The recent election has made it a virtual certainty that the Affordable Care Act (aka “Obamacare”) will be implemented. However, the ACA has serious shortcomings.

While the details are not certain, we do know that as many as 30 million people will still not have health insurance (Congressional Budget Office, July 2012).

Also, the ACA will probably not make health care more affordable, and costs will likely remain out of control.

While we are implementing the ACA, we should bear in mind that there are better solutions that should be considered, and perhaps could be fit into the framework of the ACA.

One is the Medicare program: Simply offering it to the entire population, rather than just seniors, would save significant amounts of money immediately, because its administrative costs are so much lower than those of insurance companies. Perhaps a Medicare-like plan could be included as an option in state or federal insurance exchanges. This might be possible under the waiver provisions of the ACA.

If this sounds like an argument for “universal health care,” it is.

It baffles me how the United States could have for so long treated health care like a commodity rather than a moral imperative.

We have the most expensive and least inclusive health care system in the industrialized world, and the outcomes are often mediocre. The ACA is a step in the right direction, but we need to go much further.

Kevin Tine is a resident of Brunswick.