In 1993 a television ad featuring ”Harry and Louise” -- a ”typical” American couple dismayed by the Clinton administration’s universal health care proposal -- helped to kill health care reform in the U.S. for the next decade. With the 2008 presidential election in sight the debate has resurfaced but are the prospects for universal health care any better today? In an ongoing study of health care systems spanning five countries Arnold J. Rosoff Wharton professor of legal studies and business ethics has identified a set of factors that in one combination or another come into play when a country commits to adopting universal health care. This time he says one thing seems likely: Instead of a health care ”revolution” in the U.S. change will come in increments.