Appears to be "in the air". The driving factor in the USA is cost. We need a competitive private insurance industry that is capable of driving the cost of healthcare down. If annual increases in healhtcare costs continue to top 8% it won't take long to cripple our economy. We also need to mechanism to keep in check public sector costs (taxpayer expense), the benefits are exceptional at little cost to the public employee. There are few incentives to control cost. No matter how this debate ends, if there isn't substantial headway made on controlling cost, the economy will be crippled.