Matt makes some fair points here, but fundamentally, I think he's missing the thrust of my point. I'm not arguing, after all, that a public single payer system and a substantially private individual mandate system are the same thing. What I am arguing is that they are vulnerable to the same line of attack. The argument against health care mandates offered in this campaign has been, essentially, an affordability claim. What happens if you mandate coverage, then it turns out that folks can't buy the coverage, or feel burdened by the cost of it? It's a fair claim. But it's similarly applicable to single payer. Under single-payer, you have to purchase health care, you just pay for it through taxes, rather than premiums. Administratively speaking, that's probably more efficient. But it doesn't evade the unrest a certain percentage of folks are going to feel when their taxes shoot up (even if their premiums simultaneously tumble). The anti-tax movement that powers much of American conservatism isn't, after all, primarily composed of ideologues who have a principled objection to taxation. instead, it's led by those ideologues, and composed of people who feel like their taxes are high to the point of inaffordable. Some of them will feel that way under a single payer system, too, and they'll be angry abut it, and opponents of the system will try to harness that anger to further their political objectives. This is not, to me, an argument against single payer. As a liberal, I'm comfortable defending a good system by arguing that the taxes you pay are worth the services you receive, and I'm confident that the coalition of folks who feel they benefit will substantially outnumber those who feel harmed. But insofar as the affordability question looms, it's present no matter how you construct a universal system. That's not to say there aren't other arguments for and against single payer, and individual mandate, systems. But this particular argument cuts against both.
