Merrill Goozner has an interesting post (“Unfair and Unbalanced Wonkery on Mandates“) arguing that insurance mandates aren’t good policy (I agree with him on this).
For the record: I’m opposed to mandates for two reasons. First and foremost, they’re bad politics. Americans don’t like to be told to do anything. They especially don’t like unfunded mandates.
That leads to point two. Without sufficient taxes on businesses that don’t provide insurance to their employees and/or significant savings from health care cost control (not likely given the opposition of insurance companies, drug companies, hospitals, doctors, and other providers in the system), mandates will result in inadequate plans for the uninsured — catastrophic plans that still leave the newly insured at the emergency room door for basic care and without preventive services. Higher taxes are a prescription for political failure. Lousy plans maintain the status quo in public health. Some choice.
The rest of the Goozner post argues that a single payer system is not socialized medicine. While it is true that physicians are not directly employed by the government in a single payer system, since the government is paying all physicians salaries–especially if the physician has not outside options to receive payment from another source–I would say that a single payer system is de facto socialized medicine.