The Saskatchewan model is an apt analogy...it didn't take long for the single-payer paradigm in a province of less than 1 million to expand to all of Canada. I seem to remember, politician from California were in Toronto a few months back inquiring about the Canadian system. Reports said they were impressed. Technically each province has its own single-payer system, which decentralizes the bureaucracy, but federal rules attached to federal funding creates an effectively national system. A key feature is that when you change province, your health care follows you for several months, until you new province picks you up.

May California succeed, and may it explode as it did in Canada. Once experienced, single-payer is quickly understood to be the best system out there--everyone's in, so the incredibly bloated bureaucracy of insurance company claims departments just disappear. (What kind of job is that? bonuses and promotions dependent on finding ways to deny health care to people.)