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If it costs $100 for a provider to safely and effectively deliver health care, Medicaid pays that provider $85 and Medicare pays $80. This is the law, and not open for negotiation. Private insurance pays $115 for the same care.In other words, hospitals lose money on patients covered by Medicaid and Medicare, and need to make up that loss with private insurance. But Democrats like presidential hopeful Sen. Kamala Harris, D-Calif., want to “eliminate all of that” private insurance.

Although the bill has no immediate chance of passing it already has 107 co-sponsors. This confirms not only a party-wide shift to the left, but an agenda that includes liberal health care reform as a priority.

Imagine if Apple spent $100 to make an iPhone, but charged customers $80 to buy it. Simply stated, Apple would be bankrupt before it even got started. Unless, of course, we all chipped in and paid Apple directly from our paychecks every Thursday via a new tax, whether we owned an iPhone or not.This is essentially what Democrats want to do. If we want to keep doctors employed and hospital lights on, and protect access to life-saving treatments, we’re going to need to pay for it somehow. And the answer for Democrats is always the same: raise taxes and lower reimbursements.

In New York and New Jersey where I practice medicine, the political consensus about how to offset Medicaid losses was simple: inflate statewide taxes and reimburse the physicians less for their services. My husband is a private neurosurgeon who specializes in strokes, aneurysms, tumors and vascular malformations of the brain and spinal cord. Nearly overnight his reimbursements for these lifesaving procedures were cut in half and some even more drastic than that.How will we continue to convince the brightest and most talented among us to assume these high-risk roles if we can’t compensate them appropriately for their skills?

Unfortunately, the Republicans have fumbled repeatedly in their efforts to construct a viable alternative. Ultimately, President Trump took it upon himself to dismantle some of aspects of the Affordable Care Act. He eliminated the individual mandate, introduced short-term health plans, and, with a renewed focus on drug prices, lessened FDA obstructionism and improved overall price transparency.In his State of the Union address last month, President Trump not only demanded transparency from hospitals and drug companies, but necessitated that insurance companies report their reimbursement rates. Finally, someone is calling on the massive insurance industry to disclose its role in rising fees.

This demand for transparency is essential but must go even further to involve patient responsibility. Individuals are unaware of the costs of their health care. We the people are not focused on preventing costly diseases, 50 percent of which are avoidable. To use the iPhone analogy again, while you could buy a new iPhone if you drop yours, it’s cheaper to not break it in the first place.Human beings, and economies for that matter, are not static. They are dynamic with innumerable variables, and they must be managed by a system that can accommodate innumerable scenarios. Having one, immutable, constrained and costly system is not only unfeasible, it is inviting disaster.