As someone who researches inequities in health care, I’ve diligently followed the debate about healthcare reform. However, most of my friends (and I suspect most Americans) wonder exactly what single payer healthcare is and how will it affect them. In a New England Journal of Medicine perspective piece, Jonathan Oberlander, PhD, a professor of social medicine at the University of North Carolina in Chapel Hill, expounds on the history and obstacles facing calls for single payer healthcare reform.