About this time last year, I wrote a post about the groundbreaking Medicaid study going on in Oregon right now. Oregon ran a health insurance lottery for some of its impoverished adult population, giving the winners access to Medicaid, and the losers nothing. This admittedly disgusting and embarrassing process created a natural experiment that has allowed researchers to collect completely pure data about the benefits of health insurance for poor people.

Researchers recently released more data on this natural experiment. The findings show that the insured spent $778 more per year on health care and reported feeling better and happier. The insured were also much less likely to have an unpaid medical bill, and much less likely to have borrowed money or skipped other bills in order to pay for medical bills. More data is forthcoming, but the findings so far are what you would expect: having access to health care is generally good.

The narratives of those who lost the insurance lottery are horrifying. Here are two:

For instance, a year ago, Samantha Kious, a hair stylist, went to Planned Parenthood to seek birth control medication to manage her polycystic ovary syndrome, a common hormonal imbalance.

Ms. Kious, 24, who also has depression and Crohn’s disease, a bowel condition, makes only $1,000 to $1,200 a month and cannot afford insurance. The clinic performed some tests and prescribed Ms. Kious the pills. But they also told her that she had Stage 2 cervical cancer. As of now, the condition remains untreated. She and her boyfriend even considered getting pregnant so that she would automatically qualify for Medicaid.

“It’s scary for me, having cancer and knowing I can’t do anything about it,” said Ms. Kious, her hair in an elaborate plait. “It’s an I-don’t-know-when-my-next-meal-will-be sort of thing. It’s really difficult because health problems make you scared and emotional.”

Not having insurance “affects your whole life,” said Christine Toman, 61, who has a chronic pulmonary condition and hepatitis C and did not win coverage. “I went to work. I paid my bills. And now I feel like a hopeless, hopeless old woman that’s in the way, and it’s sad to feel like that. I’d like to die with some pride.”

Ms. Toman, in a husky voice and a soft wheeze as she labored to breathe, said that she occasionally goes to the emergency room when her conditions became acute. But she generally just forgoes care.

There is quite a bit of tragedy and grief in the world that is unavoidable. Relationships will fall apart; parents and other loved ones will eventually die. These trying events are embedded in the human condition. Being denied treatment for cervical cancer and a pulmonary condition are not. Those tragedies are the consequence of intentional institutional choices.

The most appalling thing about the sheer immoral embarrassment of the US healthcare system is that one does not even need an imagination to think up alternatives. They already exist. Right now in the world, there are nations that have managed to insure that everyone needing health care gets it. I can point to them on a map. This is not like lamenting the dominance of market exchange or globalization, things for which conjuring up alternatives is a feat of imagination because alternatives do not really exist in the world at present.

No, we know how to provide health care to everyone in a country and how to do so affordably. In America, we just choose not to.