In this article for the Wall Street Journal, Peter Wehner (a senior fellow at the Ethics and Public Policy Center) and Paul Ryan (a US Republican congressman) argue that socialized healthcare is a big government 'tipping point'.
They are right. In the article they point to Britain, saying that:
Once a large number of citizens get their health care from the state, it dramatically alters their attachment to government. Every time a tax cut is proposed, the guardians of the new medical-welfare state will argue that tax cuts would come at the expense of health care -- an argument that would resonate with middle-class families entirely dependent on the government for access to doctors and hospitals.
Sound familiar, anyone?
Of course, there is also another way in which socialized healthcare alters the relationship between the individual and the state, one which Wehner and Ryan don't mention. That is that once the government is in charge of your healthcare, they think they have a right to tell you how to live your life. Don’t smoke, don't drink, don't eat salt or sugar or fat, exercise, etc, etc! Pretty soon they get tired of telling you what to do and start trying to bully you into it with taxes, regulations, and 'social-stigmatization'.
Perhaps this is what Ayn Rand was getting at when she said, "The difference between a welfare state and a totalitarian state is a matter of time."