Diogenesister: That wouldn't work because everyone would move to the state that has healthcare free at the point of access.
Well... kinda. Lots of big cities here offer a number of subsidized services for the poor, and that does indeed draw in more poor families, and sometimes pushes away the wealthy. While the budgets of many of these states are stretched thin by the demand, this hasn't really led to a mass exodus or a raft of bankrupt states (though the quality of life does suffer).
On the other hand, I do think we're seeing the effects of years of slow and steady migration of wealthy individuals and businesses towards states that cater to them. I think we're in the midst of a big experiment. The USA is so large and prosperous that we effectively have many different regions, with their own economies and rules and options. Who/what wins out is anyone's guess, and I think it will be decades before we understand the results.
Phizzy: Big Pharma would have to deal with a National buying Agency
This is where we run into a big problem with how things are done here: big Pharma --like any other large business/industry-- has an army of lobbyists who will use targeted pressure (and lots of money) to influence how things are done. I think they have an unhealthy level of influence and input into laws and regulations. The attempts to use social awareness to counter them has, IMO, been highjacked by the more extreme political elements, who have discovered that political power is even more intoxicating than money.