With a new administration coming to power in Washington, health-care reform once again has become a critical national priority. It is not a moment too soon.

The United States spends almost twice as much as any other industrialized country for health care. The number of uninsured has reached record levels -- one in seven Americans. Health-insurance premiums have increased by more than 87 percent over the past five years, outpacing the growth of other health-care costs. It seems the players who profit most from the health-care crisis are large health-insurance companies.

President-elect Barack Obama has cited the lack of health-insurance competition as a major cause of rising health-care costs and a failure of antitrust law enforcement. He has criticized the Justice Department for taking a lax attitude toward health-insurance mergers, noting that "there have been over 400 health-care mergers in the last 10 years and ... 95 percent of insurance markets in the United States are now highly concentrated."

This concentration has led to higher prices, more anticonsumer insurance provisions, longer payment delays, less coverage and poor service.

The Pennsylvania Senate Banking and Insurance Committee, the House Insurance Committee and the state insurance commissioner are now grappling with this issue as Highmark proposes to acquire Independence Blue Cross. Although these two companies have imported armies of high-priced antitrust lawyers, economists and lobbyists, this is a deal that common-sense legislators and regulators should recognize as a bad deal for Pennsylvania. They simply should say no to this merger.

The facts seem relatively simple. Both Highmark and IBC are financially strong and Highmark, in particular, has been expanding into new territories from its base in Western Pennsylvania.

IBC has by any measure a monopoly position in southeastern Pennsylvania. If not for this merger, Highmark likely would try to invade Philadelphia, forcing IBC to compete for business. This would make both companies work harder, keep prices lower and improve services -- which is just what happened when Highmark moved into Capitol Blue Cross territory in central Pennsylvania.

The insurance commissioner's own experts have said that prices would be lower if the state denies the Highmark-IBC merger. They noted in one report that there is a "great deal of evidence to suggest that competition between Highmark and CBC has benefited health-care customers in central Pennsylvania." Their analysis showed that Highmark offered "a significantly lower premium in central Pennsylvania versus Western Pennsylvania during the years immediately following Highmark's entry into the central area."

With the rapidly increasing cost of health insurance, that is a type of competition that should be protected, not discarded.

Highmark promises a billion dollars in cost savings that it would pass on to consumers. Those numbers seem too good to be true, and for good reason -- no Blue Cross merger has ever achieved savings of this magnitude. The insurance commissioner's experts found numerous reasons to fault Highmark's estimates.

But a Highmark-IBC merger would cost more than simply money -- it could frustrate efforts to reform the health-care system.

Any reforms likely to be enacted by Congress in the next few years will rely heavily on financing through health insurance, and competition between insurers in each state is critical to control costs. In those states with few insurance rivals, reform will falter.

So, the question is:

Would Pennsylvania be smarter to rely on competition to produce cost savings, which has been proven to work, or the unlikely-to-materialize savings promised by two companies who wish to stifle competition?

If this merger is approved, a single firm would have a virtual monopoly in western and southeastern Pennsylvania, providing it with more market share than any insurance company has in any other U.S. metropolitan market. If this merger is approved, you know who will call the shots when it comes time to enact national health-care reforms in Pennsylvania.

Highmark.