George Bohmfalk, M.D., is a retired neurosurgeon who splits his time between Carbondale and North Carolina. He is active in Physicians for a National Health Plan. This group of physicians believes that the only cure for our fragmented, dysfunctional and outrageously expensive health care system is to replace it with improved Medicare for all. Dr. Bohmfalk graciously agreed to write today’s guest column. — Greg Feinsinger

Medicare turned 54 a few weeks ago. Next time someone says the government can’t do anything well, ask him or her how their grandmother likes her Medicare. While not perfect, it’s a very, very good and popular federal program. Most people can’t wait to turn 65 to get on it.

Other than Medicare, our national health care system is pretty terrible. Last week, the New York Times ran a story about a Mississippi lady with job-related insurance whose company flew her and a Mayo Clinic-trained orthopedic surgeon to Mexico to do her knee replacement. The company saved so much that it gave her $5,000 for her inconvenience.

This is scandalous, but it’s nothing new. Many more people leave the United States for medical care than come here for it, due to our exorbitant costs. We have great doctors and hospitals here, but fewer and fewer of us can afford them.

Before Mexico builds a wall to keep out bargain-seeking U.S. medical tourists, and Canada stops filling our prescriptions, we need to fix our system.

Presidential candidates are confusing how best to do that. Most of them favor tinkering, taking incremental steps in the general direction of a genuine solution. Some, like Sen. Bennet, propose a public option, which would simply add one more bureaucratic insurance program to our already cluttered system without addressing the main cost factors or covering everyone.

The best and most commonsense fix, and the only way to truly control health care costs, is to have one, single insurance program, like Medicare, administered by the government, paid for by taxes, with delivery of health care remaining in the hands of private doctors, hospitals and other providers. Such a program, as in single-payer Medicare for All, could save the country half a trillion dollars each year that are now wasted on administrative overhead. That waste is the result of having hundreds of for-profit insurance companies and thousands of complex plans, with their bloated and expensive bureaucracies.

While Medicare for All is very straightforward, many people remain unclear on two points: How will we pay for it, and will people have to give up their present insurance plans?

First, we’re already paying for it. The money is just being wasted. The truth is that we can pay less for guaranteed, comprehensive health care by paying for it through taxes. That’s how we pay for many public safeguards, like fire and police protection, which we hope we won’t ever need but are happy to have available if we do. Yes, there will be new taxes, mostly payroll, shared by employers and employees. But there will no longer be insurance premiums, deductibles, copays, payments for prescription drugs, and the many other health care costs that most of us pay each year.

What matters to most people is how much money leaves their pocket for health care, not particularly where it all goes. With Medicare for All, less money will leave your pocket in taxes, for comprehensive, lifetime health care coverage, than does now for restrictive private insurance and other health care costs. Because a single-payer system can save so much money by eliminating administrative waste, we truly can pay less and get more. As employers will no longer bear the burden and cost of providing health insurance, workers should finally enjoy both higher wages and permanent health care protection.

Some say they like their current insurance and don’t want to give it up for a plan administered by the government. Really? You like the idea of being sent to Mexico or India for surgery? In a recent survey, 59% of respondents with employer-provided insurance said they would support switching that insurance to a government plan like Medicare for All as long as quality of coverage would remain the same or improve, as it certainly would. Choice of our doctors, close to home, is what really matters, not choice of for-profit insurance company.

We don’t deserve to be shipped abroad for surgery. We shouldn’t have to import prescription drugs from Canada. We can fix this. Medicare, even with its imperfections, is the most popular and efficient insurance plan in the country. Let’s improve it to cover everyone, forever, with no deductibles or copays. Medicare for All can work for all of us.

Dr. Bohmfalk is a retired neurosurgeon and member of the Colorado Chapter of Physicians for a National Health Program (PNHP.org).