On Monday morning, former House speaker and presidential candidate Newt Gingrich said something interesting on Fox News about what to do with health care after the failure of the Republicans’ American Health Care Act.

President Donald Trump had said he’ll move on to other issues and wait until “Obamacare,” his predecessor’s Affordable Care Act, melts down on its own. Gingrich said this is a mistake; instead, try again, but differently. The AHCA, Gingrich noted, was justifiably unpopular in representatives’ home districts because it would make health insurance unaffordable for many people. He said this plan was a product of Washington and was being negotiated Washington-style, with amendments tacked on and important elements left for future determination. He said reps should go back to their districts and craft a health care plan that’s so popular with people there that it passes without amendment in the Capitol.

That makes sense, but we also think that path is not going to lead in a direction the Republicans are going to like, as long as they continue to want less government health care rather than more.

We think most Americans, very much including the rural areas many Republicans represent, don’t want health coverage to be reduced or made more expensive. Places like New York’s North Country tend to be older and poorer than the national average, and a lack of competition for insurance and care drives prices up even higher. That’s a cue for insurance companies to charge top dollar, especially when they carve out their own regions and pick and choose what they’ll cover. Obamacare, which was based on Republican ideas first enacted by then-Gov. Mitt Romney in Massachusetts, forced these companies to cover certain essentials, but it also involved the government in actively protecting the highly profitable system this industry had created. Some call this market forces at work, but when one takes advantage of local market weaknesses to drive up prices for something everyone desperately needs, that’s gouging.

For seven years, Republicans in Congress railed against Obamacare as a disaster but barely hinted at alternatives. When they finally took control of the House, Senate and White House, they rolled out what super-conservatives accurately called “Obamacare Lite” — the same thing but less of it, with all the savings going to the rich and all the losses falling on the poor, old, ill, addicted, mentally ill, etc.

Places that voted Republican in the last election tend to have a lot more of those latter categories than they have rich people. Rural people might agree that the ACA is flawed, but why should they suffer disproportionately? That’s a refrain congressional Republicans are likely to hear if they follow Gingrich’s advice.

Of all the services government can pay for, health care arguably affects people the most. Everyone uses it. Unlike education, we all use health care for the entire span of our lives, from birth to death. While there are times in a healthy person’s life when he or she doesn’t need to see a doctor for a while, an accident or unforeseen illness could happen at any time. Unlike the military, health care isn’t a “We hope we never need to use this” kind of thing; we absolutely know each of us will use it.

Of all services, we see health insurance as one that makes the most sense to go through government — specifically the federal government so access and price can be consistent across state lines.

Presidents Franklin D. Roosevelt and Harry Truman tried and failed to establish a national health insurance plan – not socialized medicine, where the doctors and nurses are employees of the government, but national health insurance where medical facilities remain as they are.

Our country eventually established Medicare for older people, and we’re never going back. Then we established Medicaid for the poor, and while it’s being fiddled with — largely due to its state-to-state variation — no one is proposing to get rid of it. States have health insurance plans for children of non-wealthy families, and we don’t hear complaints about those, either.

For everyone else, we still have this nonsensical, accidental system in which employers, both private and public, are on the hook for their workers’ health insurance. It’s a gigantic burden that slows hiring, cuts capital and increases property taxes across the board. If this yoke if shifted off their shoulders, how can the economy not roar?

Medicare is widely seen as the best-functioning of the government health insurance systems. It requires the patient to pay a share, and it negotiates reasonable prices. We still think offering Medicare to all Americans is the way to go. Also, let the federal government negotiate with pharmaceutical companies to bring down the crazy-high prices Americans pay for drugs, but which other countries don’t because their health systems negotiate. In a recent Guest Commentary, Lee Keet of Saranac Lake explained in more detail how these two steps would make U.S. health insurance cheaper overall.

And yes, add tort reform to standardize medical malpractice lawsuits and thus reduce the cost of care.

Trial lawyers, health insurance companies and drug companies are powerful lobbyists and campaign donors. Democrats and Republicans have tried for too long to protect these industries. Both parties labyrinthine health plans that look like they were crafted by an insurance exec, a lawyer and a chemical engineer. The results aren’t getting rave reviews. At some point they will have to take on these titans if they want to come up with the “beautiful” plan Trump has promised.

As with every service, we have to pay for it, or its lack, one way or another. Best to do it as efficiently, effectively and justly as possible. Ultimately, we think that means Medicare for all, but it may take a while to get there.