Health and Human Services Secretary Kathleen Sebelius issued reports on Friday detailing the problems with the "health care status quo" across the country. You can find the reports at HealthReform.gov. They include statistics and supporting footnotes on figures like the percent increase in family health insurance premiums since 2000 and the percentage of uninsured residents in each state.

A couple of points jumped out at me in the report for Iowa:

*     Choice of health insurance is limited in Iowa. Wellmark BC and BS alone constitutes 71 percent of the health insurance market share in Iowa, with the top two insurance providers accounting for 80 percent.11

Iowa is not unusual in this regard. Most insurance markets in the United States are dominated by one or two companies. My family's Wellmark premiums went up 10 percent this year alone. Speaking of which, the annual salary of Wellmark's CEO has "nearly doubled" in the past five years to about $2.5 million.

*     Choice is even more limited for people with pre-existing conditions. In Iowa, premiums can vary, within limits, based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.

I know a family in Des Moines who were unable to purchase health insurance at any price because the mother has a thyroid condition. They are now covered through the father's employer, but if he loses his job they will have no health insurance options.

Two more reasons why we cannot settle for health care reform without a public option, or with a fake public option. I was glad to see several House Democratic caucuses affirm that they will fight any health care bill lacking "a real and robust public option that lives up to our criteria".

If you haven't done so already, please add your name to the petition at StandWithDrDean.com.