Two weeks ago, the Journal of the American Medical Association reported that more working-age people in Maine are dying than in most other states. Since 2010, midlife mortality here has risen by a record-breaking 21 percent; as many as 500 people have died prematurely. Drug overdoses, alcoholism, suicides – “diseases of despair” – have taken a heavy toll, made worse by limited access to health care. According to researcher Dr. Steven Woolf, health trends in northern New England are going “completely in the wrong direction.” The situation is especially bad in places experiencing “severe economic distress,” like Midcoast Maine.

Every population group is feeling the impact, “but the worst-hit areas are mostly white and rural,” Woolf writes. Among men, “drug overdoses explained almost all of the life expectancy decline”; among women, obesity and smoking compound the problem.

The root causes aren’t hard to find: government policies that have left working families behind. Since the 1980s, many families in Maine have faced catastrophic job losses, wage stagnation, reduced social mobility and explosive income inequality. And as Woolf points out, people who are “most vulnerable to the new economy (e.g., adults with limited education, women) have experienced the largest increases in death rates.” One sobering fact: for every 1 percent increase in unemployment, drug-related deaths rose by 3.6 percent.

Meanwhile, other industrial countries have avoided the mortality crisis. They provide universal access to health care, higher wages and comprehensive social services. Our political and economic elites have chosen a different path: leaving 28 million people without health insurance, slashing social services, weakening labor unions, redistributing income upward and, now, cutting food stamps. If these trends continue, Woolf predicts, it will take the U.S. “more than a century to reach the average life expectancy that other high-income countries had achieved by 2016.”

This is serious business. During the Cold War, U.S. intelligence agencies anticipated the Soviet Union’s collapse by tracking the decline in life expectancy among workers. (A health economist friend of mine did the analysis.) Rising death rates are the undeniable indicator of long-term economic and political failure. As Soviet leaders found out, it’s almost impossible for politicians to hide or lie about them forever.

Which doesn’t stop ours from trying. Take Medicare for All. Two-thirds of American voters say that health care is the central issue in our upcoming election. A majority of us – 57 percent – support single payer insurance plans that cover everybody and “eliminate all private health insurance companies.”

Yet Democratic Poobahs remain determined to resist. Their complex and subtle reasoning runs the gamut from A to B. Two favorite arguments: Universal coverage in the U.S. would make our taxes would go up. And what about that critical bloc of swing voters who love their current health plans? If we offer them something better, they’ll re-elect Donald Trump.

Real life tells a different story. Americans spend about twice as much on health care as other high-income countries. Those countries provide comprehensive insurance plans that cover 99 to 100 percent of their populations – unlike the U.S., where one in ten people remain uninsured. Health outcomes there are far better: according to the American Medical Association, we now have the lowest life expectancy among industrialized nations, the highest infant mortality rate and the greatest number of obese adults.

So we spend more and get less. But what about those private “Cadillac health plans” that voters love? More than half of all Americans rely on their employers for health insurance. But employers, too, are getting gouged. Every year, they pay more for policies with higher deductibles, larger co-pays and fewer benefits. Over the past decade, the price tag has almost doubled.

Workers pay a growing share of these costs, even as real wages shrink. In Maine, for example, employer-based family coverage averages around $19,500 per year. Employees now shell out $7,900 in premiums and deductibles, 12 percent of their total income. That’s a 65 percent increase over ten years, while life expectancy and other key health indicators here sank like a stone. No wonder that national labor unions have launched a “Labor for Single Payer” campaign.

So who are these critical voters clamoring to keep their ritzy private plans? They probably don’t live in Midcoast Maine. Would our taxes go up if we eliminated private health insurance? A bit. But we’re already paying 12 percent of our incomes to vulture corporations and receiving nothing in return. The refund we’ll get by not paying them should be more than enough to cover Medicare for All.

This column is a project of the Midcoast Branch of the Southern Maine Chapter of Democratic Socialists of America. The opinions express herein are solely those of the authors. Comments are welcome at midcoastmaine@gmail.com.