Problem: An American billionaire from Pennsylvania has decided that he wants to spend $500 million advocating for a healthcare-for-all policy, but isn't sure if he should fight for it at the local level in Philadelphia, the state level, or the federal level. He has asked you, a health policy expert, for advice. He doesn't want your opinion on healthcare-for-all, but rather on what level his advocacy could have the greatest impact. What do you tell him?