Critics of a government takeover of health-care financing are gaining momentum in part because the debate has moved from the theoretical to the practical. Ideas that may sound good to undecided Americans in the abstract are losing their attraction once the messy details get spelled out. The recent example of Massachusetts is playing a big role, given that the Obama administration and key congressional leaders are trying to import the “connector” and individual-mandate elements of the Massachusetts model into the federal legislation. As Business Week reports, Massachusetts is still struggling to pay the tab:

When Massachusetts enacted the most comprehensive insurance-for-all bill in the U.S. in 2006, it did nothing to address rapidly rising costs. Three years later the rate of uninsured residents has dropped from 8% to 2.6%, the lowest of all 50 states. But the cost of covering an additional 428,000 residents is wreaking havoc on the state’s finances.

State policymakers may resort to compelling hospitals and physicians to rearrange their business relationships and payment systems according to state dictates. That may not be socialized medicine, according to the dictionary definition, but it’s getting pretty close. Once the government takes over the financing system, it can’t help but meddle in medicine itself.