It wouldn't be state based. The federal government would pass a law that you can't charge more than Medicare +20%. This fixes some major rent-seeking costs in t

It wouldn't be state based. The federal government would pass a law that you can't charge more than Medicare +20%. This fixes some major rent-seeking costs in the current system. It gets rid of the need for brokers (which typically charge 5%) because there is no need to negotiate prices. It also gets rid of everything out of network, you know what the max is. You can't have anesthesiologist that are your only option in the hospital but they are not in network even though the hospital is. It would also push a lot of places to take a standard discount for cash at time of service, just pay Medicare rates. They take less but get it now. It does mean that health "insurance" companies would need to start differentiating on price, wellness plans and customer service instead of exploitative pricing deals.