Healthcare costs continue to rise while levels of care continue to fall, especially for those who suffer from mental illness and substance use disorder. Everyone deserves access to high-quality, affordable healthcare that offers a flexible choice of providers and eliminates excessive administrative fees like premiums, co-pays, and deductibles. Attempts to control healthcare costs within the present private insurance system have failed, and costs have steadily consumed more state, municipal, business and household budgets. We must search for alternative options – like single payer systems, which have a track record of reducing inequities in healthcare, improving access to care and reducing costs for families, businesses, municipalities and states.