reform doesn't pass this year, Pennsylvanians will be in a world of hurt.

Within a decade, 364,000 more people would be added to the 1.3 million Pennsylvanians who don't have any health insurance, according to a report yesterday by the U.S. Department of Health and Human Services. The amount of uncompensated care provided each year would go up 120 percent, with much of the cost borne by the taxpayers. Pennsylvania businesses would see their premiums double, hobbling them competitively and forcing many to drop coverage for employees.

And many more victims would be added to the 45,000 Americans who die each year because they didn't have health insurance, as reported in a Harvard University study.

Without reform, the already horrific status quo will seem like a golden era in 2019.

With reform, according to HHS, those 1.3 million uninsured Pennsylvanians could obtain coverage through a health-insurance exchange set up by the legislation, while 683,000 Pennsylvanians who have nongroup insurance, which has the highest premiums, could find more affordable coverage. Tax credits to help pay premiums would be available to 904,000 Pennsylvanians. About 2.2 million seniors would receive free preventive services, and 393,000 seniors would have drug costs in the Medicare Part D "doughnut hole," the gap in coverage between $3,600 and $6,174, halved.

Also, 151,000 small businesses in Pennsylvania - the engines of job creation - could be helped by a tax credit that would make it easier to provide insurance to employees.

It wouldn't be a complete cure of what ails the U.S. health-care system, but it would at least stop the bleeding.

Yet, with the stakes so high, the supposed-to-be filibuster-proof Democratic majority in the U.S. Senate is at an impasse. Three conservative Democratic senators from small states - Blanche Lincoln of Arkansas, Ben Nelson of Nebraska and Mary Landrieu of Louisiana - have threatened to keep the rest of the Senate from voting on health-care reform unless the already-weakened "public option" is weakened some more, if not dropped.

Republicans falsely claim that, even though the public option would be available to only 3 percent of Americans, it represents a "government takeover of health care."

Millions of lobbying dollars from insurance and pharmaceutical companies that have funded outrageous falsehoods about "death panels" and "rationing" have confirmed for us that the real problem is the for-profit health-care system. The public option in the Senate plan, which states could choose to opt out of, would provide a check on private insurers. In fact, Goldman Sachs projects that reform without a public option would increase insurance company profits by 9.5 percent. With a public option, as limited as it would be, profits would drop 1 percent.

A majority of the Senate and a majority of the American people want a public option. They are being held hostage by three conservative Democratic senators, all of whom have gotten big bucks from insurance companies. They can vote against health reform if they want. But if their threat to join a Republican filibuster thwarts the will of the majority, the entire democratic (with a small "d") enterprise will be severely threatened.

At least a few progressive senators have stated their unwillingness to weaken the bill further. Now it's time for President Obama to do the same, or risk blowing this "historic moment" he keeps talking about.