Beyond Labels

A 360° Discussion of Foreign, National and Local Policy Issues

Best Path to Universal Healthcare?

On Dec. 14, we’ll explore the paths to implementing “universal healthcare” in the U.S. We’ll assume that “universal” coverage is the consensus goal, and discuss how to get there.


  • Should it be done with a giant leap? Strong advocates seem to think so, but there are lots of unknowns (changes in behavior of providers, patients, others; cost; etc.).
  • Should it be done incrementally, such as by expanding Medicare to cover broader age groups?
  • Should a single system be implemented nationally, or should the details (or even adoption) be left to the individual states?

To Where?

  • Should the U.S. create a unique system? <How would it be different from others? Why?>
  • Should it copy one of the existing models of other countries? <Which one?>
  • Should it expand an existing program (like Medicare)? <Does Medicare currently “work” for the country?>

I’m sure we’ll have a robust discussion and will hopefully gain some insights into the risks and opportunities with such a transformation.


  • For discussion, I’d like to offer a fiscal study done for a state-level universal healthcare model in Maine. The Maine AllCare website has a summary as well as a link to the full study.

    Lots to talk about on Monday! Lynn Cheney

    • As you begin, I will be in a dentist’s chair. I may or may not catch you all in the second hour.

      The best goal is for one national plan. That plan should grow from where we are now is one of two “organic” ways. Either we expand the national the existing ACA along the lines of Medicare and offer buy-ins, allowing growth from that point that does or does not include private insurers. Or, we make smaller national moves while encouraging states to try their own single payor plans which should lead to the common adoption of the more successful plans. This might lead to the national adoption on one plan, as happened in Canada or it may not.

    • Lynn: I hope I am able to join you.

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