When President Barack Obama addressed Congress in September, he made a compelling case for healthcare reform.

I share the president's commitment to pass legislation that lowers healthcare costs, provides greater access to coverage and puts new regulations on insurance companies to protect consumers.

But as we emerge from the worst recession since the Great Depression, we cannot forget that our healthcare problem is inexorably linked to our broader economic problems and, in particular, our out-of-control national debt.

As the president and his budget director often say, rising healthcare costs are the principal driver of our long-term federal debt. That's why I agree with President Obama's pledge:

I will not support legislation that adds one dime to the already-staggering debt now or in the future.

Our fiscal house is deteriorating dangerously. In the 2009 fiscal year, which ended Sept. 30, our deficit was more than $1.4 trillion -- that's more than three times the size of last year's deficit.

Unprecedented deficit

Our nation's publicly held debt totals more than $7 trillion, and if we include debt held by government accounts -- such as Social Security -- our total national debt stands at $12 trillion, and there are estimates that it may rise to $21 trillion in 2019. Those numbers are unprecedented and unsustainable. They pose the greatest threat to our nation's future prosperity and to our children's and grandchildren's future.

If we don't get back in balance, our economy could spin out of control with countless jobs being lost.

Healthcare has contributed significantly to this fiscal crisis. As President Obama pointed out, individual Americans spend 1 ½ times more per person on healthcare than any other country.

Medicare spends more than it takes in, and the Congressional Budget Office predicts it will go bankrupt in eight years. We must not let that happen.

I am determined to help bring about focused, effective health care reform this year, because our people, state and country need it.

But I am equally determined to ensure that reform does not hamper our economic recovery or add to our crippling national debt.

I have three priorities for healthcare reform.

• First, we should take big steps to get the cost of healthcare under control by eliminating wasteful spending and improving the system's efficiency. For instance, we must stop paying health providers for every service and test they provide and start paying them for how successfully they treat patients.

We must offer providers incentives to work together so that individuals only see the doctors and have the tests they need to avoid unnecessary, uncoordinated care that sends everyone's premiums up. We should also stop paying for, and start penalizing, unnecessary hospital readmissions or easily preventable hospital infections.

• Second, we must enact reforms that compel insurance companies to treat consumers fairly. For instance, we should ensure that no Americans are denied coverage because of a pre-existing condition; that no Americans lose coverage when they are sick; and that no Americans face a limit on the amount of coverage they can receive. And we must extend health insurance to some of the millions of people who cannot now afford it.

We can make these important changes and reforms this year if we work together. Unfortunately, rather than focusing on what works and fixing what doesn't, Congress is getting bogged down in a divisive debate over whether to create a government-run health insurance company -- the so-called public option.

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