> I'm not convinced this is insurmountable. How do countries with single payer handle this? I'm confused by your question. Countries with single-payer have the

> I'm not convinced this is insurmountable. How do countries with single payer handle this? I'm confused by your question. Countries with single-payer have the same policy everywhere in the country, so there is no freeloading involved. Unless you're talking about people coming from other countries, in which case it's handled by their immigration policy.