Updated

Health and Human Services Secretary Kathleen Sebelius thrashed the insurance industry this morning, telling executives they need to choose between short-term profits and a "sustainable health insurance market."

In her prepared remarks, Sebelius told members of America's Health Insurance Plans (AHIP) to put themselves in their customers' shoes.  "Can you blame them for thinking the system's broken when their health insurance - which is supposed to protect them from exorbitant health costs - still forces them to pay thousands of dollars out of their pocket each year?"

Sebelius and her boss at the White House have toughened their stance on insurance companies in recent weeks, blaming them for standing in the way of health reform legislation.  "You can choose to continue your opposition to reform," she said.  "If you do and reform goes down in defeat, we know what will happen.  By next March, premiums will be taking an even bigger bite out of Americans' wages."

The secretary also pointed to statistics from the American Medical Association that says 99 percent of all metropolitan health insurance markets are "highly concentrated" up from 94 percent a year ago.  But a statement posted on AHIP's website today reports, "There are eight or more health insurers in each of the top 40 metropolitan statistical areas (MSAs) in the nation."

The conference and Sebelius' remarks come as the White House and Democratic leaders are trying a final push of health care bill through Congress in the next few weeks.