[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.