This week concluded a long and difficult debate over the shape and substance of our nation's health care system.

After many twists and turns the Senate put forth, and I opposed, a bill that cost almost a trillion dollars but which in my opinion, offered little to reform the current skyrocketing costs of the fee-for-service system that is dominated by the insurance industry.

The basic premise for our health care reform effort was that if we could introduce real cost containment and competition; if we could challenge the dominance of the insurance companies and push down prices, we could then use those savings to provide access to health care for every American. That was our goal. In the beginning.

Those goals were met in the House version of health care H.R. 3962, which I supported. First, H.R. 3962 repealed the antitrust exemption that allowed insurance companies to operate as monopolies and cartels in restraint of trade. Secondly, the House version allowed each State to establish a true public option with the object of offering low-cost insurance plans, thereby forcing insurance companies to compete. Lastly, the House version provided a progressive funding structure that asked individuals making over $500,000/yr or couples filing jointly and earning over $1,000,000/yr to pay a health care surcharge to pay for expanded coverage for the uninsured. That is the bill that I supported and the House passed and sent to the Senate.

In contrast, the Senate bill, H.R. 3590, then stripped out much of the reform that the House bill offered. First, it restored the antitrust exemption for insurers allowing them to continue to operate as monopolies. Secondly, the Senate Bill eliminated the modest opportunity for states to establish public options. And lastly, the Senate removed the tax on those with incomes above $500,000 and instead placed that tax on people who already have high cost health care plans. This includes many large employers and union health plans where, over the years, members opted for less money in their paychecks or stood on picket lines to gain health benefits for their families. For many years government regarded health coverage as a basic necessity, almost like food, and refused to tax it. Guess what? Those days are over.

Maybe it was because we lacked the discipline to stay in the fight, perhaps it was because we lost the message war, I'm not sure. But in the end we allowed the insurance companies to prevail.

Yes, we have added 32 million people to the insurance rolls and that is noble. My fear however is that we have added them to a system that teeters on a state of serious dysfunction. And now we need to figure out how to control the costs of this system and to pay for this massive expansion of services, as prices continue to rise precipitously- and they surely will.

In a world of finite resources, health care costs, quality and access cannot continue to rise together indefinitely. Something has to give. In the recently adopted Senate Bill, costs did not give way.

In essence, we have paid the ransom but the insurance companies are still holding consumers hostage. The passage of time will make this increasingly apparent. One need only watch the quarterly profits of insurance companies spike in the coming months and years.

Again, the basic premise for our effort was to introduce real reforms to challenge the dominance of insurance companies and push down prices, so we could use those savings to provide health care for every American. That was our goal. In the beginning. It remains our goal.

I congratulate President Obama for the serious work that he has done to try to find a solution that serves the needs of this nation.

I will continue to work to fix the bill that was just passed. We certainly have a lot of work to do.