President Donald Trump and the Republicans in Congress have a decision to make: They can step up to protect millions of people, providing the security and dignity that comes from being cared for when sick or injured, or they can keep holding our health care hostage and leave a body count.

How do I know? I’ve spent more than two decades in an emergency room on the South Side of Chicago, caring for people whose suffering stems from political choices in Washington, D.C.

So when I read about the government shutdown and Republicans cutting Medicaid to pay for tax cuts, I don’t just see the headlines about health insurance and food; I see people.

I see the face of the woman who came in unable to breathe because she’d been rationing her blood pressure medication to make it through the month. The young man whose blood sugar is out of control because his medication cost him more than a week’s pay. The mother who waited too long to get a lump checked because she couldn’t figure out where she could access affordable care, only to show up when it was too late.

That is the human cost of letting coverage slip away, and it’s a cost that will only increase if Republicans in Congress allow Affordable Care Act subsidies to expire.

If that happens, premiums in Cook County are expected to spike 95% next year, hundreds of thousands of people will lose coverage and emergency rooms like mine — already bursting at the seams with patients — will once again be left to catch people who should have never fallen through the cracks.

This isn’t inevitable. This is a policy choice.

And it’s not that we lack the money, technology or ideas to solve these problems — this is the wealthiest society the world has ever seen. It’s that we have a system that views health care as something to be won and lost, rather than a right.

We can fix that — if our leaders in both parties have the political will. We could start by guaranteeing every person in this country access to basic, comprehensive care through a system such as Medicare for all, so no one loses coverage when they lose a job or get sick.

We could rein in the corporate middlemen — the private equity roll-ups and pharmaceutical companies — that profit off sickness instead of health, by allowing Medicare to negotiate drug prices and capping what families pay out of pocket.

We could invest in community clinics and primary care in neighborhoods such as mine, where people too often have to choose between a doctor and the electric bill. And we could make mental health and addiction treatment as accessible as any other kind of care.

None of this is radical — it’s what every other wealthy democracy already does. What’s radical is accepting the suffering we see now as normal. Because when coverage is unaffordable, people lose it. And when they lose it, they don’t just get healthy and stop needing care. They get sicker, and eventually, end up in the ER. I’m tired of patching up people with preventable illness and sending them back out to this untenable system.

It’s time to demand more. It’s time to put people over profit and protect folks when they’re sick and injured.

Extending these subsidies is the absolute minimum.

The truth is that we need more than patch jobs and political brinksmanship. We need universal health care so our ability to survive doesn’t depend on our income or the outcome of a budget fight.

But, for now, we desperately need Congress to act. We need leaders who will act like lives are on the line.

Because they are.

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Dr. Thomas Fisher has worked for two decades as a board-certified emergency medicine physician in the same South Side Chicago community where he was raised. He is a Democratic candidate for Illinois’ 7th Congressional District.

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