> For single-payer specifically, I’m not sure. If the federal government were indifferent, states could certainly try it; in fact Vermont did. I mean, that's t

> For single-payer specifically, I’m not sure. If the federal government were indifferent, states could certainly try it; in fact Vermont did. I mean, that's the whole point. If you can't even muster up the political will to do something at the state level, especially in deep-blue states, what hope is there of doing it at the Federal level? States need to prove that ideas work by actually trying them out and finding the right implementations. > Where I disagree is that the states are generally on par with the federal government or their Canadian counterparts. The argument is that States are on par with the Federal government and Canadian counterparts as it relates to healthcare policy and taxation, and I'm yet to hear a convincing argument to the contrary. Saskatchewan was able to enact single payer in 1947 despite being 1/20th the population of Canada at the time. Its ability to enter into relations with foreign governments or its political will to set a Provincial language is completely irrelevant to that. > Others may be legally possible but are so politically implausible (Texas switching languages and dragging the federal government along). The argument is about the structural right, not the political feasibility of it — and also nobody is arguing for dragging the Federal government along, even for healthcare. Personally, I would actually like to see States try out different approaches to healthcare — Denmark-style single payer, Germany-style public/private hybrid, Switzerland-style individual mandate, Singapore-style HSA-driven care — so that we can have empirical data to prove which systems are superior.