The recent debates about Medicare for All in the United States reflects a number of positive developments. For one, the campaign for truly universal health care has gained serious momentum for the first time since the Affordable Care Act (ACA) passed in 2012. At that time, despite valiant efforts to insert a single-payer proposal, most politicians and activists stayed loyal to President Obama’s public-private partnership strategy.

Before the ACA, Michael Moore’s 2007 documentary Sicko — which focused on the victims of the for-profit health insurance industry rather than on the United States’ exclusion of fifty million people from health care coverage — provided a serious boost to activist organizing for Medicare for All.

The only other time in the last forty years that Medicare for All took center stage was in 1992, after Bill Clinton made universal health care a frontline campaign promise. Hillary Clinton’s subsequent task force buried that possibility after handing out shovels to the health insurance industry.