WASHINGTON (MarketWatch) — Last month’s failed attempt to repeal and replace Obamacare had nothing to do with the welfare of the American people, and everything to do with the power struggle between political factions in Washington.

But out of the shambles of that failed effort may come a reform that actually does provide affordable universal health care: a national single-payer system, aka Medicare for all.

Both ends of the political spectrum — the far left under Bernie Sanders and, improbable as it may seem, the far right under the likes of Richard Spencer — are pushing single-payer not only as the solution to guaranteeing humane health care but as a self-regulating system to rein in spiraling costs.

Unfortunately, it is the middle of the political spectrum that controls Congress, and they remain in the pocket of drug companies and health insurers that profit so richly from the current, inefficient hodgepodge of coverage.

Vox’s Dylan Matthews this week called attention to alt-righter Mike Cernovich’s plug for a single-payer system in an interview on CBS’s “60 Minutes.”

“This might seem like a bizarre position for a far-right conspiracy theorist to take,” Matthews commented. “Single-payer health care, after all, entails nationalizing most or all of the health-insurance industry and having the government set prices for doctors’ services.”

However, Matthews puts this stance in the context of the alt-right’s “vehement rejection of the free-market ideology crucial to post-World War II American conservatism” in favor of building a political base on race and identity. He reports how more moderate elements in the Republican Party are moving toward single-payer as well.

Vermont’s Sen. Sanders campaigned for the Democratic presidential nomination with a single-payer health system as a prominent feature in his program, and announced last week that he would introduce new legislation for it in the wake of the Republicans’ failed effort.

“Ideally, where we should be going is to join the rest of the industrialized world and guarantee health care to all people as a right,” Sanders said on CNN’s “State of the Union.” “That’s why I’m going to introduce a Medicare-for-all, single-payer program.”

Sanders said he would reach out to President Donald Trump and urge him to back this and other effective measures to improve health-care coverage, starting with pending legislation of limiting drug prices.

“President Trump, come on board,” Sanders said on CNN. “Let’s work together. Let’s end the absurdity of Americans paying by far the highest prices in the world for prescription drugs.”

Support for such a “socialist” intervention seems to be growing. The Pew Research Center found in January that 60% of Americans surveyed believe the government should be responsible for ensuring health coverage for all.

“The share saying it is the government’s responsibility has increased from 51% last year and now stands at its highest point in nearly a decade,” Pew’s Kristen Bialik commented.

A Kaiser poll at the end of 2015, as the presidential primary campaigns were in full swing, found that 58% of Americans favor some form of Medicare for all.

This momentum led the New Republic’s Sarah Jones to comment last week that “long derided by conservatives and centrists as a socialist fantasy, single-payer health care (sometimes called Medicare for All) is having a moment.”

Jones and her readers see it as an opportunity for Democrats to reclaim the initiative on affordable health care, but there are indications that such a move could find even wider support.

“I’m pro-single-payer health care,” Cernovich told 60 Minutes’ Scott Pelley. “Is that right-wing or is that left-wing anymore? Well, if you have a lot of people, a large swatch of the company, or country, are suffering, then I think that we owe it to all Americans to do right by them, and to help them out. So is that right-wing or is that let-wing? I don’t know.”

Vox’s Sarah Kliff reported this week how surprised she was when she helped conduct a focus group on health care among Trump voters and half of them spontaneously said they would like a single-payer system like Canada’s.

“We hadn’t planned to bring up single-payer health care,” Kliff wrote of the March session. “The focus group was about the Affordable Care Act. But one Trump voter had raised the idea that we’d be better off if we had a health-care system like Canada’s — where the government runs one health-insurance plan for everyone — and wanted to see who agreed.”

Two of the country’s most populous states — California and New York, both deeply blue — are exploring a statewide version of single-payer health care, though it’s hard to know whether even states as big as those have sufficient resources to manage such an endeavor.

What is certain is that if health-care reform is left to mainstream conservatives like House Speaker Paul Ryan and Vice President Mike Pence, all we will see is more tinkering with the deeply flawed system in place.

Trump has given little indication that he is capable of taking charge and following through on his campaign pledges, but that is what it will take if we are to get any reasonable health-care reform in the near future.

Darrell Delamaide is a freelance writer for MarketWatch.