Connecticut, Nevada, Illinois and Minnesota are looking at schemes that would allow anyone to buy into Medicaid. Washington State governor Jay Inslee and his allies in the state legislature plan to introduce a bill that would create a state-sponsored health plan—or public option—to compete against private insurers. Medicaid buy-ins and public options are little more than stepping stones to a complete government takeover of the health care system. They’d gradually put private insurers out of business. In the end, Americans would be left with low-quality government-sponsored insurance that forces them to pay higher taxes and endure long waits for treatment.

Put simply, there is nothing like Medicare for All anywhere in the industrialized world. Socialized medicine proposals, like the House version introduced last month by Rep. Pramila Jayapal, (D-WA), would offer everyone living in the United States comprehensive coverage with no deductibles and no copayments. Jayapal claims, “This is not a particularly ambitious plan, in the sense that so many others have done it.” But no industrialized nation has tried anything so sweeping. Not one provides soup-to-nuts government-paid insurance that covers everything without any cost-sharing from patients. None. Even so-called single-payer systems rely on some forms of private insurance.

Other reports show Democratic leaders are not as enthusiastic as Jayapal, et al.  House Speaker Nancy Pelosi in an interview with Rolling Stone said moving to a single-payer system was the simplest way to bring about universal health care, but then noted an estimated $30 trillion cost. “That is, administratively, the simplest thing to do, but to convert to it? Thirty trillion dollars. Now, how do you pay for that?” Pelosi said.

The sales pitch for Medicare for all is appealing—universal coverage, free access to doctors and hospitals, and no insurance premiums, copayments or deductibles. But then come the tradeoffs: Everyone would be required to give up private health insurance, and taxes could double to finance $32 trillion in added government spending over the next decade.  Washington bureaucrats would decide what services are covered and how much doctors and hospitals would be paid. Rationing and waiting lines are inevitable. The American people don’t want such a major upheaval. The right solution is to give people more choices of more affordable health coverage and have states, rather than the federal government, target resources to those who need help.

Policymakers are debating whether Congress should enact a single-payer health care system or create a system based on personal choice and market competition. The fundamental question is whether government officials or individuals and families will make the key health care decisions. The adoption of a single-payer system requires major trade-offs: a loss of personal and economic freedom, the loss of existing health coverage, the imposition of unprecedented federal taxation, major payment reductions for doctors and medical professionals, long waiting lists, and care delays and denials. 

Health and Human Services Secretary Alex Azar sounded the alarm about Medicare-for-all during the Conservative Political Action conference on Thursday. “The threat is an immediate and complete takeover of healthcare,” Azar said. Secretary of Labor Alex Acosta and Small Business Administrator Linda McMahon joined Azar on the panel led by Grace-Marie Turner of the Galen Institute. Azar said that the new Democratic health care plan would dramatically crash the insurance industry in ways that President Barack Obama never dared to do politically. “They promised you that you could keep your insurance if you liked it,” he said. “This time they are not promising that.”

Price controls in health care could be one of the major policy issues of the 2020 Democratic primary and a key way of differentiating the most progressive candidates on the Left from others seeking the nomination, but Republicans are posing the question as well. It should come as no surprise to find the outspoken champion for an incremental approach to single-payer health care, Sen. Michael Bennet, (D-CO), promoting government-set rates, but the fact that a Republican, Sen. Bill Cassidy, (R-LA), is joining him in leading the charge should concern conservative and moderate Republicans alike.

Rep. Pramila Jayapal (D-WA) is introducing the most ambitious Medicare-for-all plan yet — one that envisions a quick transition to a public health plan with a robust set of benefits.

The co-chair of the Progressive Caucus is releasing a proposal Wednesday to transition the United States to a single-payer health care system, one in which a single, government-run health plan provides insurance coverage to all Americans.

The Democratic Party’s presidential hopefuls are diverse in all ways but one — their stance on healthcare reform. The front-runners want to eliminate private insurance and put everyone on a government-run plan.

But that’s not something they’ve been enthusiastic about revealing to voters. Senator Elizabeth Warren recently refused to say whether she would support a single-payer plan that eliminated private health insurance. 

The single-payer health insurance proposal known widely as Medicare for All (M4A) cannot be enacted without first answering certain questions. Foremost among these is whether the public would support shifting more than $32 trillion in M4A’s first 10 years from private health spending, over which consumers retain some discretion, to federal health spending, over which consumers do not. A related open question is whether the federal government can adequately finance this amount of spending without triggering significant adverse economic effects. Other unanswered questions include M4A’s effects on health providers, the prescription drug market, and private health insurance. M4A would add further to national health cost growth unless provider reimbursements are cut more sharply than lawmakers have been willing to do historically. Yet the consequences of enacting such payment cuts simultaneously with a substantial increase in health service demand are unpredictable.

A political party is asking for trouble when it embraces a position on a high-profile issue that most Americans oppose. But it isn’t easy to avoid this pitfall when a majority of the party’s own members endorse that position. As the campaign for the Democratic presidential nomination heats up, the Medicare for All plan first proposed by Sen. Bernie Sanders risks pushing candidates into this trap.

The stakes are very high: This unforced error could give President Trump his best chance to win re-election in 2020.