It’s no secret that the U.S. health care system is in crisis; 70% of Americans say so, or that it at least has major problems. This has been consistent since 2000, reflecting a history of dissatisfaction with the health care system. The United States continually misses the mark in assessments of top health care systems globally. Why would the most powerful country in the world rank so low on a variety of measures compared with other high-income countries?

While this is a complex issue, one crucial difference between health care in high-income European countries and the United States is the role of profit. In countries with highly ranked health care systems such as Germany, Switzerland and the Netherlands, health insurance is implemented by public or private not-for-profit organizations. Unfortunately, in the United States’ capitalist economy, the health insurance industry’s priority is accumulating capital and maximizing profit. While the goal of European health insurance is improving well-being, the goal in America seems to be making money. Additionally, government oversight and regulation help prevent price-gouging in Europe, an area in which the United States has had less success.

Following Europe’s lead and implementing a universal health care system seems like a natural next step to address the crisis status of American health care. However, the concept hasn’t taken hold, even though most Americans agree that the federal government should ensure all Americans have health care coverage.

Universal health care hasn’t caught on in America because it’s been historically demonized and associated with communism. Throughout the early 20th century, there was a significant effort to introduce a comprehensive health insurance system, and a bill was proposed in 1943. However, in 1948, the American Medical Association began a $4.5 million “national education campaign” to decrease public support for the bill — they knew it would result in more regulations and a less lucrative field. The final straw was Senator Joseph McCarthy’s rise in 1950, which cemented the association between national health insurance and communism in the minds of Americans. Additionally, the expansion of private health insurance since the 1930s lessened the intensity with which the public supported government health insurance.

Today, the phrase “universal health care” is still demonized and used as a political tool. Though 62% of Americans say the government should ensure health coverage for all, only 21% of Republicans support a government-run system compared with 71% of Democrats. This is because the GOP continues to mislead its supporters on issues like tax rates and budget deficits — concerns only brought up in terms of social services and never in terms of, say, the $757 billion spent subsidizing fossil fuels or the $883 billion defense budget.

The most valid argument against universal health care is that the salaries of medical professionals would decrease. This is a serious problem, but it’s of our own creation; their current salaries are hyper-inflated.

A pay decrease would only align U.S. salaries with those in highly ranked European countries.

While this would certainly lead to rightful and widespread retaliation, a pay decrease would be easier to swallow for medical professionals if further action were taken to spare them from having to take out hundreds of thousands of dollars in student loans to pay for their medical education.

We’re now in a propagandized deadlock, inhibiting productive dialogue about universal health care as a legitimate option and how to handle a salary decrease for medical professionals. Even if we were to engage in discussion and pursue a universal system, it’s doomed to fail. There are simply too many paradigm shifts that must happen concurrently for it to succeed. Lawmakers must overcome decades of lobbying from the health care, insurance and pharmaceutical sectors to create laws that prioritize the needs of the people — a seemingly insurmountable task. The cost of medical school must drop dramatically to encourage incoming professionals to pursue the field despite the lower salary, and even that might not be enough incentive.

The health insurance industry’s purpose must be reoriented to improving well-being rather than making money, requiring insurance companies to sacrifice billions of dollars in profit they’ve become accustomed to making.

Finally, we must address the hyper-inflation of health care beyond salaries. The inflation rate of medical services, equipment and drugs is much higher than that of average goods and services. Attempting to reign in this hyper-inflation could lead to a recession, further complicating the transition to a universal health care system. Without radical changes, it’s hard to imagine an America capable of this transformation.

Adrianne Fantasia is a student at the University of Maryland studying environmental science and policy.