No, not state by state. That is how Medicare works in Australia, and our hospital system is a mess due to the states not spending what they should on hospitals. The Federal Government has just had to bail out the Tasmanian Government (the state I live in) out to the tune of 350 million dollars, and they aren't very happy about it.
One of our regional hospitals got a minor refurbisment recently (basically a paint and pretty up job), at the same time nurses and admin workers were getting wages cutbacks. Part of the refurbishment involved spending $800,000 on artwork!
Do you guys have universal coverage in Australia?
I'd love to move to Australia by the way. My wife won't let me.
Yes, we do. It's called Medicare. You can opt to purchase Private health insurance if you want though, maily because our Liberals forced this option through parliament last time they were in government. They hate Medicare because it was introduced by Labor, and always work hard to undermine it whenever they find themselves in power.