That's a nightmare waiting to happen if people want/need to move.

And like I said, we have a well-established history of insurance companies playing games with their insureds. Think of all the bureaucracy that goes away if they no longer have that option when everything is covered.

Government just plays a shell game of hiding insurance functions in other agencies (IRS to collect premiums, FBI to enforce policies/prosecute fraud, etc). Single payer does not eliminate those inefficiencies..it MULTIPLIES them and removes choice from citizens.

Medicare plays the same denial games as private health insurance..often even more so. Medicaid is the absolute WORST for that.

In terms of your objection to the 50 state idea. We ARE a Republic of states. The federal government actually has no Constitutional right to be involved in healthcare at all. That power is reserved to the states. That fundamental principle of Constitutional freedom outweighs any inconvenience one may get from moving from state to state. Besides, even within our current single payer system, Medicare, coverage and policies vary from state to state. There is no reason to think that would change if we adopted a single payer system.

To be frank..there is not really much benefit to American citizens if we went single payer or NHS. There is a LOT of detriment though.