Health care costs are rising twice as fast as wages. A federal bi-partisan effort to cover low-income children is vetoed on 'ideological' grounds. And a state health care plan is delayed and endangered by budget-weary legislators.

At the beginning of the year, the Gov. Arnold Schwarzenegger promised to make this the year of health care reform. It didn't happen during the regular legislative calendar --- thanks to the summertime budget impasse --- so he had to call a special session.

People are literally sick and dying. But progress on health care reform has been excruciatingly slow. Talks seem to have bogged down.

Unfortunately, this kind of impasse is all too common in Sacramento.

Of course, health care reform will not be easy in California or any other state. Doctors, insurance companies, employers, pharmaceutical firms, hospitals, nurses and unions are just a few of the formidable players in this debate.

Daunting forces, true, but also stakeholders who should recognize the system is badly in need of repair. They must take responsibility and compromise.

Medical consumers --- sometimes quaintly referred to as patients --- must also take responsibility by demanding action and holding lawmakers in Sacramento accountable.

Approaches to reform vary. One plan was proposed by the Governor, another by the Democratic leadership, and third option called "single-payer" is favored by many and passed during the regular session (but the Governor already vetoed it.)

Side-by-side comparisons of the competing plans are bewildering. But by charting solutions on coverage, individual mandates, financing and other elements, you can tell how well each interest is holding its own.

It is when groups place their own interest too far above that of the overall benefit of society that policies fail.

So what is the common good when it comes to health care?

The Alliance for Catholic Health Care --- which represents Catholic hospitals and health systems --- has highlighted the critical areas that need to be addressed. These points serve as a good discussion guide for the debate and people of faith can judge the results of reform on how well the solutions addresses each:

---Health care is a basic human right and must be available to all people.

---A basic care package, including preventive care, long-term care and other services, should be ensured for all.

---Incentives should be included that encourage the health care system to continually improve.

---All the stakeholders mentioned earlier, in short, all of us, must take responsibility for the success of reform.

---Reform needs to include respect for religious beliefs. Nobody should be forced to perform any act or procedure contrary to their religion.

---Government can play a role in ensuring that services are provided for the common good, that all persons have quality health care.

---And the most serious question in this whole debate. Who pays?

Too often, solutions hang up on that question. But it is clear that rising medical costs, millions of people with no access to affordable care and others facing ever-rising deductibles are deepening an already severe crisis.

These groups are going to have to compromise. When the interests of the few take precedence over the many it's the many who suffer. And many are suffering now.

Why can't we sculpt something that all parties can point to with pride?

Catholic hospitals, for instance, took the lead in accepting a strategy which imposes a tax on themselves (four percent under the Governor's plan). Others followed suit. Good for them. The reduction in income will be made up with increased Federal Medicare payments.

It will take strong leaders and commitment to the common good to bring effective health care to all. Unfortunately, despite a year that promised otherwise, the leadership in Sacramento was filled with inconsistency, rewards for special interest and inaction.

It's an all too common occurrence is Sacramento. In this case, our leaders are literally playing with people's lives.

Steve Pehanich is the executive director of Catholic Charities of California. Write him at spehanich@cacatholic.org.