(Flickr user Joeri Cornille )

Besides our own health-care system, Switzerland's may be the one that gets the most attention in America because of its similarities to the Affordable Care Act's new coverage scheme. So it seems worth noting that 64 percent of Swiss voters rejected a ballot measure on Sunday that would have scrapped its own system in favor of single-payer health care.

If that vote had gone through, it would have replaced more than 60 insurers with a government-run system, something that a fair number of liberals and others would like to see here, too. Instead, voters in Switzerland opted to keep their current system, which has key similarities to Obamacare. For nearly 20 years, Swiss residents have been required to purchase coverage from private health plans who compete for their business; those health plans have to offer a minimum level of benefits and can't reject people based on pre-existing conditions; and the government provides subsidies to help low-income people afford coverage. That's essentially how the ACA's expansion of private coverage is structured.

There are some differences, though. Employers in Switzerland don't provide coverage, while more than half of insured Americans get their coverage through work. The Swiss system also doesn't have anything similar to Medicare or Medicaid.

Nearly everyone in Switzerland is covered, and the country leads all others when it comes to life expectancy. But it also spends the third most on health care of the 34 countries in the Organization for Economic Co-operation and Development, and the rising costs have been a growing problem for Switzerland.

"Campaigners who championed the push for a state-held insurance scheme have said it is the only way to rein in rising premiums and guarantee they are used efficiently and transparently," AFP reported. A pretty strong majority of the country disagreed, apparently.

In the United States, Obamacare is far from the final word on health reform. There are plenty of liberals who would like this country to move to a single-payer system and see Obamacare as that stepping stone. There are some more local efforts — Vermont is trying to set up its own single-payer system, and former Medicare administrator Don Berwick campaigned on a single-payer platform in his unsuccessful gubernatorial bid in Massachusetts this year.

The single-payer concept, though, remains unpopular in the United States, and the politics of making such a shift on a national scale still seem impossible.