Given the size and diversity of the U.S. population, and the current resistance to big government programs or tax increases, Shays doesn't see much support for a single-payer system in this country. One size doesn't fit all. Some of the greatest innovations come at the state level. Indeed, leadership on the issue of universal health coverage is more likely to be found at the state level, just as Canada's single-payer policy began in the provinces before being adopted countrywide. In Chicago, PNPH is pushing a constitutional amendment that would make universal health care a right, thereby forcing the Illinois legislature to act on the issue.
Polls show citizen support for such a measure in that state is overwhelming.
Another state being closely watched, in part because of its proximity to the Capitol, is Maryland. Last month, under the leadership of Baltimore City Health Commissioner Dr. Peter Bielenson, the recently formed Maryland Citizen's Health Initiative Education Fund launched a massive campaign for universal health care. They strongly support a proposal to provide health care coverage for all Maryland residents. The survey also found that residents would vote for any candidate, Republican or Democrat, who supported a universal coverage proposal. Now the Initiative hopes to get 2,000 organizations to publicly support the idea of universal health care.