Folks on the far-right fringe – tea partiers, libertarians, secessionists, etc. – were in open revolt against Obamacare until the Supreme Court told them what the rest of us already knew: the individual mandate is completely constitutional. While they were complaining that President Obama had gone too far this time, I was thinking he hadn’t gone near far enough. What we really need in this country is universal single-payer health care.

Health care, like education, should not be a business. It’s also not a privilege, as the privileged few seem to think, but a right. There’s no reason anyone should profit from illness, least of all the corporations that profit most – insurance companies. We don’t need to get the government out of the health care, we need to get private insurance companies out of the market.

Like his father before him, my father sold life insurance for many years. The fact that at 89 he doesn’t have any himself is instructive. First lesson: insurance salesmen generally don’t know any more than you do about how insurance really works. Second lesson: there’s a good chance your insurance company is going to screw you.

After my father suffered a series of strokes, I set about to put my parents’ financial affairs in order. I discovered in the process that they were paying premiums on a decreasing term policy that had a cash value less than what they had paid in over the years. To make matters worse, it was the Veterans Administration that had sold him the policy.

When I asked the VA to explain how they could treat a veteran of World War II and Korea that way, I was told that my father could have converted to whole life at any time, but chose not to do so. The truth is that he and my mother had no idea what was going on with that policy, which is why I find the conservative proposals to turn Medicare into a voucher system so hateful. Too many Americans would buy the wrong product and end up worse off than they are now.

Our family’s health insurance provider has changed several times over the years, so I am not going to name names here, but, despite the fact that I am grateful to have coverage at all, I am often aghast at what these companies get away with. For instance, a few years ago we had a plan in which there was no charge for annual physicals – preventive medicine and all that. So when we got a bill for my physical, my lovely wife naturally inquired about it.

Turns out my doctor had changed one of my medications and consultation on medications was not covered as part of a physical exam. We asked for a list of things we could not ask about without triggering hidden charges – moles? indigestion? Athlete’s foot? – but the insurance company could not provide one.

One of our daughters recently received a bill for a sonogram. Since sonograms were covered as part of prenatal health care, she inquired about it. She was told the insurance company no longer covers sonograms for pregnant women. Not only had no one told my daughter about the change, no one had even informed her employer. She appealed. The company reviewed its own decision and denied the appeal.

This sort of shoddy practice is not unusual. Everyone I know has horror stories of insurance companies jerking them around. It’s a dirty business. Premiums and deductibles go up, coverage comes down, and profits go through the roof. I have come to believe that some health insurers routinely just deny payment initially in hopes that the patient will pay. They even employ “doctors” to review medical records and help them find reasons to deny coverage. Sick.

Medicare, on the other hand, seems to work just fine for my elderly parents. They have a little supplemental coverage from my father’s union, but everything they need gets paid for – by you, me, the guy next door and a working lifetime of paying into the system. And that’s the way it should be. That’s the American Way.

That’s also why we need universal single-payer health care. We need Medicare for everyone. If we’re all in the risk pool – young and old, healthy and sick – we can cut the insurance companies out of the deal, in the process lowering the cost of health care.

The United States has one of the worst and most expensive health-care systems in the developed world. Obamacare begins to address the inequities, but we need to do more. So let’s go – everyone into the pool. Our goal should be universal single-payer coverage like the rest of the developed nations in the world.

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Freelance journalist Edgar Allen Beem lives in Yarmouth. The Universal Notebook is his personal, weekly look at the world around him.

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