dual system probably. let me explain: i think 'medicare for all' is eventually going to happen.....and actually would be helpful as a 'bare bones' health insurance offering which would cover the basics like annual wellness exams or 3-4 periodic doctor visits per year for those who are diabetic, hypertensive, have COPD etc. for those that want something over and above it, i'm sure they'll have the option to purchase a policy via blue cross/blue shield, aetna, united healthcare, kaiser permanente etc. sort of like what we in the game now call dual eligible......those patients have medicare and medicaid. except for the 'medicare for all' those individuals would have very basic medicare and would be free to purchase 'supplemental' commercial health insurance. and, certainly, i would favor this option. for those who dont have the means to purchase a supplemental commercial policy they could be shifted over to the current 'dual eligible' medicare-medicaid pathway with the caveat that strict monitoring be instituted so as to cut down on individuals trying to get on this option via fraudulent/dishonest means.