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The Fake Democratic Health Care Debate

The opinions expressed by columnists are their own and do not necessarily represent the views of
AP Photo/Wilfredo Lee

Just a decade after Democrats steamrolled Republicans and public opposition to upend the American health care system, they are ready to move on to the next phase of their plan, which is to force every American into a government-run health care plan.


Some of them, led by Bernie Sanders, Elizabeth Warren and Kamala Harris (about half the time -she flops like a fish), openly advocate banning private health insurance (except for "supplemental coverage," meaning cosmetic surgery) and immediately forcing everyone into a government plan. That's what the "Medicare for All" bill in Congress would do. Others, led by Joe Biden, adopt a more subtle path for destroying private insurance named the "public option" — alternately called a "Medicare buy-in" or "Medicare X."

The "public option" strategy for ending private insurance is to set it up in a rigged competition with a government-run plan that can absorb losses indefinitely and can use the power of government to dictate below-market prices to doctors and hospitals. Simultaneously, private plans would be subject to regulations by the same government that is competing with them.

Americans would have the illusion of choice. They would think for a while that they can keep their private insurance, but would all eventually end up in the single payer government plan.

Some have said that makes the public option a Trojan Horse for single payer, but Yale Professor Jacob Hacker, the inventor of the plan, disputed that characterization to a 2008 audience at the liberal Tides Foundation: "Someone once said to me, 'Well, this is a Trojan horse for single payer. ' I said, 'Well, it's not a Trojan horse, right? It's just right there! I'm telling you!'"


Hacker tried strenuously to walk those comments back ever since.

But third-tier presidential hopeful Kirsten Gillibrand said it again at the Democratic debate: "We put into the transition period for our Medicare for All Plan. I believe we need to get to universal healthcare as a right, not a privilege to single payer. The quickest way you get there is you create competition with the insurers. … So, what will happen is people will choose Medicare. You will transition. We would get to Medicare for All. And then your step to single payer is so short. "

Pete Buttigieg agreed with her, adding: "Now here's how I would do it. It's very similar. ... People can buy in, and then if people like us are right that that will be not only a more inclusive plan but a more efficient plan than any of the corporate answers out there, then it will be a very natural glide path to the single-payer environment."

Biden reiterated his support for the "public option" at the debate when he called it as a plan to add a "Medicare-like plan" to the Obamacare exchanges. As his campaign had tweeted the night before during the undercard debate: "The Biden Administration will give every American the right to choose a public option. "

Notably, unlike his opponents who endorse the identical policy, Biden is less forthright that a rigged competition between a government plan and private insurance will get us to single payer. He wants to appear less radical with an eye toward the general election. But it is a disagreement only on means, not ends. Biden, like Sanders, eventually wants every American locked into a government-run health plan.


Democrats want a "Medicare for all" system where costs run into the tens of trillions — doubling the size of the federal government — and are borne by taxpayers, and the only cost containment mechanism is delaying and denying care.

They want politicians and bureaucrats to be trusted with the power of life and death, the privilege to decide what treatment is approved and what is denied.

They want a system that disincentivizes research and development and the discovery of new cures.

And, as we saw so vividly in a show of hands, they want this taxpayer-funded health care system to be open to anyone anywhere in the world who chooses to come to the United States — legally or illegally.

There is nothing moderate about tricking the American people into swallowing single-payer through a "public option" transition. And there is absolutely no reason to trust the same Democrats who gave us Obamacare with another, even more extreme version of government-run health care. 

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