Today’s WSJ has a number of letters responding to a recent article by Daniel Kessler about the looming problems associated with the implementation of Obamacare and I copy the first (and best) of them below. My only quibble is with the phrase “single-payer system.” What the so-called liberals want is a federal monopoly. Most Americans realize that monopolies, especially those run by government, are woefully inefficient and unfriendly toward their customers because they are no longer customers, but supplicants.

ObamaCare Shock, a Stop on the Road to Single-Payer

Daniel P. Kessler’s “The Coming ObamaCare Shock” (op-ed, April 30) would be funny if this wasn’t such a serious matter. He doesn’t seem to understand that it makes no difference whether ObamaCare can be successfully implemented in the coming years or not. The law was passed as an ideological imperative of the Democratic Party, an imperative extending back at least 60 years to the Truman administration, if not further.

When the problems Prof. Kessler describes emerge, the reaction won’t be to repeal the law or substantially trim it back. The reaction among the progressive community will be to demand, at long last, the inauguration of a single-payer national health-care system. Jeffrey S. Flier, the dean of the Harvard Medical School, in “Health ‘Debate’ Deserves a Failing Grade” (op-ed, Nov. 18, 2009) made the point that “this can only be the first step of a multiyear process to more drastically change the organization and funding of health care in America. I have met many people for whom this strategy is conscious and explicit.”

ObamaCare is a mere way-station on the way to a single-payer system. Why is it so difficult to grasp this concept?

Mark Packer

Bellingham, Wash.