Tommy Douglas was gov of Saskatchewan in Canada. He started a universal healthcare system . It was so much better than what they had that the whole country adopted it, He is still the most popular person in Canadian polls. That is why states are dicking with starting it. It can happen if a state creates it. However in America with universal healthcare we can elimimnate the VA, Medicare and Medicaid. That would cut the overall costs a ton. But I doubt states have that option. We also save the ourtrageous costs of healthcare insurance companeies whose function is to deny as much care as they can get away with. More profit. We have an adversarial system with providers. Our system really sucks.