If the Affordable Health Care Bill had been set up this way, would it have been constitutional: (1) Directly stating it is requiring a flat or proportional tax on all income-earning citizens who want access to the system, where the money goes to pay for govt/public health services (or as the Greens wanted it, a Single-Payer system where the govt pays the bills or invoices from the institution providing the services instead of private insurance paying this bill or invoice) (2) People can still be exempted if they dont earn enough, or have a lower amount/% to pay. But if people who CAN afford and are required to pay the tax, but want to OPT OUT, anyone can do so by CHOOSING to buy private insurance or choosing OTHER WAYS to cover health services (such as the charity hospitals or Christian coops etc.) That way it is NOT directly mandating or regulating how this option is met. Would that have been constitutional to propose it as a tax, and then people can "opt out" by choosing other methods or programs by funding privately (and also agree not to use the govt system but rely only on their private programs if they choose to opt out). It may not have passed this way, but would it have been constitutional? Would it have allowed for both public and private programs to co-exist and share the market, without causing "govt subsidies" to manipulate the pricing? Would it allow fair competition so the govt would have to be efficient in order to compete with other programs?