U.S. Sen. Jeanne Shaheen spoke to the New England Council in Bedford Friday. Among her topics: health care reform. Here is an excerpt from her prepared remarks:

The next major item on the Senate's agenda is, of course, comprehensive health care reform. For me, health care reform is an economic issue. The escalating cost of health care is simply not sustainable.

More and more small businesses are dropping health care coverage for their workers, not because they want to, but because they simply can't afford it. The high cost of health care makes it very difficult for American manufacturers to compete globally and the auto industry is a prime example of that. General Motors spends more on health care than it does on steel for every car it makes.

It also makes it hard for companies who provide health care for their employees to compete with companies who don't. At the Small Business Committee field hearing we had in August, Adria Bagshaw told us that her small manufacturing company, W. H. Bagshaw of Nashua, pays more for health care than it does raw materials. And families are spending more and more of their paychecks on health care rather than on other purchases that stimulate economic activity.

Over 60 percent of all personal bankruptcies are due to health care debts. Spending on health care is now accounts for over 18 percent of GDP. We cannot sustain this and hope to have a strong economy in the future.

As you may know, I was invited to the White House with 15 other moderate Democrats in the Senate to meet with the president last week, the day after he spoke on health care to a Joint Session of Congress and the nation.

This was a very productive meeting, I thought. All of the senators attending believe strongly that health care reform cannot just extend coverage to the uninsured, but that it must also help stabilize health care costs, and it was clear in the meeting that the president is committed to this.

I left the White House as optimistic as I'd been in months that we will come together to pass comprehensive health care reform and that we will do it in a way that helps families and businesses, especially small businesses, that are struggling with the cost of health care.

I believe it is critical that we make some changes in how health care is delivered in this country.

Right now we have a sick care system, not a health care system. Most of the money spent on health care in this country is spent on hospitalizations and acute care for chronic illnesses.

We've got to do a better job of preventing and treating those chronic illnesses. We also know from the groundbreaking research done at Dartmouth that there is a huge variation in spending on medical care in different parts of the country, and that this increased spending does not lead to better outcomes.

If we reform some of the financial incentives and give providers and consumers information about the comparative cost and effectiveness of treatment options, we can bring down health care costs. In 2004 Medicare spent $17 billion due to re-hospitalization of patients because there is no system is place to provide them follow-up care when they are discharged from the hospital. Maine Sen. Susan Collins and I have introduced legislation to fix this. This is a common-sense reform; it will improve the quality of seniors' lives by keeping them from going back into the hospital and it will reduce costs. I'm pleased this initiative has been incorporated into the comprehensive health care reform legislation the Senate Finance Committee is now considering.

As we know, passing health care reform legislation won't be easy. If it were, it would have been done a long time ago. Change is always difficult and powerful interests that benefit from the status quo are fighting it tooth and nail, and, frankly, there are those who simply want to see President Obama fail for political reasons.

It won't be easy, but I am confident that we will come together and get it done in the next several weeks. We simply have to. We cannot afford the status quo.

(Democrat Jeanne Shaheen is the junior U.S. senator from New Hampshire.)