When describing our country, Americans often express the view that we are the best and brightest when compared to other nations. We may admit that some other countries provide good lives for their citizens, but we still view ours as superior.

Here's the problem with that status. We deserve superlatives for many inventions and accomplishments, but we rank embarrassingly low on the measure of access to health care for all our citizens. The bottom line is, all Americans deserve decent and affordable health care.

Note I said "decent and affordable." I didn't say gourmet, fantastic or even congressional-level health care. I also didn't say free. Medicaid is needed to support those with very limited funds. I believe that everyone else needs to pay something, even minuscule amounts. There is no "free lunch" because health care monies must come from some source.

While health care is a national topic, it's also been on my mind as I've watched Maury's and my medical bills and insurance statements arrive for our excellent health care at Cabell Huntington and St. Mary's hospitals this past year. The charges are high, as expected, but in our case, secondary insurance plus Medicare, which takes a healthy amount for premiums out of our Social Security, means the portion we pay out of pocket is quite manageable. If an uninsured person received bills such as ours, it would be devastating and could take many years to pay off or even result in bankruptcy.

To make matters worse, for many people without Medicare or Medicaid, private health insurance has become too pricey. As great as it may sound, "Medicare for all" isn't a quick fix for what ails our health insurance system. Some have suggested that the Affordable Care Act (ACA) actually makes more sense as it coordinates with our nation's ongoing health insurance industry.

Analyses vary in determining which countries have the best health care insurance options for their citizens, but all agree that the U.S. is never near the top. A Commonwealth Fund study found that the U.S. "ranked last among 11 industrialized countries" on health care issues. NBC reported that we rank 10th in health care when comparisons are made of wealthy countries.

It has also become obvious to those in health care fields that as costs rise people try to avoid using medical services, often leading to more serious illnesses. One surprising finding is that about 40 percent of people feel that paying for health care is more frightening than getting the illness.

Emboldened by the four-page summary of the 300-page Mueller report, President Trump is now dying to kill the ACA. While imperfect and needing changes, the ACA was the much-needed first attempt to provide health insurance coverage for the millions of Americans who lacked it.

And with what do Trump and the Republicans propose to replace the ACA? Absolutely nothing. No ideas, no plans, zilch. Remember candidate Trump's speeches where he promised he would quickly have a wonderful health plan for everyone? Where is it? How would it work?

One of my favorite messages in my psychology practice was that unless your life was in danger, you first should decide where you are going before running away from what you had. That message, which applies in relationships and work, also holds true for organizations and government.

Before there's any action to jettison the ACA, solid and realistic health care insurance plans should be in place, because all Americans deserve access to decent and affordable health care.

Diane W. Mufson is a retired psychologist. Her email is dwmufson@comcast.net.