Framing of discussions is key

I think that there are good reasons that this is not the debate we are having:

But thus far to an amazing extent we haven't been having that debate. Instead we've been having a debate over whether Obamacare works, over death panels, over enrollment numbers, over income verification procedures, and over the minutia of premiums and payments. It's time to put that debate behind us. It's clear — as it always should have been — that if you offer people large subsidies to go buy health insurance, lots of people will happily take the money and go buy some health insurance.

It's time to start debating the real issue: should we do that, or is it more important to keep taxes on high-earners low than to give low-earners comprehensive health insurance?

There are extremely good reasons that people attacking programs like the Affordable Care Act or public school funding focus on efficiency or effectiveness and not on first principles.  Because the argument that money should be used to improve health care for 50% of the population is extremely hard to refute in a world where effective tax rates can be extremely low (see the carried interest exemption). 

Instead, the line of attack seems to be that these are poor uses of cash -- that the programs so funded will be filled with rent-seeking, waste, and so forth.  That makes the idea of rich people simply keeping their money seem like a pretty decent idea, as nobody wants to contribute to bloated and inefficient systems. 

So I am skeptical that we'll be able to reframe the argument this way.  It's rather like Singapore -- people focus on the pieces that are the most useful for their argument.