As President Barack Obama continues to push health care reform across the finish line, many pundits and critics say he needs to focus on jobs and the economy, asking, “Which should come first — health care or the economy?”

My answer? “Yes.”

Health care reform is job creation. Health care reform is deficit reduction.

Taking strong steps to reform health care now will take a big bite out of our deficit. As Obama reminded us in his budget, health care reform will save $150 billion over 10 years.

And, during the recent health care summit he hosted, the president made clear that health care reform is a vital component of his efforts to tackle our long-term spending problems. When private insurers raise health premiums, it drives up Medicare rates. That cost falls on the federal government, which is then on the hook for more and more money it doesn’t have.

That’s one deficit problem. The other falls on the states. The 50 states have combined budget deficits of $375 billion this year and next — much of it driven by Medicaid and absorbed costs for the uninsured.

Sure, Congress can walk away from the problem, but the states won’t be able to. They will have to raise taxes, slash workers and generally compound the problems of the recession.

In addition to the state jobs saved by fixing health care, a study published just this month by the Center for American Progress estimates that health care reform could create 250,000 to 400,000 jobs a year for the next decade. That’s up to 4 million new jobs over 10 years.

These gains aren’t fantasy. They’re possible because rising health premiums cripple the bottom line for large and small businesses. Experts predicted that health care premiums to small businesses will rise 15 percent this year, which is double last year’s increase.

The president put the choice for businesses in stark terms: “Businesses are having to make decisions about just dropping coverage altogether for their employees. If they’re not doing that, then the money that they are spending on health care is money that otherwise could have gone to job creation.”

We can solve this problem, but only if we enact health care reform that will actually lower costs. By bringing down health care premiums, we can help businesses free up resources to put Americans back to work rather than paying escalating health care premiums for the employees they already have.

The real question now isn’t why we need health care to tackle challenges like deficits and the economy. It’s figuring out exactly with whom we are negotiating over the details.

Every day, the president and Democrats make bipartisan gestures only to be met with new roadblocks from Republicans.

The best way to reduce costs would be through a public insurance option that can introduce real competition into the insurance industry. Because insurers are not forced to compete, there is no pressure for them to bring down the 30 percent of every dollar that goes to overhead and profits.

Despite widespread support for the public option from the president, the House, scores of Senators and the American public, all we have seen is a continuing parade of concessions to Republicans who have no interest in reining in the insurance industry.

If we’re going to rise to the president’s challenge to create jobs, revitalize the economy and reduce the deficit, then it’s time to get tough with these obstructionists who have stood in the way of the president’s agenda. They will not be brought into line with endless courting, and I defy supporters of this approach to find a single Republican vote that has been gained through negotiations.

Many worry that a reform opponent might resort to a filibuster on the Senate floor. We shouldn’t hide in fear of this. One option that is now gaining steam would be the use of reconciliation, which would require only a simple majority of 51 Senators to pass a health care bill.

I think that can work, but I’m not worried about a filibuster either. Anyone who wants to oppose health care reforms that will lower federal spending and help more Americans find good jobs should stand up for all the world to see.

It’s been a while since Mr. Smith went to Washington, but I bet if he came back today to see how the mere threat of filibuster has obstructed progress, he’d be the first to say, “Let ’em talk.”

Our country can’t afford to wait any longer on health care reform.

Health care reform first? Yes. Fix our economy first? Yes. Reduce our deficits first? Yes.

Rep. Anthony Weiner is a Democrat from New York.