Selling across state lines is mostly just a conservative talking point. It's something that they say so that they can sound like they have ideas to solve the healthcare issue when really, the don't.
Single-payer is cheaper in other countries because you mostly have one party, who is the only game in town, bargaining with service providers to set prices for services.
In the USA, there are a ton of payers. The government, individuals, and insurance companies. Insurance companies have an incentive to keep their rates low so that they can out-compete their rivals, but really, the more people spend on healthcare, the better off an insurance company is. Of course, healthcare still has to be affordable for the American public, or else the insurers would have no customers, but by and large, it is affordable. America is an extremely wealthy country. Basically, we pay more for healthcare because providers know that we can afford it.
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