This week, Republican senators are squabbling over the details of just how they plan to remove more than 20 million people from health insurance coverage. That’s really what their plan to repeal the Affordable Care Act means.

As of June 26, they haven’t passed their bill. What will happen if they do?

In brief, it would remove people from Medicaid and close down nursing homes. It would remove millions of poor women from care that has been provided by Planned Parenthood at women’s clinics in places where no other such care is available. It would close clinics that treat people addicted to opioids — drugs whose overdoses killed 58,000 people in 2016.

To rub salt in the untreated wounds of the people, the ACA’s replacement would cut taxes for the rich and even more for the super-rich. It would shift costs for health care and health insurance to people who can afford it least.

Whatever the ACA’s shortcomings, what the current president, Paul Ryan and the congressional Republicans are doing by “repealing and replacing” it would prolong suffering and condemn to death hundreds of thousands of people in the United States.

Thirteen white male senators debated and drafted the new bill behind closed doors. These millionaire senators — whose own health care and that of their families is guaranteed — thus avoided having their contempt for the poor aired before the population.

But the senators finally showed their contempt publicly when they had the Capitol cops brutally expel the courageous people with disabilities who protested.

The best first step this summer of 2017 is to mobilize the majority of the people who want to stop Congress from eliminating the ACA.

Even with the ACA, the U.S. capitalist health care industry produces more profits than care delivery. This lucrative profit center costs over $3 trillion, 17.8 percent of the gross national product. That’s nearly double the profit proportion in Britain, Germany or Canada. And it delivers less overall care.

This mammoth industry often fails to produce health. It always produces profits: profits for private insurance companies, for private hospital owners, for pharmaceutical cartels and for medical equipment manufacturers.

The drive for ever increasing profits determines what services are offered, what are delivered, who gets them and who is denied them.

While the ACA succeeded in giving more than 20 million previously uninsured people access to health insurance, it did so by expanding Medicaid and subsidizing insurance companies. It did nothing to control the prices and profits of the health care industry.

So the second step is to fight for what is called a single-payer system. It not only expands access to care, it eliminates excess administrative costs imposed by private insurance companies — including their profits. In capitalist countries where such a system exists, there is more control of costs for procedures and medicines.

Medicare, available to most people in the U.S. over 65 years old and some people with disabilities, provides a model. Single-payer is a version of “Medicare for all” that is easily understandable and already has polling support from a third of those asked.

Workers World supports real socialist medical care. This can only take place in a socialist society that removes profits as the driving force of this industry, profits that increase the costs of medicines, equipment and care. That’s why we fight for a socialist society that places all the means of production into the hands of the workers.

What faces the U.S. workers now is a murderous attack, an attempt to replace the ACA — also called Obamacare — with “Trumpsick.” If workers here can mobilize first to stop that attack, we can then move to fighting for “Medicare for all.” In that struggle, Workers World will continue to expose the pernicious role of capitalism that puts the drive for profits before the care of the people.