The prospects for universal health care in the United States appear unusually bleak these days. Just as the first U.S. state — Vermont — was getting ready to implement a universal, publicly financed health care system, its governor pulled the plug on his support. Years of studies, preparations and proposals, a mountain of supportive data and a clear legal mandate fell by the wayside as soon as Governor Shumlin felt that the political stars were no longer aligned. Meanwhile, in Washington DC, even the Affordable Care Act’s approach of making private health insurance more affordable by subsidizing over-priced insurance products is under attack in the Supreme Court.

Why is universal health care, which is commonplace around the world, so hard to achieve in the United States? Why are we unable to overcome a market-based system that leads to a hundred thousand unnecessary deaths each year? Corporate interests in maintaining this system are powerful, as is a culture of competition and consumption that sees health as a personal choice rather than a human right. The odds against universal health care advocates are long: What does it take to turn a market commodity into a public good, and dismantle an entire industry along the way?

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