YORK — As a medical student, I remember HMOs being touted as the answer to the spiraling costs of health care and the high number of uninsured Americans. That was over 30 years ago.

The situation did not improve, and perhaps got worse, and so 10 years ago we were led to believe that the Affordable Care Act (“Obamacare,” or the ACA) would improve health care while reining in costs. It didn’t. And the reason it didn’t is that the health insurance and pharmaceutical industries were eventually allowed to be involved in the negotiations and implementation of the ACA.

Thirty million Americans have no health care coverage and another 60 million have inadequate coverage. These Americans struggle every day with health insecurity.

The single leading cause of bankruptcy in the U.S. is medical issues, researchers have found, with over half a million people affected every year.

The U.S. health care system does an abysmal job of providing quality care to individuals and families. Nearly all objective analyses of health care outcomes show that the United States falls well short of most developed countries in many measures, including overall mortality, premature death and preventable death.

And despite these poor outcomes, the health care system in the United States is exorbitantly expensive. On average, we spend nearly twice as much per person on health care than any other wealthy country.

The U.S. health care system is best designed, first and foremost, to produce massive profits for the health care related industries such as health insurers and pharmaceutical companies. These two industries each generate tens of billions of dollars in profits every year, and they do it specifically by imposing barriers to individual access of much-needed treatment – barriers that often result in excessive suffering and premature death.

Imagine your neighbor’s house catching on fire while the street you live on gets blocked off, preventing access for firetrucks and the firefighters from doing their jobs. Or imagine never allowing some children to go to school or the benefits and opportunities afforded them through a K-12 public school education.

Most would consider denying access in these situations to be remarkably cruel and reflective of a stunning lack of understanding of the basic developmental needs of human beings.

Denying access to health care is tantamount to blocking that access to fire protection or educational opportunity and should be considered no less cruel or uninformed. And it is no less devastating to individuals, families and communities.

Our fire departments and schools are funded by tax dollars for very good reasons. Why aren’t our health care services?

Health care is not a commodity that reacts effectively to the free-market forces that govern capitalism. And as campaign finance laws have loosened, profits for health care-related industries have skyrocketed. When a politician contends that our health care system can be affordable, effective or compassionate while the for-profit health insurance industry is involved, you can be certain that the insurance or pharmaceutical industries are among his or her major campaign donors.

But objective analyses of the comprehensive 2018 study released by the Koch brothers-funded Mercatus Institute demonstrated that a single-payer system would reduce costs dramatically, saving $2 trillion over 10 years. And it would do this while covering every single American with more expansive coverage than what is provided under the best plans today.

A single-payer system is not likely to be endorsed by the establishment, including much of the mainstream media as well as both political parties, because it could upset the status quo and disrupt some very big players on Wall Street.

A single-payer system, or “Medicare for All,” would not put the U.S. health care system under the control of the government.

Quite the contrary. A single-payer system would put financing of health care under the control of the federal government, which in turn gives more control to the health care professionals and our patients. Ultimately this leads to more affordable, higher-quality and more compassionate care.

More control to patients and health care professionals, and less control and profit to industry, will help ensure that all Americans, not just the privileged, will have the opportunity to live their lives getting the health care treatment we all deserve, affordably and with compassion.