America’s healthcare system has failed. It hasn’t failed by accident - it has failed because our political system is polluted and corrupted by big moneyed pharmaceutical and insurance corporations that fund politicians — like Republican Congressman Ed Royce — and they get their way.

I know this, because I’m an international healthcare executive.

Since 1999, I’ve worked for a company that sells international medical insurance. Our niche is to provide medical insurance in jurisdictions or under circumstances where the local infrastructure is unable to provide wide ranging medical insurance. As that company, now called Global Benefits Group, grew to have over 200,000 clients in 125 countries around the world, I got hands on experience working with medical providers, the diverse medical needs of clients, and local health insurance companies all over the world.

I’ve learned a lot in over these 18 years, but one lesson stands out: the most efficient way to provide universal access to affordable health care is a Medicare for All system that ensures care for everyone.

No other system can offer as universal access and as effective cost controls. Private systems spend between 10% and 20% of premiums simply figuring out who will pay the bill. Additional costs eliminated by single payer systems include the underwriting profit earned by the insurance company, usually between 8% and 15% of the premiums, and another 10% or more used for expenses and commissions. All in all, the current insurance system is a very expensive and inefficient way to pay for medical costs, and this inefficiency in turn makes it unaffordable for a broad section of the population.

In fact, the US system is unusually inefficient; as a percentage of our total income, the US spends twice as much on health care as our peer countries around the world, (England, Germany, France, and Canada for example), yet we still deliver worse outcomes on many of the most basic measures of medical care. Both the rate at which our newborn infants die in their first year of life, and our overall life expectancy are at or near the lowest ranking among the 30 richest countries in the world. Even with the progress under Obamacare, millions of families remain totally uninsured and vulnerable to severe strain in the event of a medical emergency.

The US medical system leads the world in many forms of treatment, and remains the gold standard for many advanced treatment options. The shortcomings are not due to lack of skilled and dedicated professionals, or falling behind in medical technology. No, our health care is expensive, access is far from universal, and our outcomes are substandard for the most mundane and basic of reasons; our private system does not provide the proper mechanism for the payment of basic medical services. For that we need a new system — Medicare for All — and we need it now.