During my meeting with clinic administrators, I learned that over half (57 percent) of the uninsured patients they provide care for are working, but at jobs that do not offer health-insurance benefits.

This problem is hardly unique to Washington state. Since 2001, 4 million people have lost health-care coverage nationally, and premiums have more than doubled. Americans routinely cite the cost of health-care coverage as their most pressing concern.

The rapidly increasing cost of health care and the growing number of uninsured Americans is not hurting only individuals. It is a drag on our economy and a barrier to our global competitiveness.

America is one of the few countries where health-care coverage is predominantly employer-based. That means companies essentially pay an additional expense for their work force here in America that they would not pay in foreign countries.

Small businesses and their employees in particular are feeling the pinch. From 2000 to 2003, health-insurance premiums for small companies rose 47 percent. Small-business employees pay more of their health-care costs than employees of big companies, and over half of the 44 million uninsured Americans work for small businesses.

Addressing the health-care crisis is one of the most important things Congress could do to help individuals, employers, and our economy at large. Unfortunately, neither the administration nor congressional leadership has shown a willingness to do so.

There are several things we could do to significantly improve health care. These are actions that would increase access to health-care insurance and decrease costs for both employers and consumers.

First, we need to help small businesses, the engine of our economy and biggest creator of jobs, provide health insurance to their employees. I am a co-sponsor of legislation to provide further incentives to small businesses across America to pool their risk and purchasing power so as to expand their access to affordable health-insurance options for their employees.

Second, we should expand coverage options for young Americans and adults between 55 and 64. Young Americans are the least insured population in America, and adults over the age of 55 but not yet eligible for Medicare have the most difficult time finding affordable coverage. Allowing these two particularly vulnerable populations to enter existing government health-care programs is a cost-effective way to increase health-care coverage, benefiting these individuals and our overall health-care system.

Third, we must ensure that losing one's job doesn't mean losing one's health care. I support helping workers between jobs keep their health-care coverage by increasing the tax credit afforded individuals in order to ensure workers can keep their health insurance between jobs.

Fourth, we can cut premiums by approximately $1,000 per family per year by having the federal government pick up the cost of catastrophic health claims. In 2001, only four-tenths of 1 percent of private insurance claims were for individuals with health expenses in excess of $50,000. However, these claims accounted for nearly 20 percent of medical expenses for private insurers.

In short, private insurers and their customers are spending a fifth of every health-care dollar on less than 1 percent of the people. The federal government can help with this small number of high-cost claims, lowering premiums for employers and employees alike.

Finally, we must use technology to reduce administrative costs. Twenty-five percent of health-care costs are spent on nonmedical costs, primarily paperwork. This is far higher than any other industry in America. As one example, financial institutions have cut their administrative costs to less than a penny on the dollar.

We can use technology that protects people's privacy and streamlines the administrative process, providing better care for patients with fewer errors and lowering costs across the board.

These five common-sense steps would make a dramatic difference in our health-care system, helping individuals, business, and our economy at large.