There are certain paradoxes of life that are beyond the realm of rational explanation. To me, one of such is that a country that figured out how to defy gravity and conquered the cosmos has time and time again proven to be incapable of taking care of the most basic human need, namely: a commonsense health care delivery system.

U.S. spending on health care in 2016 was estimated at about 17.2 percent compared to just 8.9 percent for the OECD median. The problem is not only that we outspend those other countries, but on the whole, our access to health care and outcomes is worse, including in areas like life expectancy, infant mortality, asthma, and diabetes.

We spend $3.5 trillion or about 18 percent of the national economy on health care. A study taken under the auspices of the Peter G. Peterson foundation reported that the primary driver of America’s long-term fiscal challenges is the inefficient health care system. As alarming as those numbers are, I am sure this doesn’t come as a surprise to any of the players in the health care space.

Successive U.S. administrations over the years from both parties have come up with different kinds of proposals to tackle these crises. None has been able to garner enough bipartisan support and so none has enjoyed a successful implementation. Obama’s Affordable Care Act came close to answering some of the nagging questions pertaining to the protection of individuals with pre-existing conditions and routine physicals. Its Achille’s heel, however, was that even with the addition of about 20 million newly insured in the pool, it could not halt the skyrocketing insurance premiums and cost. The provisions of the Individual mandate was also seen by some as an infringement on the freedom of choice and had faced legal challenges. Worthy of note in all fairness is that there has never been any good faith effort from the opposing side to give it even a slight chance to work.

As a physician in active practice, every day, I seethe with resentment for being part of a system so grossly flawed. Yet there is little or nothing one can do personally to remedy the situation. Contrary to popular opinion, physicians are surprisingly the weakest link in this value chain.

Of all the drivers of high health care costs, the Big Pharma and insurance companies ought to take the cake.

This is not to downplay the ridiculous billing practices of hospitals, unnecessary duplication of services in addition to the monumental waste and abuse inherent in the system. Whereas most hospitals are set up as not-for-profits, that can hardly be said of insurance companies. When an insurance executive is making a seven-figure bonus, it’s very clear his loyalty lies somewhere else outside the interest of regular Americans struggling to pay an infinitely rising monthly premium. I believe it’s time to re-examine the value and role of this conscienceless middle man holding everyone else hostage.

When an American pharmaceutical company decides to mark up the price of a life-saving vaccine by 1,000 percent, no one should complain because we have a free market economy. When an insurance company refuses to sign you up because you have a “pre-existing condition,” it’s all good because both individuals and cooperate bodies should all have freedom of choice.

Oh! And you even have to take care of your auto repair before your insurance company finds a reason to jack up your premium for any little infraction. It doesn’t matter that they have been collecting your premium for years on end. I can go on and on and on, on how corporate bodies screw up average Americans every day with the active connivance of Washington lobbyist posing as congressmen.

Much has been said about the partisan gridlock in Washington and how the current generation of lawmakers have acted in a way to suggest everything else but love for the country. Whether it’s acting as a check to a president actively working to undermine America’s century-old institutions or standing up for the ubiquitous lobbyists working on behalf of corporate hawks, they have proven time and time again incapable of advancing the values set forth by the founding fathers. Every move is predicated on what can get more political mileage. Of course, every shameful self-serving behavior can always be explained away in their own version of what is good for America. It doesn’t even matter how asinine such justification seems.

I am not a fan of socialist medicine. On the contrary, I am a firm believer in the free market enterprise system. That said, there ought to be strong legislation and enforcing institutions in place to check the greed and excesses of men that continually find ways to exploit system weaknesses. I believe there are certain aspects of life so critical to be left in the hands of corporate shenanigans who see nothing beyond return on investment.

The cost of health care is so huge with politics so divisive that a wholesome approach is well-near impossible at this time — at least not with the current political climate in the nation. But we can adopt measures and legislations that can help address critical issues. One way to start, for example, will be a strong bipartisan effort to craft and enforce legislation to reign in on the Big Pharma and all the profit-driven insurance companies.

Osmund Agbo is a pulmonary physician.

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