's health insurance doubled from 1999 to 2008. A national study found that 27 percent of Hawai'i residents under the age of 65 were uninsured a portion of the time in 2007-2008. And those who are insured subsidized those who aren't, with insured families paying about $700 more a year.

Across our state, the stories are chilling. We are hearing from people that to make ends meet, they are risking not insuring their children, with the hope that they will stay healthy. No family should ever have to face such a choice.

And rural conditions worsen. Critical medical services are not available on the Neighbor Islands. At a recent health care meeting on Kaua'i, I learned that chemotherapy is not available on Kaua'i, forcing patients to fly to Honolulu for care.

Following a presidential campaign in which the health care crisis took center stage, the United States Congress and the Obama administration are now working out the details for health care reform. Washington, D.C., may seem a long way off in miles and relevancy, but make no mistake — this is your health we are talking about.

President Obama offered three principles that health care reform must achieve: reducing costs, guaranteeing choice and ensuring everyone has access to affordable health care. Obama has achieved collaborative commitment from the medical industry to reduce costs on the one hand and sustained very real-world, grassroots pressure on the other. Like any tough political issue, making health care reform happen will take a constant combination of toughness and flexibility.

A fundamental element of the proposed reform is a public option in health care. If you like your health care coverage, you can keep it. But if you don't have coverage or if you lose your coverage, you have another option.

Much of the reform effort will center around the cost structure of health care. As we all know, we are spending too much money on treatments that don't make Americans any healthier — our system equates more expensive care with better care. To provide Americans more affordable care, our health care system needs to replicate best practices, incentivize excellence and close cost disparities. For example, we will save billions nationally by introducing generic biologic drugs into the marketplace and by bulk-purchasing drugs for seniors under Medicare.

The next steps in health care reform will take extraordinary political will and the support of all Americans. We are fortunate in Hawai'i to have a congressional delegation that backs health care reform and Obama's agenda. We can all be proud that they are working diligently on this issue and that they see the inseparable bonds between stimulating our economy and keeping people healthy.

Far away as this issue and its legislative mechanics may seem, nothing is closer to our lives than our family's health. That is why we must stay informed and let our congressional delegation know our thoughts, preferences and support. And together, we can work toward reforming our health care system, and Hawai'i can again be the Health State.

Brian Schatz is chairman of the Democratic Party of Hawai'i. He wrote this commentary for The Advertiser.