Today is Medicare's 49th anniversary, having become law in 1965 under President Lyndon B. Johnson. Before 1965, as many elderly became sick but too old to work, they simply became impoverished and died.

Despite its warts and room for improvement, Medicare remains more efficient than private health insurance. Its costs have risen more slowly, and yet it provides better access to care, better financial protection, and higher patient satisfaction.

In contrast to ideological disputes over the Affordable Care Act (Obamacare), Medicare offers 49 years of living proof that public, universal health coverage is superior to private insurance in every way.

Unlike the rollout of health care, government and state exchanges under the Affordable Care Act, Medicare was implemented smoothly and at low cost because the program is universal and didn't juggle enrollment in hundreds of private insurance plans.

All industrialized nations, with the exception of the U.S. provide health care to their citizens. While we should take pride that seniors have wonderful health insurance in Medicare, we should be equally concerned that 40 million Americans under the age of 65 do not. This can be fixed without raising taxes.

The United States spends twice as much per capita as any other nation on health care. Despite the fact that we have the finest medical schools, research laboratories and hospitals in the world, they are of little value to patients who can't pay for care.

With all we spend, we can afford to provide essential services to every American without imposing co-pays, deductions, caps or exclusions.

A bill in Congress, HR 676, would do just that. Titled the Improved Medicare for All Act, it would provide basic services, including preventative care, hospitalization, medications, mental health, and long-term care.

The Congressional Budget Office (CBO) determined it can be provided without raising taxes.

Universal health care would not only extend coverage to everyone below age 65, but it would improve coverage for seniors.

For example, Canada's universal plan covers 79 percent of seniors' costs compared with 51 percent covered by Medicare in the U.S.

Single payer also makes Medicare financially sustainable. Medicare would have saved $2 trillion if its costs had risen at Canadian rates since 1980.

While we can afford health care for all our citizens, we cannot afford the wasteful system we have today.

For-profit insurance companies suck a quarter of all health care premium dollars away from providing care and instead fuel a very healthy bottom line.

Medicare does what insurance companies do for a tenth of the cost.

If for-profit insurance companies disappeared tomorrow then those premium dollars could be put into our rural hospitals and clinics and not the pockets of insurance CEOs.

The way to improve Medicare is to drop the enrollment age from 65 to 0. Replace the paper pushing that for-profit insurance does at 71 percent efficiency with Medicare's 98 percent efficiency.

Continue to deliver care privately - choose your own doctor and hospital, but fund it publicly - like police, fire departments and libraries.

David S. Ball, R.N., MHA

Healthcare for All - SC

Winchester Drive

Charleston