Republicans have been fighting tooth and nail against any substantial health reform efforts. They say the dont want government takeover of the healthcare system. Liberals have already compromised the single payer system, and are not in a mood to compromise further. I have a solution that involves a trigger, and would satisfy left and right.
The solution is this. A state can vote to opt into a robust healthcare reform platform including a strong public option and a importation of cheap prescription drugs from Canada. According to the polls, the blue states are for the healthcare reform plan and the red states are against. So the blue states would opt in, and the red states would opt out. The blue states would be the test states. Most of the population would be covered.
This is where the trigger would come in. Eventually, when relatives of red state residents who live in blue states, tell their relatives about how they got really sick and was able to see a good doctor and did not end up with crippling, bankrupt-inducing bills, the red states relatives would want that too. The trigger would allow this.
Since for every dollar paid to the government by blue states, receives less back, blues states are in effect subsidizing the red states. So the complaint that the red states would be paying for the health care of the blue states would not be true, in the grand scheme of things. I know this sounds confusing. But I think that it is a good idea. The only downside of the plan would be that liberals in red states would have to move.