Medicare for all. What does it mean? Why is it important?

In 2009, before Obamacare, a Harvard study estimated that 45,000 Americans died annually because they didn’t have health insurance. Obamacare has shrunk the ranks of the uninsured from 50 million then to less than 29 million now — meaning that 8.8 percent of the country’s 327 million people still run the risk of premature death. And lack of health insurance is the leading cause of personal bankruptcy, a uniquely American problem.

We spend far more on health care than any other nation — in 2017, 18 percent of GDP, a whopping $3.5 trillion, projected to exceed $5 trillion by 2023. Despite this huge sum, we lag behind other countries in health outcomes, including life expectancy and infant mortality.

Why do we pay so much and receive so little? As anyone who’s received a bill from a doctor’s office or hospital knows, they’re complicated. Thirty cents of every health care dollar goes to profit and administration, a percentage that dwarfs all other nations.

Half of health care spending goes to 5 percent of Americans. In this group of chronically ill patients, best practices are often not followed, and complex care may be poorly coordinated, including end-of-life care delivered in an ICU, which may be both medically futile and undesired by the dying patient.

Costly overtreatment isn’t limited to ICU settings. It’s both wrong and wasteful to subject patients to care that can’t help them, whether it’s unnecessary antibiotics or surgery when watchful waiting is a better alternative. Such care is rooted in outmoded habits, supply-driven doctor behaviors and ignoring science. Our current patchwork health care system doesn’t do enough to encourage appropriate care.

Ever wonder why you can get the same drug in Canada for a fraction of its cost here? Because our government is prohibited from negotiating drug prices with pharmaceutical companies. Why an MRI or a CT scan here costs several times more than the same exam in Europe? Blame a lack of price transparency and competitive markets.

So the time is right for HR 1384, introduced in the U.S. House on Feb. 27 by Congresswoman Pramila Jayapal, D-Wash., and 106 co-sponsors. The bill would cover all Americans, irrespective of if they’re employed. (Employer-based insurance is an American historical anomaly; companies offered health insurance to lure soldiers returning from WWII.)

Under HR 1384, patients would not be responsible for cost sharing of medical expenses. Coverage would include hospitals, doctors, preventive care, prescription meds, dental and vision care, and mental health and addiction treatment. Unlike a recent similar bill, nursing home care is also rolled in. Private insurers would be prohibited from competing with the government plan, though they could offer packages for non-covered items like cosmetic surgery.

How would it be paid for? A national health budget would be developed. There will be taxes, offset by reductions, for individuals in insurance premiums, co-pays and deductibles. The government would negotiate drug prices with the companies that manufacture them.

Because company-provided insurance would go away, workers should expect higher salaries. No longer will people be tethered to a job because of having insurance there. Employers won’t have to worry about the year-to-year unpredictability of insurance premiums.

Opponents will decry what they will deem a “government takeover” of health care. But the only such takeover in HR 1384 concerns who pays the bills, and the government — Medicare, Medicaid and the VA — already pays nearly two-thirds of health care costs. The existing infrastructure of hospitals and clinics and medical schools will be unaffected.

The outcry from vested interests will show that HR 1384 will indeed cut costs. Remember Harry and Louise? Expect to see similar deceptive advertising. On the right, Sarah Palin’s death panels will be back in vogue, giving palliative care a bad name.

Our conservative friends advocate a society of equal opportunity, not equal outcomes. But when tens of thousands of our fellow citizens die annually because they lack health insurance, can we say that we’re providing equal opportunity?

Annual health care spending exceeds $10,000 for each American, and it’s going up. Are you getting your money’s worth?

Please contact Congressman Ron Kind, D-La Crosse, and encourage his support of HR 1384, and encourage Senators Tammy Baldwin and Ron Johnson to advocate for similar legislation in the Senate.

Dr. Steven Weiss is an Altoona resident and internist at Mayo Clinic Health Care System in Eau Claire where he’s practiced for 30 years. He and others have started a western Wisconsin chapter of Physicians for a National Health Program. Co-signors for this article were Drs. Mark Neumann, Lonnie Simmons, Ralph Knudson, Steve Manson and Erin Gutowski, all of La Crosse; Dr. Steve Brown and Diane Brown of Menomonie; Dr. Taryn Lawler of Viroqua; and Craig Brooks of Buffalo City.