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Medicare was instituted in 1966 and STILL isn't right, hence the tweaks each year. When, and only when, they get it right should they look to expand Medicare to M$A. We had universal healthcare in the US before the ACA. I do not know of any hospital that turned someone in need away and most every county in the United States had clinics for people without private insurance. The ACA was a benefit only for the people with pre-existing conditions (read...people who did not want to pay for insurance until they needed care). I used to be able to cafeteria plan an insurance packaged based on what the consumer wanted. At the hint of ACA I only had 3 options to offer. Single male, too bad you get pregnancy coverage. Middle aged female, too bad you get pregnancy coverage also. Wake me up when the government figures it out.