Just about every day, I order tests and provide emergency medical treatments that bankrupt people.

And I feel terrible about it.

A recent Harvard study published in the American Journal of Medicine revealed that almost two-thirds of bankruptcies in the United States are caused by medical bills, with most stemming from a single illness or injury.

Even more surprising, almost 80 percent of those bankrupted had medical insurance at the start of their medical problem, only to be dropped by their insurance companies when they needed help the most. The lead author of the study likened our medical insurance system to an expensive umbrella that melts in the rain.

This should not be the case in our great country. Luckily, we're on the cusp of sweeping reform that will provide cost savings to individuals and businesses and extend life support to our failing health care system and our flagging economy.

Opponents of health care reform may think "tough luck" when hearing about medical bankruptcies, but they're worried that by extending health care to all Americans, we'll sink our ailing ship of state. In fact, taking steps now to reform health care will save money in the long run while remedying the grotesque status quo that - among other awful situations - forces parents to hold bake sales for kids with cancer.

Here are a few central pillars of reform that would prompt cost savings while providing coverage for all Americans:

► Just as everyone must have auto insurance, health insurance must be a requirement. People who cannot afford a policy would be offered a subsidy or be enrolled in a public option that would incentivize preventative care and the appropriate use of health care services.

► Insurance must be portable across state lines. Patients should not be denied coverage on the basis of "pre-existing conditions" or be dropped from the rolls when they become seriously ill or injured. This would encourage health insurance companies to keep their enrollees healthy, screen widely for serious illnesses, and aggressively treat them at the first sign of significant problems in order to minimize overall expenditures.

► A comprehensive electronic medical record (EMR) that includes pharmacy usage - either online or on a computer chip card similar to the very successful "Carte Vitale" in France - would save tens of billions of dollars per year. The EMR would streamline billing procedures, avoid redundancy in testing, limit prescription errors and drug allergies, and - importantly - help prevent the rampant fraud and abuse present in our system today.

► Create a comprehensive approach to tackling the enormous problem of rampant obesity in our society, which costs billions of dollars each year because of the awful health consequences. Just as we tax cigarettes and alcohol, we should tax foods known to cause ill health down the road - products with high sodium content, high sugar content, saturated fats and/or cholesterol.

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