> I'm not sure that governments have a history of keeping costs low, so voters would likely be skeptical of that. In general that's true, but in healthcare it'

> I'm not sure that governments have a history of keeping costs low, so voters would likely be skeptical of that. In general that's true, but in healthcare it's not. As a percentage of GDP, the US spends as much taxpayer money as the UK, but clearly gets far less for it - the NHS vs. Medicaid, Medicare and other limited programs. I suppose the problem is that states would have to set up a parallel system with costs on top of the existing federal structures, which as you say would be expensive.