It is possible, for example, that the results of the legislation will turn out to be unpleasant more quickly than most observers realize. The bill requires insurers to charge people with pre-existing conditions the same as everyone else, and the only reason for people not to game the system — dropping their insurance until they get sick and the insurer has to take them — is because the law requires them to buy insurance or pay a fine. For many people, the fine will be a cheap price to avoid premiums that could run around $8,000 a year for a family of four. The effect of the legislation could be to cause the number of healthy people with insurance to fall dramatically — and for premiums to rise, which would cause more people to drop their insurance. If this happens, we can expect liberals to agitate for a single-payer system; but we can also expect the public to blame the Democrats whose health-care system it will now be. A less lopsidedly Democratic Congress is not going to respond to this chaos by enacting single payer or strengthening the fines.