Here's a thought... Given the formidable task of enacting rational, effective, and affordable healthcare reform, and the fact the insurance industry would fight to the death to defeat any initiative that would truly reduce healthcare costs, I wonder if a State-based system might be our best bet. It would take a leader to forge the way (California?), but could start a movement where some states offer rational, universal coverage. Businesses would flock to those states, I assume, and their economies would thrive. Those who resist (Mississippi, Texas, Kansas...) would see their citizens looking longingly across their borders. Eventually the political climate would shift to embrace a rational national approach. Or perhaps I'm just dreaming.