And what about the medical components in workers' compensation and auto insurance? Skyrocketing bills for medical care and drugs (in a system without deductibles or co-payments, as with single-payer) inflate premiums and cut into carrier profits. If you are hurt on the job or in a car accident, are the bills taken care of by the same single-payer system? If so, what impact does that have on incentives to make workplaces safer?

My ignorance on these issues shows how insular Americans are about the broader world–insurance or otherwise. (We might do a story to clear up these questions in a future edition of NU. Stay tuned!) It also proves that we often work in a vacuum on critical issues, ignoring the lessons of other systems around the world. Let's try to improve upon the wheel, rather than struggle to reinvent it, or keep bumping along on a square tire.

The bottom line is whether you agree with Mr. Moore or not, there has got to be a better way of financing our medical needs–spreading the risk so that no one is bankrupted by the system, or forced to pass on necessary preventative or acute care because they don't have insurance or enough savings in the bank.

We passed Social Security and Medicare to keep our elderly from ending their days in poverty. We passed unemployment and disability insurance laws to cushion the blow if someone can't work or loses their job. We should be able to come up with a more fair and egalitarian system that doesn't allow tens of millions to fall between the cracks, don't you agree?

I truly believe Americans are the most resourceful, innovative people on Earth. We are born inventors, risk-takers and problem-solvers. I do not accept the notion that this challenge is beyond our capabilities–financially, intellectually or politically.

Single-payer systems in Canada, the U.K. or France might not be THE answer, but certainly there is much we can learn from their approaches.

When will we finally see comprehensive reforms? When enough people are put at risk that a political tippping point is reached. Maybe it's when 70 million are uninsured. Or 100 million.

Maybe it's when 10 percent of doctors refuse to accept insurance, sending out-of-pocket expenses soaring, or perhaps 20 or 30 percent.

Maybe all it will take is a change in leadership in the White House and Congress come November 2008.

In any case, with coverage gaps widening every year, and insecurity about the ability to afford care on the rise, change, I am convinced, is inevitable. We should be proactive and visionary about it, not defensive and short-sighted.

I want to thank all of the readers who took the time to thoughtfully respond to my blog entries this week. It's been a terrific dialogue, and an example of the kind of vigorous discussion and heated debate we can no longer afford to postpone nationally to do better by our fellow Americans.

Additional comments are welcome. I'll never get sick of talking about the implications of the points raised by “Sicko.” It's the most productive six bucks I ever spent!