This week our country formally begins the election process to determine who will be our next president come January 2021. There are so many critical issues that face our nation as we look to the future. When it comes to the general well-being of our country no issue is more important than health and the access to medical care for all. It is estimated there are approximately 90 million people in this country who have either no insurance or who are underinsured. To remedy this issue there is really only one option that guarantees universal coverage to everyone and that is Medicare for All. This program is promoted by Senator Bernie Sanders who has championed universal single payer healthcare for decades.

As a family physician I am faced with a daily dilemma of trying to care for individuals who have no insurance or who are underinsured and are unable to purchase prescriptions, let alone pay deductibles or significant copayments required to get the care they need. This is particularly true in both my working poor families and impoverished elderly patients living off their Social Security checks. It often boils down to buying groceries and paying the rent versus paying for their prescribed treatments. This insane choice often affects the outcome of disease management and can even be life-threatening. This is especially problematic in dealing with conditions like diabetes management and the cost of new insulins, therapies for common life-threatening heart arrhythmias with the exorbitantly priced blood thinners necessary to prevent strokes and death, and the newer biologic agents for various types of rheumatologic and arthritic conditions where prescription costs can be in the thousands of dollars a month.

The excessive drug costs across the entire healthcare spectrum can be overwhelming for families with limited means. This often results in the need to prescribe older and often substandard therapies or even having patients make the choice themselves, typically unknown to me, to go without therapies or to take these therapies on alternate days often resulting in disastrous outcomes. The further reality is that these families often find themselves one illness or injury away from bankruptcy.

As a practicing physician, the delivery of healthcare is increasingly burdensome and costly from the authorization and referral work and redundancy required to coordinate and direct patient care to the billing, referral, authorization and coding staff required to process and justify the necessary care. These add costs, burdens and delays to the process of care provision. Even with insurance, our role as physicians in recent years has added the component of patient advocate to navigate the system.

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There have been alternative proposals to address these health disparities and access. These include providing a public option which ultimately is simply an extension of our current dysfunctional piecemeal, non-uniform tiered system. This is represented as allowing individuals greater choice to determine their own healthcare needs. Unfortunately, no one can know what their future health needs will be. When will tragedy or illness hit? Individuals will invariably purchase the lowest cost program assuming they have coverage only to find huge deductibles, copayments or inadequate drug and pharmacy coverage. In addition, employer based programs are moving similarly to these bare-bones options.

Only through universal coverage of every person in this country through a comprehensive Medicare for All program will people obtain the preventive and follow up medical care services that is their right and should be afforded to everyone in our country.

It is at long last time for the United States to move from providing the world’s most expensive sick care to providing the world’s greatest healthcare. The American College of Physicians, the nation’s largest medical specialty society has recently endorsed single-payer Medicare for All.

For the wellness and health-sake of our nation, will you join me in supporting Senator Bernie Sanders for President of the United States?