One angle on the healthcare debate, as I see it, would be that individuals who push for allowing buying health coverage across state lines, then turn healthcare into interstate commerce. The moment it becomes interstate commerce, then the government can get involved. The federal government then can require people either have their own health insurance or sign up for government offered health insurance, if the state doesn't do it. This could be done by having people who don't own insurance (opt-out) be signed up in Medicaid and have their taxes adjusted accordingly.
An issue now is that health care doesn't fall under interstate commerce.







