Earlier this week, I came across this post at Belmont Club. Now, that is a secular (albeit conservative) blog and I have no idea if the author, Richard Fernandez, is a believing Christian or not. And the blog post was about the rise of the BNP in the UK, not healthcare. Nonetheless, I think this comment connects to the points you have made:

For as long as man imagined himself to be sacred and accountable to the Creator he stood at the center of polity. The state was there to serve him and not the reverse. Today he has lost that central place and is no more or less than a collection of curiously animated chemical substances with a market value of less then fifty dollars which the state has deigned to keep alive until some bureaucratic panel decides it is too expensive to do so. Just as Global Warming can be understood at one level as an attempt to bring nature into the purview of politics, it is impossible to understand the Left’s fixation with abortion except as a sacramental affirmation of the state’s power over man. The strident insistence on abortion on demand goes way beyond any conceivable need to prevent backroom abortions, or even an affirmation of a woman’s right to choose. It is really an absolute display of the power of politics over life. Abortion’s principal utility is as a stake driven through the heart of the notion of human sacredness, which once performed, ought to prevent its revival entirely.

That is why I wonder about left-leaning Catholics who seem to assume that a large nanny state will happily co-exist with religion. The larger the state gets, the more it will view religious groups not as valuable co-partners, but as threats to the state’s authority. Forget the Bible and the Pope – the government will tell you what is right and wrong.

Economy of scale. Consolidating operations of any type can produce an economy of scale that allows for more efficient and effective operation. But sooner or later you reach a point of diminishing returns where the additional consolidation starts reducing efficiency and effectiveness. It seems to that part of the problem with health care is that the current organizations providing it are long past the point of diminishing returns. Further consolidation would only increase the inefficiency and effectiveness of heath care delivery.

Predatory pricing. Monopolies engage in predatory pricing unless there something to stop them. This is often because the normal pressures on an organization push the monopoly in that direction, rather than a premeditated sense of greed. Part of the high cost of heath care that parts of the health care system are limited or quasi monopolies. Moving heath care into a monopoly can only increase this effect. Government regulation can often restrict monopolies but when the government is the operator of the monopoly the regulator and the operator are the same and the regulator function loses. No necessarily greed, just the effect of thousands of decisions responding to normal operatons.

Living wage. The proposal will move about 20% of the economy into the governmental sector. The government gets money by taxes, even if they are called something else. Yes paying taxes is a duty, but those who levy the taxes have duties to insure they are just and do not cause harm, certainly they should not be so high as to reduce wages to the point that they are no longer a living wage. How this is to be prevented does not seem to be a major item of discussion or consideration by supporters. But a shift of this size could easily do this or cause other distortions not consistent with Catholic social teaching.

Human dignity. R.J. Rummel, Professor Emeritus of the University of Hawaii, is one of the worlds experts on mass murder (not just genocide) by governments. His conclusion of alife time of study is that the single predictor of government committed mass is the unchallenged ability to do it. This has nothing to do with ideology, if the ability is there sooner or later it will happen. A national health care system will give that kind of unchallenged authority to the government. Not that people set out to do that, or the establishment of “death panels,” but dening care, providing poorer care of even providing fatal drugs will be an easy solution to many day to day problems. Any one who could challenge these decisions is appointed by the same people making the decisions and under the same pressures. Even if things to not rise to the level that Dr. Rommel’s theory would predict, decisions contary to the human dignity of the patients will become more and more common.
See his power Kills website and his book Death by Government

Reading a little deeper nay help this discussion.

The section on Subsidiarity runs from 1881 to 1885 and the COMPENDIUM
OF THE SOCIAL DOCTRINE OF THE CHURCH, chapter IV section four has a more detailed discussion.

185. Subsidiarity is among the most constant and characteristic directives of the Church’s social doctrine and has been present since the first great social encyclical. It is impossible to promote the dignity of the person without showing concern for the family, groups, associations, local territorial realities; in short, for that aggregate of economic, social, cultural, sports-oriented, recreational, professional and political expressions to which people spontaneously give life and which make it possible for them to achieve effective social growth.

Snip

186. The necessity of defending and promoting the original expressions of social life is emphasized by the Church in the Encyclical Quadragesimo Anno, in which the principle of subsidiarity is indicated as Nb>a most important principle of “social philosophy”.

Snip

On the basis of this principle, all societies of a superior order must adopt attitudes of help (“subsidium”) — therefore of support, promotion, development — with respect to lower-order societies.

Subsidiarity, understood in the positive sense as economic, institutional or juridical assistance offered to lesser social entities, entails a corresponding series of negative implications that require the State to refrain from anything that would de facto restrict the existential space of the smaller essential cells of society. Their initiative, freedom and responsibility must not be supplanted.

Bold text emphasis is mine.

I think the principle of subsidiarity says a little more than saying if the lower unit can do it better it should be done at the lower level and the reverse for the higher level. Intermediate social institutions often have the right to their own decision making and operation. The fact that the higher level of society may not agree with the decisions is irrelevant, unless the problems caused rise to the level of harming the common good.

The principle of subsidiary is rooted in the need to protect human dignity, an institution that is to large, and with out effective intermediate levels makes the individual to an anonymous cog that has no dignity. The larger unit may in an economic sense be more efficient, but if locating a funciton there tends to harm human dignity the less efficient lower level would be preferred. A good example is that while the Pope is the head of the church the bishops have authority in their own right and the Pope should not intervene in the internal operations of their diocese under normal circumstances no matter how much he disagrees. I think we all know of seveal dioceses where the ocal bishops prunential decisions scream of stupidity, but in fact the bishop, was acting in good faith with in the confines of the faith.

When considering the common good the Churches Social teaching is that the common good protects the individual, even the least individual. Many secular people using the term see it as meaning abanding the least individual for the more efficient operation of society. Thus some secualar persons see abortion as promoting the common good by getting rid of marginal individuals. But their language is often reminiscent of Catholic teaching if one is not listening carefully, though they are often (unknowingly) promoting the opposite.

I think that the principle of subsidiarity requires a substantial level of evidece that, not mearly health care can be run on a national level, and run more economic efficientcy at the national level but than othe levels but that it provides for individuls and their doctors to make good health care decions on the indivudual basis. I find the case lacking.

It seems to me, that even in the doubtful case that all the claims for National Health care could be met, it would de facto restrict the existential space of the smaller essential cells of society to effectivly provide healt care to individuals.

Excellent point. Like my earlier comment, Massachusetts and Hawaii already offer something like this to some degree.

RestrainedRadical,

That would be my favorite, send the vouchers directly to the individuals.