It looks like we're on the path to insuring 30 million more Americans and ending denials for pre-existing conditions. While we celebrate these advances, let us remember that we are building on the most expensive, bureaucratic system of paying for health care that the world has to offer.

Instead of a single, not-for-profit system, we will still have our governments paying for the majority of health care, while still relying on 1,300 private, for-profit insurers through 17,000 different policies.

Private, for-profit insurers must compete among themselves for the profits to attract and keep investors. This competition drives them to collect premiums and not pay for health care. If they can't do it through pre-existing condition denials and rescissions, they will do it with higher copays, higher deductibles, annual and lifetime caps, and whatever else they can think of.

More of us will be covered; more of the coverage will be under insurance.

We have a choice. Use our taxes to pay for a single, not-for-profit system. Or use our taxes and premiums, high copays, high deductibles, providers' huge billing expenses, the fallout of bankruptcies and foreclosures due to uncovered medical expenses, and the cost shifting of those left uninsured and still needing health care to pay for our amazingly complex and inefficient multi-payer system.

Current health care reforms will keep us entrenched in the latter option. It is the main reason why we spend almost twice the average of other industrialized countries for our health care, yet are 37th in outcomes.

We need to question our fear of taxes and see that expanding some version of Medicare for all will give us true security. Private for-profit insurance claims to offer protection.

Bill Semple

Boulder