I believe in single-payer healthcare, but there's one common argument for it that's misleading.

It came up several times at the last debate, via Bernie. Different variations of, "We are the only industrialized nation that does not have universal healthcare."

I've only recently begun to see through this line as it relates to the single-payer discussion. Saying we are the only such nation without universal healthcare conflates "universal coverage" with "single-payer." For years growing up, I assumed single-payer was the norm among the rest of the civilized world.

And then I did my homework, and I found that "universal coverage" is a goal obtained in many different ways.

France is often held up as the paragon of a health system: Low costs for great outcomes. And the people love it. But it's not a true single-payer system. It's a hybrid of public and private systems. The vast majority of costs are covered by the government, but almost all French have some additional private insurance, like Medigap here in the States. There is an insurance market in France, and the government regulates the shit out of it, which is a big reason costs are so low.

Germany also has a multi-payer system that achieves universality. It mandates public insurance for people below a certain income level and allows private insurance for those who earn more. It's also tied to an employer-system in which employers and employees pay premiums into a healthcare pool.

There are many such examples of countries achieving universality through a system unique to them. And even within the single-payer models, from Canada to UK to Scandinavia, there is variety depending on whether the providers are primarily public or private and how the system is financed.

I believe in single-payer, as I believe it is simple, cost effective, and moral. But there are realities to being an American and to the current political possibilities, and our solutions to fix our awful, complicated, expensive system will have to involve compromise and creativity. More importantly, and to the point of this post, achieving universality through a means other than single-payer doesn't mean we're fake progressives or that our nation should be embarrassed. It would put us in good company, actually. Let's keep moving the ball forward.