It's true the Patient Protection and Affordable Care Act expanded health care choices and extended coverage to people across the United States. The mandate, the subsidies, the federal and state exchanges and various other aspects ofthe law have opened up a number of pathways to health care.

But PPACA didn't go far enough for people in Vermont. The Green Mountain State in 2011 decided to initiate the construction of a single-payer system. In a single-payer system, the government pays all health care costs on behalf of its citizens and private insurance companies go the way of the dodo. A number of countries, including Canada, have single-payer systems, and proponents say that single-payer provides better results than the U.S. system — a patchwork of big government programs, private insurance and community-based systems. (Thanks to PPACA, you have to throw accountable care organizations into the American mix, too.)

But observers across the country are eyeing Vermont's effort to see how it works out. Vermont's system was profiled in a recent USA Today article that noted the state's implementation of a single-payer system could spread to nationwide much the way single-payer grew in Canada, where it began in one of the prairie provinces and engulfed the rest of the Great White North.