A hundred years ago medical care didn't make much difference to whether you lived or died. But now medical care has become adept at saving lives. It is as necessary a part of current human life as sanitation or transportation.

Our health care system has excellent providers, and uses excellent technology, but we are getting very poor results. Each year costs increase while our infant mortality rate is higher than 37 other countries including Cuba and Slovenia. We are now paying more than 16 percent of our gross national product on health care. That's almost twice as much per person as any other country. And people in other developed countries are living longer and healthier lives.

We think of medical care like a commodity, like a car or an iPod, to be purchased with disposable funds. But health care is not a free-market arrangement. It is also based on human compassion.

If you have a heart attack and call 911, the dispatcher doesn't inquire about your financial status before calling an ambulance. Instead, you receive life-saving care regardless of your ability to pay. But somebody pays.

Those people who insist that they don't want to pay for other people's care are deluding themselves. They are already doing so. The cost for emergency medical treatment is distributed to everyone through increased insurance premiums, increased deductions from paychecks, increased out-of pocket expenses, and increased government programs.

So should we keep a system where we all pay for emergency care for about one-fifth of our people, while they are denied basic primary care and preventive care that might avert the emergency?

Currently, most health insurance is tied to employment. The insurance companies are delighted with that arrangement. After all they don't have to hassle you for payments; the boss takes the premiums out of your paycheck. If you get really sick, you probably will not be able to work and you will lose your insurance. That lets the insurance company off the hook.

Our health insurance is a regressive tax. It comes out of your paycheck. It is not based on income, it is based on age and infirmities. It is paid to the insurance companies whose basic motivation is not to provide us access to health care but to make a profit for investors.

Having a national health insurance would not bankrupt our country, but not having one most certainly will. We cannot rely on canisters located on grocery-store countertops to pay for medical treatments.

Let's start thinking about health care like we think about the fire department. Would you really want the fire department to only put out fires for people who could pay for it? We, the richest country on earth, can use our wealth and power to fund adequate health care.