‘Medicare for all’ means everyone gets health care

When we debate how to improve our health care system, we talk about the cost, the complexity, and the challenge — but these are all secondary to the fundamental concern: In the world’s richest country, is health care a human right or a privilege?

During medical school, we learned countless lessons about the human body and how it breaks down, but not enough about our broken health care system. I helped run the Equal Access clinic for people without insurance, where we learned that our lectures didn’t apply if patients couldn’t afford treatment. They knew they were sick, but they had to choose to pay for medicine or the light bill. I recall the mother who cried when she told me that she couldn’t eat the birthday cake her kids made her because she couldn’t afford her diabetes treatment. When we helped them, the look on their faces was pure gratitude —

not because of the medications, but because someone cared if they lived or died. It was in this clinic that I learned that health care is a human right.

In the book “An American Sickness,” Elizabeth Rosenthal describes our system: “We live in an age of medical wonders — transplants, gene therapy, life-saving drugs and preventative strategies — but the health care system remains fantastically expensive, inefficient, bewildering and inequitable.” Our system is a byzantine structure of federal, state and local laws, of competing interests with different goals and of well-intentioned ideas gone awry. How can we do better?

I believe our long-term goal should be a program like Medicare for all. This is not a government takeover, but rather a health care system that provides basic coverage to all Americans, including the 10 essential health benefits outlined in the ACA. These include preventative care, maternity and newborn care, primary care, hospital care, mental health and substance abuse treatment and prescription drug coverage. I would also add coverage for clinical trials and research, the engine for new treatments and cures. Private insurance would still be available for these services and for specialty care for people who wanted to buy additional coverage. This program would affirm health care as a human right, make Americans healthier and more productive and would actually save money.

How could this be cost-effective? The uninsured rarely seek care until they are very sick, often relying on emergency rooms for short-term solutions at a high cost. Ensuring that all have basic insurance would lead to better prevention, earlier intervention and improved control of chronic medical problems. Healthy people work and provide for their families, open businesses and live longer, more productive lives. Investing in new cures would mean less disability and preventable deaths. Transitioning from for-profit to public coverage would reduce overhead and put those dollars to work providing health care instead of CEO bonuses.

It won’t be easy to make this transition, but we are currently on an unsustainable path of spiraling costs, profit mongering and inadequate coverage. We must take steps now to stabilize ACA marketplaces, allow Medicare to negotiate drug prices and increase transparency in health-care spending. Reforming health care in America is vital to the security of our country, our economy and our people.