I don’t know about you, but everyone I know these days is struggling with something: with their health or the health of a loved one, with their finances or their career, with an addiction or a relationship — even with the nature of existence itself. That’s life, right? True, but something more is fueling these struggles, something harder to define, something that makes already difficult problems feel impossible to bear. Most of us put on a brave face each morning and attempt to be cheerful, but an undercurrent of vague worry pulses through our surface interactions; a shared common sense that things aren’t right in the world, our communities, ourselves.

I wish I could blame this perception on a fertile imagination. But statistical science proves otherwise. In the last few decades, Americans’ sense of wellbeing has steadily declined, a disquieting trend that’s been gaining in severity and speed over the last few years. One frequently cited culprit is extreme income inequality, currently at levels not seen since the years leading up to the Great Depression. In fact, several studies have proven that “the more income is concentrated in the hands of a few, the more likely individuals are to report lower levels of life satisfaction and more negative daily emotional experiences.” That makes sense. But abstract analyses like this fail to address and define the concrete factors underlying them. What exactly is getting us down?

For the 78 percent of American workers living paycheck to paycheck, the constant (if deeply buried) knowledge that we’re one severe illness or hardship away from the streets is the “wolf at the door” preventing us from feeling truly happy even when, on the surface, everything seems to be going our way. This brand of survival mode can lead to chronic stress, a medically acknowledged precursor to a variety of mental and physical illnesses. According to a report by the Institute of Medicine titled “Shorter Lives, Poorer Health ” : “Even advantaged Americans — those who are white, insured, college-educated, or upper income — are in worse health than similar individuals in other countries.”

The decline in our mental and physical health seems to be driving our decline in wellbeing. American life expectancy is down, in part because suicides are up, increasing 33 percent from 1999 through 2017. Even when we might need medical attention, too many of us abstain because nearly half the population is uninsured or under-insured, putting the astronomical costs of health care out of reach. Now, more than the fear of getting sick, we fear the cost of getting sick.

Our ongoing health care crisis is perhaps the most discernible and deadliest symptom of our culture’s rampant inequality. When a 10-15 year life-expectancy gap exists between the richest and poorest, and when Americans die from curable diseases more often than in other nations in the Global North, is it too far-fetched to speculate that systemic injustices like these might be part of what’s making us sick?

Meanwhile, over on Wall Street, business is booming and has been for years. In the third fiscal quarter of 2018, the eight largest health insurance companies profited $132.4 billion, while the top pharmaceutical giants raked in around $30 billion. By the end of 2020, health sector profits are projected to increase by $500 billion.

Some groups in the health sector are now using some of those profits to wage a campaign against Medicare for All, attempting to skew public opinion by saturating the debate with misleading headlines, cherry-picked “facts” and politically divisive rhetoric. It would be a mistake to let ourselves be fooled. There’s only one reason the health care industry opposes Medicare for All, and that’s profit.

Of course, it takes money to make money, which is why this year alone the health care industry spent $284 million on its brainwashing mission. Lobbyists are all geared up to help our elected officials express their concerns. The Partnership for America’s Health Care Future (PAHCF) is perhaps the most dominant menace, but this disinformation campaign is being waged by smaller groups, such as the American Hospital Association and America’s Health Insurance Plans, that also stand to profit from our nation’s widespread misery.

A recent article in Forbes titled “Health Experts Unanimous In Objection To Medicare-For-All” is a glaring, shameful example. The unanimity between “health experts” here applies to just three-of-three panelists who led an otherwise unremarked-upon conversation about “value-based care and cost containment” at the 2019 Forbes Healthcare Summit. More importantly, these panelists are far less experts in health care than they are experts in profiting from health care, each boasting a top executive position at a company that reported record profits last year (Dana-Farber, Northwell and Aledade).

Even the writer of the Forbes article, Lisa Fitzpatrick, appears to have an agenda. The CEO and founder of Grapevine Health, a company with the hazy mission of “demystifying healthcare for the community” and headquartered in Washington, D.C., Fitzpatrick contributed her first article to Forbes in November 2018, around the same time health industry lobbyists and their sponsors started executing their strategy to turn what they saw as mounting support for Medicare for All into opposition.

Regardless of the confusion and doubt being planted by those who’ve amassed tremendous wealth from our current system, the truth, as always, is simple and clear. Americans already spend far more on health care, while getting far less than in any other country in the world. How could cutting out the middlemen who drive prescription drug costs up and the quality of patient care down be a bad thing? Sure, we’ll have to pay more in taxes, but that amount won’t come close to what we currently spend on insurance premiums and other medical expenses. Eliminating the burden of health care costs will give the middle class the much-needed financial boost it’s been deprived of for a generation. But the clearest and simplest truth is this: Every nation with universal health care boasts a population that’s significantly healthier and happier than ours, and that can’t be by coincidence.

PAHCF claims it wants to “build on what’s working” and “fix what’s not.” But there’s no use in hammering shiny new nails into a collapsing structure. What we have now isn’t sustainable. The entire foundation is rotten. If “Obamacare” taught us anything, it’s that incremental progress within a broken system is a fantasy.

Speaking of the moniker “Obamacare” and its politically divisive connotations, I suggest we start calling Medicare for All what it actually is: universal health coverage. Medicare (and its lexical sibling Medicaid) are vital social programs which Republicans nevertheless tend to spin as charitable services doled out to those unable to pull themselves up by their own bootstraps. Medicare isn’t a gift the government benevolently grants us at the age of 65. It’s something we’ve paid into, worked hard for and absolutely earned.

At this critical time in our history, we can’t afford to fall prey to “greed is good” capitalism, myths about the poor being lazy and the rich being industrious “jobmakers” or the blatant deceit of those who claim our government can’t afford to guarantee its people health care. On the contrary, numerous studies have shown that we can’t afford anything else.

At the root of the debate about health care is a fundamental question that will help us define the next phase of our evolving national identity: Who are we as a people? No doubt, it’s a big question, but answering it will help us move past the death of the “American dream” into a waking reality of what many of us believe against all odds might still be possible: equal rights and equal protection for all under the law.

Justice in the context of the U.S. Constitution refers to set laws that guarantee the human rights of each citizen, ensuring some degree of fairness. Life isn’t fair and no one said it would be fair, but our government’s purported primary purpose is to mitigate some of this unfairness so that the powerful, violent, greedy or simply immoral members of our society aren’t allowed to cause injury to others. If our government isn’t responsible to provide its people with health care, why then did it help to draft and then ratify “The Universal Declaration of Human Rights” which plainly states that it is? In regard to this right and many others, our government presumes exemption.

In the most clear-cut battle between the haves and haves-nots in U.S. history, the haves are winning by a landslide. What do any of us have without our health? Not much. Yet we’re getting sicker and poorer while our nation’s surplus of wealth keeps getting funneled toward and consolidated at the very top. Most of us think of ourselves as either a “Democrat” or a “Republican,” and however we feel about Medicare for All is apt to depend on that.

But if we can think of ourselves as human beings first, we can win this battle. The principle of the matter is our shared belief that it’s wrong for both the quality and the duration of our lives to be determined by our income, as if we’re each walking around with a dollar amount on our foreheads determining our human worth. Seventy-one percent of Americans favor a system that would guarantee health care as a right. Support fluctuates based on questions of how it will be instituted and paid for but the guiding principle here, shared by a supermajority of voters, is abundantly clear. Because when we look beyond our party’s blinders, we see that the crux of the health care debate isn’t a political one, but a moral one. Working together on an issue that transcends partisanism could help unite our divided states for the first time in many generations. It’s not only urgent that we do so, it’s a matter of life and death.

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