To apply a federal initiative requires all states to forego their stakes in healthcare (or anything else) which seems unlikely in the US, as I’d guess a fair amount of income flows through that?

Even here, where Medicare is a working system, many people prefer private health insurance in order to have a choice in their doctors and treatments, though more and more, insurance companies are narrowing the perks and conditions. I daresay soon enough private health will be unaffordable for most and useless to those who have it when it comes to many conditions.