Greg Ip’s Wall Street Journal article about Sen. Elizabeth Warren’s Medicare for All proposal (Nov. 6, 2019) takes a much needed look at the costs of healthcare in America. Respectfully, the piece overlooks some critical day-to-day realities many patients, their families and doctors like me encounter every day.

In my emergency department, I sometimes find myself begging patients to take a test that could diagnose a life threatening condition but which they’d like to skip because the test costs too much or they’re worried their insurance won’t cover it. I’ve sat on the phone with pharmacists countless times when a drug prescribed a day or two earlier is not covered, as I pore through the patient’s chart to find alternative medications they can afford. I work in a hospital with a dedicated financial adviser who spends eight hours every day helping cancer patients hunt for rebates, coupons and grants so they can pay the $15,000 bill for an infusion.

These are the daily challenges that Sen. Warren’s Medicare for All proposal aims to overcome. Where the average family of four in America today pays $28,000 for premiums and an extra thousands of dollars more in out-of-pocket costs, Sen. Warren’s proposal reduces those costs to zero.

Expensive healthcare forces my patients to effectively ration care, making decisions based on what they can afford, not on what they need to be healthy, independent and productive.

The real drivers of runaway costs are drug and insurance corporations that price medications and premiums out of range for most Americans. Big Pharma is not shy about raking in huge profits: In 2018, drug companies spent a whopping $3.73 billion in TV ads. Johnson & Johnson spends twice on marketing than on research and development. Meanwhile, Americans are making pilgrimages to Canada for cheaper insulin, which costs $18,000 a year and without which diabetics can die.

As healthcare expanded between 2010 and 2016, uncompensated care –  a financial albatross around the necks of hospitals at $38.4 billion a year – fell by one-third as a share of hospital budgets. In my state, Michigan, Medicaid expansion slashed uncompensated care by more than half. The evidence also shows that when more people have healthcare, such as through Medicaid expansion, they tend to use the ER less often and stay in hospitals shorter. Contrary to Mr. Ip’s assertion, data shows healthcare expansion has no impact on utilization rates. In short, getting people insured is a good thing, for patients and hospitals.

Sen. Warren’s Medicare for All proposal covers all 331 million Americans, lowers prescription drug costs through Medicare’s bargaining power, allows patients to see any doctor they want anytime because virtually every provider and hospital is technically in the network. Dental care will be covered, something providers know can make a huge difference for kids who would otherwise skip school because of embarrassment and adults who can now confidently go to a job interview.

Sen. Warren deserves credit for her courage to intentionally outline how she’ll pay for Medicare for All, and more importantly, how her plan can help stabilize hospitals and other healthcare delivery systems. By expanding Medicare, hospital-based specialties like emergency medicine, general surgery, orthopedics and OB/GYN would be more financially viable. This is especially crucial for small hospitals  struggle every fiscal year to keep critical departments open, from labor and delivery to outpatient rehab and therapy.

My fellow physicians and I went into medicine to help people. While we’re privileged to get to do that, we also find ourselves spending too much time wrestling with the insurance industry for approvals. Billing, coding, prior authorizations – all the red tape and frustrations of our current dysfunctional healthcare system would be significantly reduced under Sen. Warren’s plan. For patients, stress is the last thing they need. Medicare for All allows patients to focus on healing, not insurance bureaucracy.

Our healthcare paradigm today correctly encourages doctors and providers to treat the whole patient. As an emergency physician who’s seen patients for 20 years, I believe Sen. Warren’s Medicare for All plan understands the symptoms of our ailing healthcare system, provides a responsible diagnosis, and prescribes holistic treatment that our nation ignores at our peril.