[jkeel]

What I think would be a better solution that could fit in everyone's worldview (those that want a more socialized health care system and those who don't want a powerful federal government) is to have cities provide a public health insurance option that a person or business could buy into.

I think that the risk pool would be large and the members would be local (thus giving more rights to local communities rather than the federal government).

I think it could then encourage cities to be more healthy cities (less pollution, more activities for locals, encourage walking/biking rather than driving) in order to drive down health care costs for their citizens. Being a healthier city would then encourage people to move to there thus increasing the risk pool.

Citizens wouldn't be required to purchase through them but the plans could still be managed by private companies like Aetna, Cigna, etc. so that the plans could be used when local citizens travel to other parts of the country.

[astrodust]

You could do it on a state-by-state basis, where each may provide a differing level of coverage but all of them would provide at least a base-line care for citizens that are residents of that state.

This could lead to a form of "competition" where some states might provide perks to help encourage people to migrate there from other parts of the country or make it more attractive for prospective employers.

This is the way it's done in Canada. Each province has differing rules as to what's covered, but emergency treatment and preventative care is never impaired by cost or a lack of insurance.

[Anechoic]

have cities provide a public health insurance option that a person or business could buy into.

That only works if all cities have plans, otherwise you can find yourself trapped staying in a city that same way that one might find himself trapper working for an employer.

[jkeel]

Good point! I guess I was looking at it as an advantage and other cities would start their own program to compete just like employers do today. I just figured people tend to not move geographically as much as they change jobs.