At the end of a long presentation outlining new services, new doctors, new facilities and a growth in income this year at a rate greater than the growth of the economy, Dr. Kent Palmberg, the unusually savvy and successful senior vice-president and chief medical officer of Stormont Vail HealthCare, sighed and quietly said, "I'm not sure where all this is going, but we'll probably end up with something like Medicare for all."

He added, "I'm not sure that's all bad. They pay promptly, predictably and adequately, with a minimum of paperwork. That beats costly fighting with scores of insurance companies, plus caring for the many uninsured."

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