With the collapse of the latest dismal effort to repeal the Affordable Care Act, commonly known as ObamaCare, the Graham-Cassidy block grant scheme, it's time to try a different approach - let's expand coverage and improve our healthcare system, not decimate it.

Sen. Bernie Sanders (Vt.-I) this week is unveiling new legislation, the Medicare for all Act of 2017 that could finally achieve the dream reformers have advanced for more than a century - genuine universal care for all its people, guaranteed for everyone, regardless of ability to pay, gender, race, nationality, or where you live.

Medicare for all is not a "pony" as some dismissive critics would smugly like to assert. It's a life and death struggle for millions of Americans.The "pony" crowd is losing ground to a growing mass movement and popular support.

A July Associated Press-NORC Center for Public Affairs Research poll reported that 62 percent of public - and 80 percent of Democrats - believe it is "the federal government's responsibility to make sure that all Americans have health-care coverage."

Support is rapidly building, both for the new Sanders' bill and Rep. John Conyers (D-Mich.) single payer bill.

Reasons for the shifting moment are many - the ongoing health crisis experienced by far too many of our neighbors and family members, the overwhelming response to Sen. Sander's emphasis on the issue in his 2016 campaign and since, and the tireless work of long time activists, especially nurses, on the need for transformative healthcare reform to a system based on patient need, not private profit.

Even with the considerable gains under the ACA, 28 million are still uninsured. Millions more struggle with out of pocket costs so high, even after paying their premiums, that prods them to forgo needed care, putting their health and life at risk.

Here's what one nurse, Michelle Gutierrez Vo, who works in a hospital clinic, experiences.

"I see patients not taking their medications to prevent life threatening conditions from advancing or happening, or bypassing appointments when not feeling good, because they can't afford co-pays. They wait until they're really ill and then end up in the emergency room where the co pays are sky high."

"By the time they end up in the ER, they may be near death, literally, with a bigger bill, and then they usually will end up being admitted to the hospital. So now they are fighting for their life, and if they are lucky enough to survive, they come home with a bill they can't pay. That is inhumane," says Vo.

Or Deborah Burger, RN, co-president of National Nurses United, who works in a gastroenterology clinic doing colonoscopy and upper endoscopy screenings, and following up with patients with gastrointestinal bleeding.

"I've seen more patients delaying their very important pre-cancer screenings because even with good insurance they are having co-pays of $300 to $3,000 for a colonoscopy or upper endoscopy. When they then come back, many of these patients have pre-cancerous polyps that have become cancerous, which makes treating the disease going from a simple snip to having major surgery."

No wonder death rates from colon cancer for white Americans under 55 are increasing. It's not just colon cancer. Overall, Americans are dying younger. A Bloomberg news report found that in 2015 the death rate rose for the first time since 1999.

As Sen. Sanders emphasizes, we're the only major country that does not guarantee care for all of its people. Over the past seven years, for example, France, Japan, Norway, Taiwan, and the United Kingdom had an aggregate total of zero people affected by bankruptcy due to medical bills; in the same period the U.S. had 4,872,487 people.

More than four in ten adults with health insurance face financial distress due to the high cost of deductibles, according to a recent Kaiser Family Foundation survey. Nearly 30 percent had trouble paying medical bills, with 73 percent of those cutting back on spending on food, clothing or other basic items. Significant numbers skipped dental care, going to the doctor, getting a recommended medical test or treatment, or filling a prescription.

"It's frightening to think some of our patients suffer the consequences of major heart attacks or worsening strokes because they didn't come in when they first saw the symptoms and thought they could take care of it at home. And then they end up in the hospital with major strokes or heart attacks and damaged brain or heart tissue as a result of the delay," notes Burger.

All the other countries that have embraced guaranteed, universal care are not letting private insurers or pharmaceutical giants, or the politicians and think tanks they fund, dictate whether people are entitled to care. It is viewed as a moral obligation, a responsibility to the common good, what it means to value people as part of your community, as contributors to your nation, not as commodities to be exploited to pay for the next CEO's private jet.

"We all need access to care in order to survive," says Vo. "We can't live without healthcare, from birth to death, no matter how much money you make. I think about it with my patients every day, they are one appointment, or one illness away from being homeless, all the time. People don't realize that, until it happens to them. In a country so rich, it shouldn't be like that."

RoseAnn DeMoro, executive director of National Nurses United, has emerged as one of the nation's preeminent advocates for genuine healthcare reform and working people. DeMoro also serves as national vice president and executive board member of the AFL-CIO.