To the Republicans, that means "universally" available (it's there); but it doesn't mean "universally" affordable. That is the system we have now; if you can afford it, you can have it. (Except for the very poor, who sometimes [but not always] have Medicare {and in California, MedCal} to provide.) The real middle class (sometimes called the "lower middle class") can neither afford coverage by private, individually purchased, health care plans, or, with the rising costs of employer provided insurance or the loss of employment altogether, are left unable to purchase either health care services or medicine. The Republicans continue to see health care as a profit center (whether it is health care itself or health insurance). Some of us liberals, and some Democrats, see health care as a basic need; like national defense and national and local security. (Don't get me started on the exagerated costs of "security" for everything except the pay to soldiers, sailors, firemen, and policemen, etc.) The U.S. may (still a question) have the greatest health care system; but it isn't available to everyone because it is run as a profit center, not as a public service. And yet, it is as important to our national, as well as personal security, as is our expensive (if misdirected) national defense.