Is there hope for the uninsured?

In an anecdote popular on the conference circuit, an American health policy analyst who has ascended to heaven asks God, "Will there ever be universal health insurance coverage in the United States?" "Perhaps," sighs God, "but not in my lifetime." This paper argues that this tale accurately describes the prospect of covering the uninsured in this country. Neither moral sentiments among a majority of U.S. political leaders, economic self-interest among those who would have to pay for universal health insurance, nor political pressure from the uninsured and likely-to-be-uninsured will provide a sufficiently strong imperative to move this country toward universal coverage soon, if ever.