That depends on what you expect to achieve, Plane. Personally, I don't think the government can ever match the flexibility and adaptability of a decentralized market, but then some people are not interested in that. I also think centralized planning will create more long-term problems than it ever solves in the short-term. Part of the problem here is that some people seem to be looking for a perfect system wherein everyone gets health care right away, and I think real-world applications of socialized medicine have shown that simply doesn't happen even if everyone has some level of "guaranteed" health care. And there are larger issues, of course. As much as people complain about illegal immigrants abusing the system now, just imagine what that will become if the U.S. institutes a government run universal health care program. I don't see how we will avoid a national I.D. card.
I'm not trying to push fear, I'm just saying what I think the natural and political consequences will be.
Remember your question about dividing the populace into who does and who does not take citizenship seriously, that could become a real issue. The more centralized control is exercised, the more centralized control is needed to maintain centralized control. Those stories about states and cities outlawing smoking will become stories about laws regarding food intake and what sort of foods people should eat. No, not immediately, but there is no reason to think that people who want to legislate health care issues for the public good will forever balk at trying to regulate fatty foods and their consumption, particularly when there are federal health care costs in the mix. Now for some people, that is a desirable outcome. Health care for all, healthier people, what could possibly be wrong with that? And I have little doubt that people opposing such aims will be accused of wanting people to suffer and die.
Maybe a more regulated populace is a better way to live, but I can't help thinking we will lose something important along the way.