The November 2019 AJPH podcast is out here: https://am.ajph.link/POD_November2019. The US system of insurance is at a crossroads. Will it continue to grow incrementally or are we on the brink of a profound transformation in which all of the existing financing institutions are canceled and replaced by a single system? This complex machine was built progressively and underwent many social and political battles. The population coverage has improved in quantity and quality over time but remains a combination of sometimes contradictory systems and, importantly, it leaves out 30 million people without health insurance. My guests are Prof Jonathan Oberlander (University of North Carolina) and Dean Sherry Glied (New York University)