By now, most people must realize how expensive the health care system has become under the Affordable Care Act.

Who is paying for all the subsidies to private health care corporations? Taxpayers are.

Who is paying their millionaire CEOs, their lobbyists, lawyers, stockholders and for the TV ads? The taxpayers are.

The Affordable Care Act allows 20 percent of health care costs to go to those wasteful enterprises called “overhead,” while the actual health care benefits they deliver are lower than with any other industrialized nation in the world.

A government-sponsored, not for profit, system of universal health care coverage — basically, an improved Medicare for all — can pay for health care services for everybody with an overhead of around 3 percent. According to Physicians for a National Health Plan, the U.S. could save $400 billion per year. That money could be spent on medical services that are not presently covered.

An expanded Medicare could negotiate physician fees, hospital costs, drug prices, costs of procedures, and prices of medical equipment. It could do meaningful studies on the effectiveness of medical treatments and of outcome measures.

How can this nation afford to not have a national health insurance program?

How can the people of this nation afford to not raise the quality of health care in this country?

John Sytsma, Farmington