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We face unique challenges to tackling the rising costs of today’s health care. A family’s health-care costs can sometimes even be described as paying for a basic economy car every year.

But importantly, much of what we’re hearing proposed at the national level would actually make the marketplace worse in our state. We need to be vigilant when understanding the impacts.

This issue is expedited in Iowa given that nearly half of our population resides in rural areas, sometimes with limited access to care. Under government-run plans, geographic penalties and shortages are already occurring. It’s a fact Iowa has been plagued with extremely low Medicare reimbursement rates for years.

When quality of care or access to care are threatened, so too are the affordable plans and unique solutions we help create for Iowans every single day. Remember this the next time you hear the terms public option, “Medicare for All,” or a single-payer system: There is nothing in a one-size-fits-all proposal that properly addresses cost and access issues. Instead, these issues will be exacerbated if we decide to scrap our health care system.

The Affordable Care Act did not create a perfect solution, but it did establish a framework we are still working through. Rather than threatening to upend the ACA and the 160 million who receive insurance through their employer, Congress, regulators, and the private sector should work together to build upon and improve the system we have today.

One of the most important points often overlooked in health care is that we are not living in a bubble. Whether you reside in a rural or urban area — or are an individual, small business owner, or a large business employing Iowans — no one is immune to changes in the marketplace. Every Iowan must understand the implications of what health care reform can do and how we can best support it.

More education is needed. A recent poll found 55 percent of the public believes they can keep their own plan under a Medicare For All scenario even though this simply isn’t the case.

Expanding government control in health insurance would compress and drive out the private market.

Private plans work alongside government programs and can offer cost-effective solutions like Medicare Advantage to help cover additional services. But relying fully on the Medicare infrastructure carries significant risks for consumers in the long run.

You’ve heard plenty about these proposals on the surface level, but we still don’t really know what would be covered. What happens if consumers’ options are eliminated and patients are forced to pay for certain care completely out-of-pocket? This could become our reality.

These changes could also have a devastating impact on health plans and access to care in Iowa. A recent study noted that under a public option, Iowa’s rural hospitals could lose $476 million, putting as many as 52 hospitals at a “high risk of closure.” Understanding this picture should make us rethink these proposals. Importantly, it should also renew our commitment to addressing the root causes of our rising costs, rather than focusing on what sounds the most appealing.

The impact on hospitals also would jeopardize the stability of our entire insurance marketplace. Even if you stay on your own private plan, premiums could rise due to the artificial changes the public option would make that would imbalance the system.

As we continue to discuss much-needed reforms, our primary goal should be meeting Iowans’ biggest concerns: rising costs and diminishing access. Replacing our current structure with a massive, government-run proposal would put this goal at risk. Saving money on co-pays and deductibles won’t be much of a relief when your hospital ends up closing, your insurance plan becomes eliminated, or you are hit with much higher taxes on your business, your household, and your pay stub.

Regardless of the plan you currently have, you are not in a bubble. Private plans are vital to the marketplace because they support government-run plans, and have the flexibility and innovation we need to create savings. We can improve healthcare for every Iowan by focusing on priorities over taglines.

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James West is president of the Iowa Association of Health Underwriters.

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