In the upcoming midterm elections, the future of healthcare in the U.S. will be a major issue. As a practicing physician in central Pennsylvania. for over 35 years and as a cancer survivor, I offer my experiences and insights.

The three established measures of health care are quality, access and cost. Our current US healthcare system is frighteningly expensive; now totaling 18% of our gross domestic product and rising.

We spend on average twice as much as the more than 25 countries who provide universal health care for their citizens. But do we get more 'bang for our buck'? Unfortunately, the answer is no. If we look at three standards of health; infant mortality, life expectancy and preventable deaths, the U. S. ranks in the middle to back of the pack.

The Affordable Care Act (ACA) was an attempt to gradually provide health care for all. The ACA had success decreasing the percentage of uninsured from 18 to 12 percent nationwide. In states that expanded Medicaid coverage, the drop was greater.

Currently in Pa. only 6 percent of the population lacks health coverage. However, the ACA has suffered from a thousand small cuts from those who decry 'government-run' health care. The ACA like Medicare is not 'government-run' but did set standards for insurance quality.

Currently a health insurance policy for a family of four is on average $25,000/ year and rising. This system is not sustainable. Universal health care like Medicare would define the benefits guaranteed to each individual. It would not be perfect or all inconclusive.

The most unpopular condition of the ACA was the requirement of everyone to participate.

Of the over 25 countries with universal health care, all demand everyone to participate.

Yet, there has not been one country that decided on universal health care that has regretted and reversed that decision. What I hear frequently from patients is that they are 'thankful' they reach Medicare age and often their children and grandchildren were also.

Another frequent argument against universal health care is that we cannot even afford our current Medicare and Medicaid programs. Medicaid currently provides care for over 1.3 million military veterans, the bulk of nursing home costs for our elderly and disabled and children.

My experiences in clinical practice has led me to support universal health care with a single payer system over our current fragmented, expensive system. Universal health care will make our families healthier and our communities and country stronger.

Dr. THOMAS McGARRITY, Hershey