Brian E. Keeley is president and CEO of Baptist Health South Florida, a $3.6 billion not-for-profit healthcare organization based in Coral Gables, Fla. with seven hospitals, 30 outpatient centers, and 15,000 employees.

The United States, the richest nation in the world, is the only advanced country without some form of universal health care for all its citizens. And the US now spends around 18 percent of its gross domestic product on health care – the highest percentage in the world....

The best argument to implement universal health care through an individual mandate, other than the national embarrassment that the wealthiest country in the world does not provide basic health care for all its citizens, is that America already provides universal health care – by default. It’s called EMTALA.

The Emergency Treatment and Labor Act (EMTALA) was passed by Congress in 1986. It essentially requires every hospital with an emergency room to screen and treat all patients who present themselves and require emergency treatment – regardless of citizenship, legal status, or ability to pay. This is, in essence, a federal unfunded mandate without a provision for reimbursement.

Many uninsured people simply use the emergency room as an access point for “free” health care. While free to them, the cost of providing care of these so-called “free riders” is shifted to others....