Nonsense. If you're unemployed then you will be exempt from the penalty. If you are self employed you will have access to lower cost insurance through an exchange, and if you are lower income you will be entitled to subsidized insurance.
Or ... you can pay the small penalty, have no insurance, and foist off your health care costs on everyone else.
My understanding is that those exchanges are already not working out very well, and that there are already huge cost over-runs even with uptake rates being lower than anticipated. Let me see if I can track down the article.
And just to be clear, I am from Canada and I am reasonably happy with single payer, though I have no illusions about it. I certainly don't like a number of things, including, in no particular order: (i) we criminalize paying to jump the queue, which incidentally just shifts the queue jumping from those with dollars to those with lots of doctor connections, which works for me too); (ii) we significantly under-invest in capital equipment, such that, e.g., "elective" MRIs on things like bad backs can take up to a year; (iii) wait times for elective procedures like, say, hip or knee replacements, can take up to 2 years or longer (and, again, you can't pay to jump the queue); (iv) we are slow to adopt new and better technologies (e.g., when the U.S. had virtually 100% adoption rates for drug coated stents for angioplasties, we were still around 20%, with again no option to pay extra to buy the better products ourselves; (v) amenities at hospitals and other medical care facilities sort of suck. The places are depressing because there is no incentive to invest in appearances or technologies or, say, an extra bed so that when you pay for a private room with your wife who just had a c-section you can stay the night without sleeping on a chair. Lack of profit motive or the need to try to pull patients from otehr facilities does exactly what it does in other markets - reduce the quality of offerings to consumers.
And I certainly don't like the lack of incentives for patients to conserve care or consume care efficiently that co-payments provide. Nor do I like the massive taxes we pay into the system, which when you look at it are really massive wealth transfers from younger people (who consume far, far less care than they pay for) to older people (which is what Obamacare does too, incidentally)
But all in all, whille I wouldn't propose an NHS type debacle of a national system, single payer is equivalent to government insurance for private care, and seems to work reasonably well. And I see your system rolling invariably to disaster, cause it is a mish-mash of dysfunctional nonsense.
I also suspect you can do far more good for the affordability of your health care system with good, targeted, comprehensive tort reform. Not only do your docs waste tons of money on malpractice insurance with massive premiums, but the degree of waste generated by defensive medicine (extra unnecessary testing, procedures, etc) is massive. That's one of the ways our system manages to be way more efficient than yours (and if we spent what you spend as a % of GDP, our system would be better than yours in pretty much every respect).
Now just to get a parting shot in cause I now we are not supposed to agree too much, it is my understanding that the biggest impediment to substantive tort reform are the trial lawyers, who are a key democratic constituency for funding purposes. No wonder Obama's comprehensive reforms leave the lawyers alone in their little game of rent seeking.
