I wouldn't necessarily say we're missing something that other countries have. Each system has strengths and weaknesses. Reform on this scale is difficult to do correctly even if your major political parties can compromise and work together on something.

Personally, I'm more excited about the potential of MFA than Mark; however, I'm equally frustrated by the national conversation around it. It's a political battleground and the public debate lacks nuance or depth. MFA, in my opinion, solves a set of problems and introduces a set of unknown problems while doing nothing for certain root issues (clinical variation, potentially avoidable events, etc.). The focus on who pays and taxes is a very small part of a much larger conversation and many of the voices talking about it lack industry knowledge or experience. But the same can be said about a bunch of different controversial issues right now and I'm off topic.

To actually get to your question - it's MFA+Medicare reform+a whole bunch of other reforms related to the delivery of care. MFA is not enough because it's just one piece of the puzzle. If we're missing anything as a country, is a political environment that would make this sort of widespread societal reform possible because it truly isn't as simple as switching to single payer.