Democrats often cite Hayek's implicit approval of state assisted health insurance (The Road To Serfdom, chapter 9) when supporting the current Democratic efforts to drastically remake the U.S. health industry. This legislative sausage, however, is better treated as an illustration of one of Hayek's arguments for the incompatibility of socialism and democracy. The illustration does not require you to accept the assertion that this legislation is, in fact, creeping socialism.
In The Road To Serfdom (Chapter 5), Hayek argues that while it is possible for a democratic people to agree to empower the state to manage a sector of the economy in order to achieve a desired social goal, the execution of such a program "requires more agreement than in fact exists." Too many choices between competing priorities and too many value judgments must be determined for any majority to agree to the entire plan. Hayek argues that success can only be achieved by taking the plan outside the democratic process, placing ever more power in the hands of unelected and unaccountable individuals, paving the way for the eventual loss of democracy.
The broad goals behind the attempt to reconstruct our entire health care system, especially universal coverage, garner broad support. A vast array of choices including: who pays, how to ration care, and ultimately whom the state will allow to die must be included in such a vast state mandated plan. None of the proffered plans have been able to win majority support of the voters for all these myriad elements. The Democratic leadership, however, has invented a new technique for bypassing Hayek's problem: drafting 1000+ page bills and forcing votes on them without allowing the congress an opportunity to read the bills. Even these corruptions of our democratic process have foundered on the rules of the senate. In order to push such a plan through, the Democratic leadership talks of further subverting the rules of the senate using the reconciliation process.
The Democrats forget that each corruption of the democratic process introduced for what they deem a current good can be used later, perhaps to achieve an end they abhor.