For decades, the primary goal of those who would fix the U.S. health system has been to help people without insurance get coverage.
Now, it seems, all that may be changing. At least some top Republicans are trying to steer the health debate away from the problem of the uninsured.
The shift in emphasis is a subtle one, but it's noticeable.
Take this exchange between Fox News Sunday host Chris Wallace and Senate Minority Leader Mitch McConnell (R-Ky.) earlier this month, just after the Supreme Court upheld most of President Obama's health law.
Wallace: "What specifically are you going to do to provide universal coverage to the 30 million people who are uninsured?"
McConnell: "That is not the issue. ... The question is how can you go step by step to improve the American health care system? It is already the finest health care system in the world."
Wallace: "But you don't think that 30 million people who are uninsured is an issue?"
McConnell: "Let me tell you what we're not going to do. We're not going to turn the American health care system into a Western European system. That is exactly what is at the heart of Obamacare. They want to have the federal government take over all of American health care."