is that its proponents often compare it to the health care arrangements in the Nordic countries - that their systems are the ideal, or close to it, and that we should adopt their kind of system. Ideally, maybe we should. But here's the catch: Those countries have never had for-profit, privately-owned primary health care. In Norway, for example, the oldest hospital still in existence was built in 1277 and was operated by the church; later on, other charities ran the hospitals. After WWII the government took over the entire health care system, with the actual provision of services being managed by local governments. https://www.lifeinnorway.net/healthcare/ In contrast, the United States has never had government-provided health care, with the exception of the VA. Even Medicare isn't really government health care because it is provided by privately-owned and in many cases for-profit providers, and we and our employers, not the government, paid for it (and you still pay premiums). So the transition to a government-managed single-payer system would require massive restructuring of almost everything, that would take years to implement. Candidates flogging M4A aren't being honest if they're trying to convince voters that it's going to happen like flipping a switch as soon as there's a new administration.