Any "single payer" system MUST not forbid obtaining services outside the socialized system for those who can afford it.  Fortunately for Canadians they can come to the U.S. and pay out of pocket when (not "if") their commu-care system fails them.  Ditto  in Britain where those with the means can bypass The National (un)Health Service and "go private".  More and more doctors are opting out of NHS.  In Britain, what we would call "Emergency Rooms" are having to expand.  Not the rooms - the parking lots to have room for the ambulances with the ill or injured clinging to life inside them while they wait for an open bed.  At times for hours.  So let's be sure that if Alaska gets "single payer" it includes funding for more ambulances and ER parking lots to house them.  While they wait.