By Kyle Edwards

America does not have a healthcare system.

I pulled back the curtain and saw a woman in her early 60s lying in the hospital bed. She looked emaciated -- sunken eyes, a thin, narrow face, and quick, shallow breaths. Her husband and children perked up for updates. I had been caring for her for weeks and had come to know her well.

"We call her 'Daisy' because she loves flowers," her daughter once told me.

Daisy had stage IV colon cancer. She was dying. That morning, we had to tell Daisy and her family there was nothing more we could do except keep her comfortable. They broke down in tears -- any remaining hope vanished. A few days later, Daisy passed away.

This is not an isolated story. Nearly half of patients with colon cancer are diagnosed with late-stage disease, when it's already spread. Yet, colon cancer, along with many chronic conditions like diabetes and heart disease, can be detected early through routine screening -- dramatically improving outcomes. So why are so many Americans dying unnecessarily? Because America has a sick care system, where people often receive care only after they're already ill.

The Affordable Care Act (ACA), better known as "Obamacare," sought to change this. One of its most impactful provisions requires insurers to cover preventive services that are recommended by the U.S. Preventive Services Task Force (USPSTF), like immunizations and cancer screening, without out-of-pocket costs. An estimated 100,000 lives can be saved each year when individuals access these services. Since the ACA passed in 2010, the use of many recommended preventive services has increased. Despite the progress we've made in providing more affordable, accessible, and comprehensive care, the Supreme Court is hearing oral arguments in Kennedy v. Braidwood Management, Inc. this week, which could undo the ACA requirement for preventive care coverage. If the Court upholds the conservative Fifth Circuit's decision, it would jeopardize access to lifesaving screenings and services for millions.

The public health consequences would be devastating. We know that people are much more likely to get vaccinated when the costs are covered by insurance; deterring vaccination may hamper the protective powers of herd immunity and increase illness or death rates for countless infectious diseases. Meanwhile, people who are screened for colon cancer are far more likely to be diagnosed at an early stage where the cancer is localized and the 5-year survival rate is 91%. But for those who wait until symptoms appear, the chance of surviving 5 years drops to just 13%. Requiring insurers to cover these screenings isn't just good policy -- it's a matter of life and death.

It's not only a health issue; it's an economic one. The U.S. spends nearly 18% of our GDP on healthcare, yet we have worse outcomes and shorter life expectancy than other developed countries. If we screened 70% of eligible adults for colon cancer, Medicare could save $14 billion by 2050. Imagine the lives and dollars we could save by prioritizing screening and preventive care for cancer, heart disease, diabetes, and other high-cost chronic conditions. At a time of growing pressure to cut federal spending, it makes no sense to eliminate preventive care -- a measure that saves money and lives.

To be sure, the U.S. has the most robust pharmaceutical industry in the world, constantly innovating new medicines to treat illness. Revolutionary treatments have extended life for people with cancer and other serious diseases. But these treatments are expensive, have side effects, and, as in Daisy's case, can be too little, too late. Americans are sick -- often because we don't give them the tools and care they need to stay healthy in the first place.

If we truly want to "Make America Healthy Again," we need more access to preventive care, not less. Benjamin Franklin said, "An ounce of prevention is worth a pound of cure." This is still true today. If the Supreme Court allows the rollback of the ACA's preventive care protections, we will all pay the price with higher costs, more suffering, and more families like Daisy's left grieving.

As a medical student training at the largest public hospital in the country, I see the consequences of Americans forgoing care every day. I will always remember Daisy's story, not just as a tragic loss, but as a reminder of how we can do better. I don't want to practice in a system where I have to tell another family that their loved one might have survived, if only they had access to a simple screening. I came to medicine to heal, but true healing starts long before a hospital stay. It starts with prevention. If we lose that, we aren't just failing our patients, we're failing the very idea of what healthcare should be.

Let's keep Americans healthy by transforming our sick care system into a healthcare system.

Kyle Edwards is a third-year MD/MPH student at the University of Miami Miller School of Medicine.