All of this represents an enormous price to
pay in exchange for the law’s small increases in
insurance coverage. There is very little “bang
for the buck.”

Even more significantly, this law represents
a fundamental shift in the debate over
how to reform health care. It rejects consumer-
oriented reforms in favor of a topdown,
“command and control,” governmentimposed
solution. As such, it sets the stage
for potentially increased government involvement,
and raises the specter, ultimately, of a
government-run single-payer system down
the road.