You are 100 percent right. The Europen model would be an ineffecient nightmare in the U.S. And people over 85 will be in deep do-do. Need a new battery in your pacemaker? Forget it.
Those 16K additional IRS people are going to go after small businesses. Not to mention add what amounts to a whole new agency to the Federal bureaucracy. Scary, if U ask me.
Kozuh - The Supreme Court ruling has allowed the states to decide whether that want to participate in or opt out of the Exchange program. Numerous states are going to opt out and let Uncle Obama set them up and take over that long term obligation. Only the bankrupt/insolvent states or strong democratic states will primarily opt in to running the state program IMHO.
Good deal short term for states to opt in and absolute bad deal long term with no way out.