There's a big reason why Americans pay about twice as much for healthcare as people in other developed countries, and it's not corporate greed or political cowardice, although those are also factors.
This was highlighted for me by the dozens of emails I received in response to a recent column on "Medicare for all." I laid out the case for why conservative claims of financial Armageddon were wrong and why a national single-payer insurance plan could save us trillions of dollars annually.
Gerald Kominski, a professor of health policy and management at UCLA, told me that once you clear away all the complicated policy brush, there's one inescapable conclusion about Medicare for all.
"Most families would be better off," he said, citing multiple studies showing that total out-of-pocket costs for most people would go down if current premiums, copays and deductibles were replaced by a tax.
This didn't sit well with some readers.
"I don't care that most families will be better off," one commented. "I am strongly opposed to paying for someone else's healthcare."
I reached out and asked if he'd be willing to elaborate on his email. He said he'd speak with me if I agreed to shield him from social media scorn by not publishing his full name.
So I'll refer to him only by his first name, which is David. He's a 58-year-old "software professional" residing in San Diego County. He's a registered Republican.
"I make a lot of money," David told me. "I'm not ashamed to say that. I work really hard."