I have wondered if an option would be to have a state make it law that every 4 or 5 years they open the bidding for a health care insurance provider for the entire state. A state committee then takes the bid with best premiums to services ratio and they do the job for the contract term.

There would still be the option of people and businesses to buy 3rd party "extras" like private hospital rooms, vision care etc. on top the state plan, but some level of basic health care would be provided to all people paying into the state plan.

Would that work?

No, overwhelmingly more people support a single payer healthcare system. The issue is that the people in Washington won’t make it a “votable” decision.

My question is why a sizeable portion of the American (and greater Western) public seemingly votes against their interests?

If I voted for this, could I save $1 trillion? Or would it save other people who are not me $1 trillion?