Good points! I wonder then how it works for Vermonters on Medicaid, which is mostly state run. If they get sent to Boston is their Medicaid covered?
Is private insurance covered since that is often in-state too?
And why would these out-of-state hospitals not want to be providers if they are getting a fair amount of money from Vermont's single-payer?
Sorry for all the questions but you seem knowledgable and I'm genuinely curious. With that said, perhaps New York, Massachusetts, and Vermont could form a "single-payer network" where they each accept each other's or perhaps they create one big multi-state single-payer.