For nearly forty years, Medicare has ensured that all of America’s seniors have access to healthcare. But this week, the program’s trustees set an end date for health benefits—they announced that the Medicare trust will be broke by 2019. Medicare has come back from the brink before, and, clearly, Washington should do what it takes to protect it. But the prospect of an end to seniors’ health benefits should remind Americans of how weak the system of state-sponsored health insurance is in this country. When even the elderly aren’t guaranteed a basic level of coverage, the nation has to reevaluate its priorities in the healthcare industry.

In 1965, President Lyndon Johnson signed legislation that authorized an insurance program for senior citizens, Medicare, and a state-run program for the poor, Medicaid. The law was intended to be a step on the road towards providing health insurance to every American. Since 1965, America has failed to make health insurance universal. While every other industrialized nation in the world has extended health insurance to all of its citizens, America, the wealthiest nation on earth, has fallen short. More than 43 million Americans were uninsured last year, an increase of 2.4 million from the year before.

Americans should demand more than just the leftovers from the Johnson administration. A much more extensive program of universal health insurance should be a right in the United States.

Indeed, even though it’s too limited, and it’s now losing money because of spiraling health costs in an overmedicated America, Medicare shows that anti-government conservatives are dead wrong on healthcare. Medicare spends 2 to 3 percent of its budget on administration, compared to nearly 10 percent in the private sector. Far from being a massive government bureaucracy, Medicare is a relatively efficient program that avoids many of the costs—like marketing and profits—that divert money paid into private health insurance companies from going towards quality care. Medicare has also led the way in developing techniques to control increasing healthcare costs. Before most private insurers had any idea what to do about rising healthcare costs, Medicare instituted the Prospective Payment System, which lowered costs by discouraging overuse of medical services. Medicare has constantly sought, often successfully, to control costs in order to use public resources more effectively.

The story of Medicare shows that government-sponsored healthcare can work efficiently, and that a vastly-expanded federal insurance network does a lot to solve the problem of the uninsured in America. A single payer system—a Medicare-style program that covers every American—would prevent redundant bureaucracy, enable effective cost control and ensure that no American is denied needed healthcare thanks to the greed of a private insurer. It is time to complete the work that Lyndon Johnson began in 1965; it is time to provide health insurance for everyone.