According to a June 2017 poll, Americans agree by a 60-to-39 margin that the federal government bears a responsibility to ensure health care for all Americans; 33% said that they favored a “single-payer” health system, 12% more than in 2014. The prevailing belief that the government should actively promote broader health insurance coverage contrasts strikingly with the nearly successful effort to repeal the Affordable Care Act (ACA), executive orders that threaten to destabilize ACA marketplaces, and repeated calls by the majority party in Congress to slash Medicaid spending.

At present, either the single-payer or the incremental approach to universal coverage may seem fanciful. But political winds shift, and it is important for those dedicated to expanding insurance coverage to determine how best to proceed when they do.

Two broad strategies exist to extend insurance coverage. One is exemplified by a House bill (H.R.676), introduced by Representative John Conyers (D-MI) and 120 Democratic cosponsors on January 24, 2017, and by a Senate bill (S.1804), introduced by Senator Bernie Sanders (I-VT) and 16 Democratic cosponsors on September 13, 2017. Each would replace the current insurance system with a national, tax-financed system.

Read the source article on universal health care by Henry J. Aaron, Ph.D. at The New England Journal of Medicine