system that our own single payer monopsony would bring us. Single payer activists, don't give up. As President Obama said in his press conference this week, "persistence!? Universal healthcare is okay for a small country or organization like Switzerland, Canada, or the Veterans Administration, but it wouldn't work when scaled up to meet the needs of a large country like the US Medicare is a national program that works reasonably well. There isno reason whatsoever that would make it hard to scale up. Indeed, Medicare was initiated (and administered for tens of millions of enrollees) before computers became available - scaling it up 7 or 8 fold should not prove difficult. In Canada, health care is administered at the provincial level. The Ontario Health Insurance Program, which includes the city of Toronto as well as rural areas, is a good example. Since much of the program we envision would be regionalized, with regions similar in size to Ontario, that program seems a sound indication that scale should not be problematic. Some conservative opponents of single payer health reform have been claiming that new research proves that Canada's single payer national health insurance program has performed poorly, and that projected savings on administration are illusory. In the commentaries below we analyze the two most prominent examples of this new research a paper by June and Dave O'Neill ("Health Status, Health Care and Inequality: Canada Vs. the U.S. ") and a report by Bejamin Zycher ("Comparing Public and Private Health Insurance: Would