"All of this is a way of saying that getting to single-payer – especially, single payer without any private health insurance is not likely to happen in the foreseeable future."
Secondly, the elephant in the room.
"Next debate, please remember that health care is still the number one issue everywhere in the country. It’s an issue we win on, but only if we remind Americans of the difference between Democrats and Donald Trump."
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Differences Between Universal Coverage and Single-Payer
By Kelly Montgomery Updated October 04, 2019
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Challenges in the United States
Some experts have suggested that the United States should incrementally reform its current health care system to provide a government-funded safety net for the sick and the poor (sort of an expanded version of the ACA's Medicaid expansion .. https://www.verywellhealth.com/whats-the-difference-between-medicaid-obamacare-1738843 ) while requiring those who are more fortunate health-wise and financially to purchase their own policies.
However, the political gridlock that has been in place over the Affordable Care Act over the last several years makes it difficult to imagine such a proposal gaining enough traction to pass. But it is technically possible to construct such a system, which would provide universal coverage while also having multiple payers.
While it is theoretically possible to have a national single-payer system without also having universal health coverage, it is extremely unlikely to ever occur because the single-payer in such a system would undoubtedly be the federal government. If the U.S. federal government were to adopt such a system, it would not be politically viable for them to exclude any individual citizen from health coverage.
Despite this, a growing number of congressional representatives have called for the establishment of "Medicare for All," a proposal popularly endorsed by the supporters of Vermont Senator Bernie Sander his in 2016 presidential bid (and one incorrectly labeled "socialist" by most in the Republican Party.)