The issue of providing guaranteed health coverage for all Americans, as exists in all of the other 20 richest nations, has been absent from the current election season – that is, until it was recently announced that the Obamacare 2017 benchmark Silver plan premium would increase by an average 22 percent, up from a 7.2 percent increase in 2016.

The plan’s average cost will be $296 a month for a 27-year-old male in 43 states and the District of Columbia. And importantly, 85 percent of Obamacare enrollees are eligible for low-income federal subsidies, which can lower premiums to less than 10 percent of income.

But the headline of a 22 percent premium increase, not surprisingly, has unleashed another wave of mindless public reaction, self-serving political rhetoric, stale TV punditry and well funded, misleading political ads, all of which focus on supposed misguided government policy. The blame game centers on political opposition to Obamacare, while avoiding independent roles of prominent private-sector players, ignoring the successes and potential of Obamacare, and citing the supposed unaffordability of the richest nation in the world. Consider the following:

First, the Organization for Economic Cooperation and Development reports the U.S. devotes the smallest percentage of GDP to paid taxes and has the highest income inequality and index of health and social problems among the 20 richest nations. And, in 2016, America has a greater percentage of its population uninsured than most of the industrialized nations. Thus, by international standards, the principle and affordability supporting American universal health care has long been established.

Second, the objective of Obamacare to improve access to health care for those who do not have access to employer-provided health insurance by expanding the social safety net meets a dire humanitarian need. Accordingly, we examine Obamacare’s last year and next year’s average 7 percent and 22 percent insurance premium increases, which may be individually reduced by a subsidy, relative to the costs for individuals covered by their employer’s health insurance program that is independent of government policy. So what are the nature and level of employee health care cost increases?

The Kaiser Family Foundation reports from 2011 to 2016, people having health insurance through their employers had an average 63 percent increase, $1,221, in their deductible responsibility and an average premium contribution increase of 23 percent, $1,129. Additionally, from 2008 to 2015, according to Express Scripts, the average price of brand-name prescriptions increased by 164 percent. Thus, employers and insurance providers affect the cost of employee health care insurance independent of the government.

Third, why are health costs increasing so much? Steven Brill’s Time article of March 4, 2013, “Bitter Pill: How Outrageous Pricing and Egregious Profits Are Destroying Our Health Care,” follows the money trail to exorbitant profits:

“Over the past few decades, we’ve enriched the labs, drug companies, medical device makers, hospital administrators and purveyors of CT scans, MRIs, canes and wheelchairs. Meanwhile, we’ve squeezed the doctors who don’t own their own clinics, don’t work as drug or device consultants or don’t otherwise game a system that is so gameable. And of course, we’ve squeezed everyone outside the system who gets stuck with the bills.”

Brill focuses on the health industry’s abuses in pricing and its brazen greed rather than on the current worn-out political debate of government-versus-private-sector domination of health insurance coverage. He claims, “Hospitals may be the most politically powerful institution in any congressional district”; politicians need the votes and the financial support of Big Money to survive. A joint effort by Bank of America and McKinsey & Co. found that in 2011, the 2,900 U.S. nonprofit hospitals, exempt from income taxes, had a higher average operating profit, 11.7 percent, than the 1,000 for-profit hospitals.

Fourth, six years ago, 16 percent of Americans did not have health insurance. In 2016, this figure is 8.6 percent with 11 million people insured, but leaving about 29 million uninsured. Unfortunately, 19 states declined to participate in Obamacare, which denied coverage to 4 million people. The critics of Obamacare initially labeled it “a job killer” and predicted dire budget consequences. But more than 14 million new jobs have been created, the unemployment rate has dropped to 5 percent, and corporate profits and the stock market have reached historic highs. And according to the Congressional Budget Office, the federal cost of Obamacare through 2015 was $157 billion, 25 per cent less than forecast in 2010.

Fifth, beyond the issues of health care and insurance costs, surveys of 11 of the developed nations conducted in 2013 by the Commonwealth Fund provide a useful context for identifying potential weaknesses in the nation’s system of health care delivery. The U.S. ranked next to last in patient appraisal of their access to same-day or next-day appointments with their provider and ranked eighth in finding it “somewhat” or “very easy” to access care after regular working hours, resulting in the U.S. ranking second in emergency room use (39 percent in previous two years). Also, the U.S. ranked last in general practitioners per capita and for whether they made house calls.

Finally, Obamacare, as was initially true for Social Security and Medicare, clearly needs revision and improvement. But as is evident from recent history, the appetite for profits of major drug companies, hospital conglomerates, health equipment manufacturers, insurance providers, and national corporations and their investors and CEOs, relative to worker wages and benefits, has dominated and will continue to dominate health care cost and policy. Meanwhile, a paralyzed, inactive House of Representatives has passed over 60 bills to repeal Obamacare, which had no chance of becoming law. And the Republican-controlled Congress has refused to consider constructive improvement of health care insurance, cost and delivery as well as to address anti-recessionary economics; training and jobs; immigration; long-term Social Security and Medicare solvency; air traffic control and national electric grid modernization; and adequate assistance for the needy, most of which have well-recognized logical solutions.

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Tom Wallace is a resident of Loon Lake and Bonita Springs, Florida.