[preview]

The issue is whether a state-by-state single payer system would be universal. It would not be in the US--the Republican states would never enact it. How would Canada's system react if Ontario had single payer but British Columbia did not?

[einhverfr]

Actually Canada has had issues with provinces not coordinating medical issues very well. They are actually less centralized than the US is. One of the reasons why SARS hit Ontario so hard was that there was no equivalent to the CDC nationally or at that time in Ontario.

But for the US, if you sent things to the states, coverage could follow residency, and states could decide the level of coverage they wanted to provide (coverage varies significantly between Canadian provinces btw).

The big problem for the states is you can't do it as long as Medicare is fully federal and Medicaid is so heavily regulated by the federal government. You'd probably have to hand these programs to the states first.

[einhverfr]

Just noting, provinces in Canada with CDC-like organizations did pretty well regarding SARS. Ontario, OTOH, had one of the highest mortality rates (and public health impacts) in the world. Keep in mind Toronto was closing hospitals due to the spread of the disease there during the public health crisis...