Americans want changes to their healthcare, and the candidates in this year’s midterms are making bold promises about how they are going to improve it: Medicare-for-all , or a public health insurance option , or free primary care for everyone . If Democrats win big this year, they could build up momentum to control Congress and the White House in 2029, which could leave them well-positioned to take on the thorny problem of how to fix the US health system.

History suggests that this won’t be easy. For every Affordable Care Act, you have the failed attempt to repeal it or the calamity of the Clinton-era healthcare initiative . Americans want change — but they fear it, too. I’ve spent years reading healthcare polls , talking to voters , attending focus groups . The public’s opinion of the healthcare industry has grown more and more sour, and distrust of the medical establishment is at an all-time high.…