The elephant in the room on the health care question is the insurance industry, with its perverse incentives that reward "service" rather than maintain health and its profit from basic human needs. To dismiss Sen. Bernie Sanders' plan to ensure adequate health care for all Americans simply because it has not been accomplished in the past is pallid and cynical. The profoundly ill get extraordinary care. Our seniors get extraordinary care. Health maintenance for all is largely ignored. That is not the system to deliver the best outcomes for the greatest number of people. It needs to change — and not in increments building on a flawed market-based ideal.