In 2020, the United States collectively spent $4.1 trillion on healthcare. In 2021, the number went to $4.3 trillion. We don’t have numbers yet for 2022, but judging by the continued price-gouging in the pharma and insurance sectors and the continued incursion of profit-hungry private equity, that number will be higher.

Let’s give this a bit more reality because numbers with that many zeros tend to get invisible. Our healthcare system sucked up around $136 billion every day in 2021. In short, we collectively spent more than the annual Pentagon budget in about five days.

There was a very astute meme a few years ago that said,

“Universal health care is such a complex beast that only 32 of the world’s 33 developed nations have been able to make it work.”

One can get the idea that we are just a nation of suckers. Indeed that might be the case. Every argument against the idea of universal healthcare or Medicare for All is attacked with vengeance as a Communist plot or worse—ever since the AMA made those allegations against the idea when Truman proposed it in 1947.

The fact is that all of the arguments against some sort of universal healthcare system come exclusively from companies and entities that profit from holding the health and very lives of Americans hostage.

Our healthcare system practices a legalized form of extortion. And it should come as no surprise that those who seek to siphon all available funds—and more—from our wallets scream foul and shout about Communist plots if these income rivers are threatened.

With the signing of the $1.7 trillion spending bill last year, we saw the first brakes being applied to some of the rampant abuse from this sector with the $35 monthly cap on insulin for seniors. That was a good thing. But what was largely ignored is that drug giants are still price gouging everyone not on Medicare for insulin—a fact that California and other states are suing them over.

A study in 2020 cited by Public Citizen stated that universal healthcare would save trillions and eliminate another pernicious element in our society: medical debt. Healthcare costs has gotten so enormous that an entire financial industry has grown to prey upon people who cannot afford their treatments.

Drug companies are of course the first target when one thinks of the price gouging of medications needed to keep people alive. But they are by no means alone. Hospitals, Pharma Benefits Managers, and private equity firms all have their hands in our pockets.

Medical over billing is a huge problem, with people being trapped in debt and hounded by collectors. Hospitals have become notorious for massively inflated charges. Kaiser Health News has a whole section dedicated to these billing practices. Pharma Benefit Managers (PBMs)—the murky middleman organizations like CVS Caremark who have inserted themselves between patients, insurance plans and pharma companies—further inflate costs to pay for their “services.”

The bottom line for Americans is if you become ill and want to stay alive you have to pay a LOT of pipers for that privilege.

The truth of the matter is that universal healthcare is not that complicated. But the people who benefit from its perceived complexity are the same people who created that complexity—for their own benefit. So when anyone tells you that universal healthcare is a bad thing, a Communist plot, a conspiracy theory to take away some right, ask them, “Are you being paid to say that?” When it comes to Members of Congress, of either party, the answer to that question is probably a resounding yes—even though they might choke saying it.

Getting out of this decades-long mess will take resolve, understanding, enormous political will and integrity. It will require a collective recognition that there is nothing right about this situation, well expressed by Chris Rock’s character in the film Head of State:

This is the attitude we all need to take, all the time, unrelenting until we as American citizens get the one right back that has been kept off the table: the right to not have our lives and health held for ransom.

How did it get this crazy? We believed liars.

Solution? Don’t do it anymore. Call them out. Vote them down.

End of story. It is actually not that hard to fix and we all get the benefit of health without being held for ransom.