A Clean Slate for Care

How America Could Finally Embrace Universal Healthcare After Regime Collapse

For as long as I can remember, the United States has treated healthcare not as a birthright, but as a commodity. We’ve built a maze of copays, deductibles, insurance networks, and prescription tiers. We call it freedom, but it feels more like a tax on pain. And we’re alone in this—outliers among nations that made peace with the idea that a human life shouldn’t depend on the fine print of an insurance policy.

It’s not because we’re broke. It’s because we’ve let greed and ideology park themselves in the driver’s seat. Industry lobbyists set the course, and we’ve been paying the tolls ever since. But what if that all fell apart?

Imagine a true collapse—not just the crumbling sidewalks and bankrupt hospitals, but the whole system finally giving way under its own contradictions. A full come-apart. The sort of rupture that lays everything bare and, for a moment, makes room for something new.

Post-collapse, if such a moment came, the United States might find itself in a rare kind of daylight. That breath of possibility between what was and what could be. It’s happened before—in Berlin, in Cape Town, in places where old powers fell and people got to ask: what kind of country do we want now?

In that fragile window, when the ground is soft and the rules are still being written, universal healthcare might stop being a pipe dream and start being the foundation. Not a campaign promise. A simple fact.

Why? Because it’s easier than we’ve been told. The resistance we face now—the money, the gridlock, the tribal posturing—might vanish when the old regime does.

After the fall, the usual obstacles have a way of getting cleared out. People become willing to demand dignity again. Power shifts. Laws get rewritten. Allies show up with blueprints and a little cash. Suddenly the unthinkable becomes obvious.

Picture this: within months of a regime’s collapse, we redirect a portion of the defense budget to plug immediate healthcare gaps. Medicare expands temporarily. By year’s end, we pass a new law—call it the National Health Act. It sets price caps, creates public coverage, and reins in the chaos. Over the next two years, we build out regional systems, rewire infrastructure, and fold everyone into the new way. By year three, we’re not talking about whether healthcare is a right. We’re just living like it is.

That doesn’t mean the road is smooth. We’ve got a patchwork of systems and a workforce spread too thin. Some states will dig in their heels. But it’s nothing we haven’t overcome before. What once looked immovable might, in the light of a new beginning, reveal itself to be nothing more than shadows.

Help would come. Not as colonizers or meddlers, but as collaborators—nations like Canada and France offering what they’ve learned. Training doctors. Lending planners. Filling gaps while we get our footing.

And when we finally stand tall in this new framework, it won’t just be a victory of policy. It will be an act of moral repair. A reckoning with our past cruelty. A declaration that here, in this version of America, we do not let people die because they were born poor.

That’s the dream. And if it takes a collapse to get there—if the cost of healing is a fall from grace—then let’s not pretend we weren’t warned. Let’s not act surprised when the walls give way and daylight pours in.

We may yet become the kind of country we always told ourselves we were.