I live in Los Angeles—a place Dorothy Parker once called “12 suburbs in search of a city”—and while I enjoy my hometown, New York City is my favorite place on the planet. I am a huge fan of the city’s subway system because it allows you to interact with all segments of the population. It occurred to me on a recent visit to the Big Apple that Manhattan’s subway system is just like the health care system I dream of—equal access for all at a fair price.

I am in New York several times a year for work, so it made sense to have a doctor there. But cost has become a factor. I am self-employed, so I pay for my health care out of my pocket. My co-payments are higher than those offered through group insurance policies. And even though it’s expensive, I don’t have much choice but to keep paying. But I can’t keep this up forever. Without quality health care that is affordable and accessible, I have no future. And without the possibility of a future, I don’t have a reason to dream—and I have a lot to dream about.

Several years ago, I spent time in a hospital. While there, I made a bargain with God. I said, “God, just keep me alive long enough to see my nephew’s graduation and that will be enough.” Today, I have four of the most wonderful nephews. So, I want to renegotiate that initial bargain. I want to see all of my nephews graduate. I’m asking God for more time. And to have more time, I’m going to need the help of a health care system that works.

Health care has become one of the most pressing issues of our time; it is a deal-breaking issue for many voters in the upcoming presidential election. As a person with AIDS, I have no choice this November. Senator Barack Obama supports a universal, affordable and portable health care system. Senator John McCain proposes a plan that falls far short of universal health care. If McCain were to get elected, individuals with pre-existing conditions (read: people with HIV/AIDS) would join a state-created nonprofit that would provide them a chance to purchase insurance—a situation that sounds very similar to the current Medicare system, one that is far from perfect.

The preamble to the U.S. Constitution suggests that the government “promote the general welfare [of the people] and promote the blessings of liberty for us and our posterity.” Clearly, our founding fathers had no idea that health care would become the industry it is today, nor could they have predicted how it would become disabled by its evil stepsibling—the insurance industry. Had they known, perhaps they would not have even dared propose that the government provide for our general welfare. Blissfully blind as they were to the complications of modern health care, they wanted to guarantee one thing: that all subsequent generations would have every possibility to achieve their potential. Without providing access to even the most basic of health care for its people, any government is doing itself a disservice. It’s not just people living with HIV/AIDS who suffer from an inadequate health care system; it’s also their home nation that is deprived of the benefits of their full potential. In a country with poor health care, both the country and its people lose.

We need to meet the needs of people living with HIV/AIDS. We need to increase funding for the Ryan White CARE Act and ensure that it is given support until there’s a cure. We need to continue to fund treatment research. We must allow all Americans access to all available antiretroviral drugs and not let the states decide which drugs are, or are not, on their AIDS Drug Assistance Program lists.

Giving all positive Americans access to the best care possible gives them their best chances for a future. We will honor our founding fathers—and strengthen our nation.

I don’t think it’s unrealistic to expect a health care system to do what it says right there in the name: care. I don’t think it’s impossible to create a health care system that works just like the New York subway: one that is open to all, at a fair price, and provides the services we need. And I want a health care system that makes me feel welcome—not like another person at the velvet ropes outside an exclusive club.

Yes, I want to renegotiate that bargain I made with God. I want more time. But maybe that won’t take divine intervention. If my country gives me access to quality health care, there’s a good chance I’ll attend my nephew’s graduation day. All four of them.