[slickpoppa]

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State by state is a horrible idea for any welfare policy. The problem is free riding.

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How is free riding a problem? That's the entire point of socialized medicine.

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Mr. Jones needs a kidney transplant, but lives in a low tax state with crappy health care. So he moves to another state with high taxes and great care to get the kidney transplant, then moves back to the low tax state when he's healthy.

Obviously there are ways that states can combat such free riding problems, such as requiring residency for a certain period of time, but free riding is definitely an issue that would need to be dealt with.