As a family physician and health-care advocate, I have fought for universal health-care access for more than 25 years.

In 1997, I advocated for the proposed Healthy and Well Kids in Iowa (HAWK-I) program by writing in an op-ed that a “child with a laceration on the arm goes to the school three days after the injury happened. The wound is held together with a bandage of rags and electrical tape. The child has no insurance.”

After the passage of the Affordable Care Act (Obamacare), I helped create CoOportunity Health, the health-care cooperative that, in one year, insured 120,000 individuals in Iowa and Nebraska. Though CoOportunity failed, it showed the need for an option for individuals unable to find adequate health-care insurance.

My work with HAWK-I and CoOportunity Health has taught me three lessons regarding the citizens of Iowa.

• First, we all want the peace of mind that our families have access to health care. Thousands of parents signed up their children for HAWK-I. Likewise, despite a projection of just 17,000 in the first year of CoOportunity, 120,000 signed up.
• Second, Iowans want choices. Being told they are trapped with only one choice of health coverage will draw much unhappiness. But more importantly, Iowans will not like having private insurance taken away from them. I have learned from personal experience the wrath of taking a service away from a populous.
• Third, Iowans trust what they know. If they are healthy and/or have good health insurance, they will still prefer private insurance. As an alternative, Iowans know and trust Medicare. Medicare will be a good second choice of Iowans.

Democratic presidential candidates are touting their plans for universal health care. Since 2016, I have supported expanding Medicare to individuals 55 years of age and older in a graduated, voluntary enrollment process. Please see those discussions from May 2016, March 2017, April 2017 and July 2019.

I believe private insurance companies have been egregious in their attempts to thwart efforts to provide for universal health access, including those that led to the demise of CoOportunity Health. Also egregious are their actions to provide less-than-adequate care in relation to access to or cost of medical procedures or prescription drugs. Nonetheless, I do not think it is feasible politically nor popular per our citizenry to eliminate private insurance.

I do believe a good public option such as a Medicare buy-in will eventually lead to a great diminution of employer-based private insurance, as well as the individual private insurance market in the future. I do not think organizations will want to be in the business of providing health care to their employees. I think businesses will offload health-care responsibility if their employees have a reasonable alternative.

I have observed that even countries with universal health-care coverage have private insurance options for their citizens, as does our own Medicare program, which has private supplemental-insurance options.

To eliminate private health-care insurance seems to me a goal that is an unnecessary obstacle that is not worth it in the fight for universal health-care access in today’s climate.

This was also published in the Des Moines Register’s opinion section Dec. 15, 2019.