For Obamacare, the individual states defined how it was implemented.
When Republicans offer solutions allowing health insurance companies to sell across state lines, they mean allow health insurance companies to sell policies that are different than what the state allows, usually less coverage. That's an instance where they don't believe in state's rights.
Canada is similar, the health care can differ between provinces.
I don't think there's many places where for profit healthcare is banned outside the US, but I'm happy to be corrected.