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I'm guessing the economy of scale for such a buy in isn't enough, and that states would have to take out as much debt as their yearly budgets or even more. Even a Elizabeth Warren's proposed solution was something like 17x the federal budget.

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States wouldn't be able to borrow on anything like that scale to fund a healthcare program. Any major increases in healthcare spending would have to be funded by huge tax increases.

> increases in healthcare spending

FWIW, New York's current Medicaid budget alone puts it between San Marino and Israel for per capita healthcare spending. Widening the net a bit, that's between Italy and the UK.

NYS has a bigger population than all of Canada which seems to do make universal healthcare work.

There’s comments above that explains it “working”. Here’s a site that explains it better. TLDR, taxes go up a lot, private spending for medical procedures slightly falls. Quality of care drops. Pretty well a losing proposition all the way around.

https://www.heritage.org/health-care-reform/report/how-socia...

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