Ezra Klein says yes.

But it’s also worth saying that, long-term, conservatism could suffer no greater disaster than the death of the individual mandate. This country will have a national health-care system, and sooner than later. The cost pressures make that inevitable. If you want that national system to be private, as most conservatives do, then your only hope is the individual mandate. That’s been true in countries such as the Netherlands and Switzerland, and in Singapore, which is often upheld as a conservative model, contributions to health savings accounts are compulsory. Eliminate those options from the U.S. menu, and you’re ensuring that Medicare, Medicaid or some sort of public option will eventually take over the market, as there’s no constitutional issue with taxation in return for public services.

Given that the weak individual mandate will almost certainly fail to do its job, this is discouraging. But I’m not sure it’s quite right. While Medicare-for-all would be a very bad thing in my opinion, it’s by no means clear to me that it is superior to the Democratic reform model from a conservative perspective, which essentially turns private firms into arms of the federal government, as Michael Cannon has argued.

Like both the House and Senate bills, the Clinton health plan would have mandated that individuals and employers purchase private insurance. In its 1994 score of the Clinton plan, Bob Reischauer’s CBO included those mandated “private” payments in the federal budget –- i.e., as federal revenues and federal expenditures. And yet, none of the CBO scores of this year’s bills include the costs of similar individual/employer mandates as federal revenues or federal spending. My read of the CBO’s score of the Clinton health plan is that the private-sector mandates accounted for around 60 percent of the Clinton health plan’s total cost, the remainder being (traditional) government spending. So how is it that the CBO made the full cost of the Clinton health plan apparent to the public in 1994, but may now be revealing only 40 percent of the cost of the Obama health plan? For some time, I’ve suspected the answer is that congressional Democrats have very carefully tailored their individual and employer mandates to avoid CBO’s definition of what shall be counted in the federal budget. Democrats are still smarting over the CBO’s decision in 1994. By revealing the full cost of the Clinton plan, the CBO helped to kill the bill.

Cannon goes on to explain that Team Orszag tailored the legislation to manage the optics.

Crafting the private-sector mandates such that they fall just a hair short of CBO’s criteria for inclusion in the federal budget does not reduce their cost, nor does it make those mandates any less binding. But it dramatically reduces the apparent cost of the legislation. It is the reason we’re all talking about an $848 billion Reid bill, rather than a $2.1 trillion Reid bill.

This is very shrewd. It should go without saying that for all the problems with Medicare-for-all, we’d at least have a sense of the actual scale of our new spending commitments.