By Laura S. Boylan, M.D., and Joanne Landy, M.P.H.This piece was originally posted at the Web site of Physicians for a National Health Program (http://www.pnhp.org).

One can only feel sorrow and dismay at the bullying and hate-mongering that is taking place at health care forums around the country.

Massive job losses, the devaluation and foreclosures of people’s homes, and precipitous declines in lifetime savings produce widespread fears of further loss. In an era of insecurity, mainstream Democratic Party proposals for reforming the health system have played into such fears.

A health care “reform” that protects private insurers and massive profits for the pharmaceutical industry inevitably becomes an ugly game where ordinary people’s interests are pitted against each other. Witness, for example, the proposed cuts to Medicaid and Medicare to fund an initiative that subsidizes the mandated purchase of private insurance with taxpayer dollars. Relatively little is offered to the already insured majority who are told of upcoming belt-tightening.

The near-total exclusion of single payer from the health care debate by our political leaders and the media has contributed to the present state of affairs. Single payer is an expanded and improved Medicare for All (“Medicare 2.0”). Many, perhaps most, Americans have come to believe in the false choice between universal coverage and quality health care.

Our nation needs a meaningful dialogue, including a fair hearing of the views of the 20 million constituents of the Leadership Conference on Guaranteed Health Care (of which Physicians for a National Health Program is a founding member), who advocate for single-payer national health insurance. Polls show that most of the public and their physicians favor such an approach.

There is simply no other viable solution to the problems facing us all, insured and uninsured. With Medicare 2.0, the already insured would benefit from radically reduced out-of-pocket costs for comprehensive insurance and expanded choice of doctors and hospitals. Medicare 2.0 stays with you for life, independent of your employment. The epidemic of medical[-related] bankruptcies would be just a bad memory.

It is unnecessary to pit the insured against the uninsured, or those with Medicare and Medicaid against those with private insurance.

Multi-payer, for-profit health insurance adds cost but not value to American health care. Savings of $400 billion a year can be obtained through the conversion to a single-payer system. With the money we are now spending (twice as much per capita as other developed nations), we can provide full service “what you need, when you need it” health care for everyone and control costs going forward.

With the “everybody in, nobody out” approach of a Medicare 2.0 system, we can all get more freedom, choice and security.

Single-payer advocates have been excluded from debate not because our premises or facts are wrong but because special interests, including the private health insurance industry and the big drug companies, have been allowed to define the limits of “politically feasible.”

We support the right to lively and dramatic expression of all views about health care and other issues in American political life. We share a common sense of frustration expressed by many protesters that it often seems that Washington’s ear is tuned to special interests over public interests. However, we strongly condemn the bullying and hateful speech that has precluded meaningful discussion at many town hall meetings.

The ugliest language suggests that the uninsured or undocumented should be allowed to “die in the streets” and asserts that areas with less racial and ethnic diversity are “the real America.” President Obama’s citizenship is questioned and he is likened to Hitler.

These actions have been facilitated and promoted by networks of well-funded, right-wing interest groups who have tapped into a vein of fear and discontent in a time of rapidly rising hardship and anxiety.

With this deteriorating public dialogue, we should affirm that we can get better health care by sticking together to support single payer. We support meaningful dialogue. We affirm the dignity of all persons and insist that health care is a universal human right.

Health care is instrumental to “life, liberty and the pursuit of happiness.” We continue, as ever, to insist that “everybody in, nobody out” is best for all of us and embodies the best of American values.