djplong..I appreciate your indicating you have some knowledge in the medical field at a hospital. This goes way beyond that as the medical piece is small when compared to the infrastructure that would be required to drive requirements of this size. I will avoid being personal other than saying that I have many many years in the systems, technology and business aspects of the computer field and the requirements for a government insurance based system to cover the broad alternatives is in itself enormous. You cannot treat this as a sort of "turn key" from current systems. Just the staffing is huge even with outsourcing to India, Japan, Germany, etc. New systems would have to be developed and installed and that is not usually a quick turn around and if new hardware is required that is very time consuming and costly when there are government only restrictions.. All of this considering the staffing required is available and can be brought on board quickly. I am sure it would be a boom to other countries as a lot would be outsourced and that will not help the current labor market in the US. If the work is assigned to a US Computer Manufacturer you can go to the bank that they would outsource a lot of the work outside the US.
The bottom line is that to install such a far reaching system to cover many alternatives and 30M people is a very expensive piece of work. Do not just look at the practice that is being considered but also the tremendous costs associated with it..