Who among us hasn’t heard the stories of small businesses struggling to balance their books forced to cut jobs because they can’t afford the rising cost of insuring their employees?

Perhaps you’re the small business owner having to make these tough choices; or the parent deciding whether you can afford to get your children their flu shots this year; or the senior citizen cutting your medicines in half to make them last longer.

Tough choices indeed. Want a better choice? Then let’s take on health insurance reform.

Forty-five million Americans don’t have health insurance. Some 14,000 Americans lose their health insurance every day. Families’ benefits are eroding because they can’t keep up with the cost of care, higher premiums, co-pays and deductibles.

Simply put, the current system isn’t working.

In Michigan, Medicaid programs provide the threads that make up a safety net for those who are struggling. Today, more than 1.7 million people are enrolled in Medicaid, which helps them pay for medical bills. That’s up from just over 1 million in 2000.

I’m talking about low-income families, refugees, some immigrants, pregnant women, people with disabilities and children – our state’s most vulnerable citizens.

But Medicaid alone can’t keep up. And it shouldn’t have to.

Instead, we should embrace those who seek to reform the health insurance system. Those who seek to make it better for all Americans.

On the campaign trail, President Barack Obama promised to work with Congress, hospitals, doctors, businesses and unions to enact comprehensive health insurance reform. I ask you to join the list of people working together to reduce long-term growth of health insurance costs, guarantee choice of doctors, invest in prevention and wellness, end barriers to coverage for people with pre-existing medical conditions, and ensure every American receives the health care they need and deserve.

This isn’t just a social issue. Over the long term, reforming our health care system will lead to economic growth, higher take-home pay for workers, greater employment opportunities and a more level playing field between small and large businesses.

It isn’t just an issue for the uninsured either. It’s an issue for anyone who’s ever been afraid of losing their coverage if they become sick, or lose or change their job.

Will all of this change be easy? Absolutely not. Change seldom is.

Is it worth it? Absolutely. We need reforms that reward prevention and wellness, that emphasize quality over quantity, and encourage patient involvement. We need a health care system that brings security and stability to people who already have insurance and gives access to quality, affordable care to those who don’t.

I encourage you to act. Join the conversation and ask your members of Congress to make the right choice: The one that ensures the future of our state and of our nation.

Ismael Ahmed is director of the Michigan Department of Human Services.