Two things that come to mind every time this debate comes up.

1) Can you imagine the press coverage when people who have "opted out" (in one scenario) or those who can't buy insurance even with a voucher (because no insurance company will touch them at ANY price) have no options? It'll make that silly "death panel" discussion look tame.

2) Why is it that nobody has raised the issue of why we pay more and get less than any other nation?