Universal health care involves much more than providing insurance coverage to everyone. It also means ensuring that appropriate, affordable, and timely medical services are available to all, in keeping with the view of health as a fundamental human right. In the US, the framework of Medicare for All is gaining traction. Health workers in Mali are working deep within communities to provide free health care to anyone in need, and under-age-five mortality rates in rural communities have plunged as a result. Is universal health care a realistic goal and what tradeoffs have to be considered to achieve it?