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By Robert Milch

After four decades of medical practice, I’ve learned to recognize a grim prognosis. I’m speaking now not of an individual patient, but of us as a society that has come to tolerate the inadequacies of a system of health care delivery threatening to bankrupt us both financially and ethically.

The evidence for this is stark, well- documented and irrefutable, and ignored at our collective peril. We spend more than double the next ranked nation per person for health care, yet our life expectancy ranks 51st in the world.

Reported by the Institute of Medicine, other measured outcomes of access to and quality of care consistently put us in the second or third tiers among developed nations.

Health care sponsored by large employers is estimated to cost $9,560 per employee, with the average employee’s share $2,975 before out-of-pocket costs such as co-pays, benefit denials and uncovered services such as mental health, long-term and home care – all this, while corporate overhead for insurance companies often exceeds 30 percent.

According to the Census Bureau, even with the Affordable Care Act, more than 40 million of our citizens are or will be uninsured or under-insured. Some insurance companies will no longer offer Medicaid supplementary policies because they are “unprofitable.”

The status quo is unsustainable fiscally and unsupportable morally. And yet, we perpetuate an unjustifiably expensive, dysfunctional system no longer serving societal well-being. Rather, a corrosive, self-serving corporate alliance of sorts has evolved among insurance companies, drug companies, hospital systems and even providers.

Even better, as is being done in other states, a similar program can be enacted in New York without a more expansive federal policy. But bills such as A05389 (Gottfried) and S02078 (Perkins) haven’t even been brought to the floor of our Legislature, obstructed by “leadership” – why one can only guess.

We must demand of our lawmakers substantive explanations of their positions – why they are complicit in failure to discuss the merits of alternative remedies for our worsening illness, let alone to enact them.

We will suffer the status quo if we must. But that suffering is unnecessary and we deserve better, especially because we know what could be.

Robert Milch, M.D., lives in Williamsville.