Now that the most recent effort by the Republican party torepeal the Affordable Care Act has crashed and burned in the Senate, thepossibility that Republicans might actually have to talk withDemocrats about ways to improve the health care system in the U.S.has become a more realistic possibility.

In fact, as Politico reports, it has already started happening, witha very quiet effort undertaken by a bipartisan House group that’sbeen meeting under the radar for the past month. The group, knownas the Problem Solvers Caucus, is exploring ways that the ACA mightbe stabilized —something that’s essential if the program is not tocollapse under the Trump administration.

And other prominent lawmakers are talking, too — withprogressives from Senators Elizabeth Warren, D-MA and Chuck Schumer, D-NY to former PresidentJimmy Carter weighing in on the debate — aboutsingle-payer insurance. Most Democrats are reluctant to getinvolved in the Medicare-for-all/single-payer debate, but manyprogressives believe that now is the time to push for a moreradical solution to health care.

And while a Trojan Horse opportunity presented itself to votefor single-payer during Republicans’ efforts tokill the ACA in the form of an amendment presented by Senator SteveDaines, R-MT to advance single-payer in an effort to getprogressive and moderate Democrats squabbling over the issue,Democrats uniformly opposed the measure, led by Senator BernieSanders, I-VT, who led single-payer supporters in refusing to fallfor the ploy.

But another Sanders, Bernie’s wife, Jane O’Meara Sanders, hastaken an additional step in the quest to get people talking aboutwhat’s at stake on health care. Jane Sanders, a founding fellow ofThe Sanders Institute, a nonprofit educational organization, joinedNational Nurses United to deliver a research paper from theNational Nurses Union titled “Medicare For All vs. All the Healthcare Each CanAfford” to the offices of all members of Congress.

The paper, according to the Institute, “analyzes our currentfragmented health care system and suggests a system of health carereflecting the nurses’ values of caring, compassion andcommunity.”

“Twenty-eight million Americans are currently uninsured andmillions more are underinsured, every piece of legislationcurrently being debated in Congress continues to leave millionsuninsured and underinsured, the U.S. spends $9,451 per person onhealth care every year. [T]his is nearly two and half times the$3,814 average of other major countries and 58 percent of Americanssupport a Medicare for All system,” the paper says. It goes on tolay out a plan for changing how the system works — and that systemincludes the Affordable Care Act.

The paper “begins by examining our market-driven health caresystem and the failings of our private insurance system.” It goeson to “[include] discussions on why adding a government-run publicinsurance option to the ACA private insurance marketplaces couldnot remedy the problems the marketplaces face and on thelimitations in care under a market-driven system.” Finally, itconcludes “it will examine the major features of a Medicare-for-allsystem and how our country could provide healthcare as a right, nota privilege.”

Tackling the place of insurers in the system, the consolidationof hospital and physician practices, the amount spent on healthcare and how little return Americans get for their money comparedwith systems in other countries, the paper presents an approach inwhich health care is treated as a right and not a privilege. Butsince it moves away from a market-driven approach, it certainlywill not be popular with some of the biggest players in the field:insurers and health care providers.

However, if it at least gets people talking in Washington aboutalternatives to the current state of affairs, it might achieve itsstated goal of “broaden[ing] the discussion to go beyond insurancecoverage to a debate about creating a healthy society, with ourcitizens as the focus.”