By Dr. Louise Marie Roth for The Hill

I was in Canada this past June when I broke my wrist and had to go to the ER. They were fast and professional and the bill was much lower than what American ERs charge you just for walking in the door.

Under single-payer health care, you can see the savings on administrative costs with your own eyes. When you walk into physicians’ offices in Canada, they have a small administrative staff, often consisting of one person behind the counter.

They don’t need to employ extra people to fill out dozens of different forms for various insurers with multiple plans, all with different copays, deductibles and coverage. There are no copays or deductibles and everyone knows the rules for what is covered and how to bill the provincial insurance plan. They don’t need staff to spend hours fighting with insurers about which services or medications they will cover or how much they will pay.

Meanwhile, the U.S. pays more than twice as much per capita for health care ($10,348 in 2016) than Canada ($4,752), Australia ($4,708), or the UK ($4,192), but has lower life expectancy and higher infant and maternal mortality rates even compared to some less developed countries.

As someone who grew up in Canada and moved to the United States more than two decades ago, I have seen firsthand that American health care is expensive, unequal and inhumane — and that there is a better way that costs less, is more equitable and covers all pre-existing conditions. It’s time to solve this problem with single-payer health insurance, so that everyone gets care regardless of their ability to pay.

In this year’s midterm elections, health care was a top issue for American voters and nearly 60 percent favored Medicare-for-all. Now that the Democratic Party is poised to take over the House, it’s time to move forward. The most likely next speaker, Nancy Pelosi, said that all health-care options are “on the table,” and 123 Democratic representatives in the House are co-sponsors of Medicare for All legislation. Most Americans know that health care in the U.S. costs too much for too little, especially since the Trump administration and

Republican-controlled Congress have gutted the Affordable Care Act (ACA) by cutting insurance subsidies and permitting plans that exclude pre-existing conditions or lack comprehensive coverage on the insurance exchanges.

Even though the ACA was an inferior solution compared to single-payer, the result is that a growing number of Americans once again lack adequate health insurance.

Of course, Republicans, including President Trump in a recent USA TODAY oped found to have many fact errors, are fighting Medicare for All by calling it “socialism.” But when I ask my students if they would prefer a capitalist fire department, where firefighters only put out a fire if you have up-to-date private insurance or can pay the bill, they think that a taxpayer-funded socialized fire department is a much better idea. They do, however, worry that single-payer health care would not work in the U.S. because of its larger population. They usually don’t know that the U.S. already has socialized medicine in the form of Medicare and Medicaid, which covers more than 30 percent of the population. If federal and state governments can cover more than 30 percent, then why can’t they simplify the whole system and cover everyone?

What about the cost? Americans don’t want to pay higher taxes, even though single-payer costs much less per person than the current system. According to PolitiFact, people would pay more to the government for health care under Medicare-for-all, but less overall. Employers pay a de facto tax when they subsidize their employees’ insurance plans and could pay higher wages otherwise.

Some employers, like Walmart, pay their employees so little that some of their employees qualify for Medicaid. That way taxpayers pay instead of the employer. Others, like GM and Ford, move production to Canada where they pay slightly higher wages but are not responsible for health insurance. And when people use Emergency Departments for primary care because they have no coverage to see a regular health-care provider, everyone pays for their care.

Single-payer is simply the most efficient and most humane way to cover everyone, including those with pre-existing conditions, which many people have through no fault of their own.

My oldest son had a vascular malformation in his brain and needed brain surgery when he was six. Fortunately he is doing fine now but, as the federal government removes more and more of the protections under the ACA, I wonder if he will be insurable when he is no longer covered under my insurance. Why should he be unable to get insurance or have to pay exorbitant premiums when he did nothing to cause his medical history? Luckily he has an anchor mom — he can always move to Canada. Not everyone has that option.

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