“Medicare-for-all” is quickly becoming a rallying cry for many Democratic White House hopefuls, but there are growing questions about how to pull off such a dramatic switch to a government-run health care system.

The debate over scrapping private insurers has heated up in recent days since Democratic Sen. Kamala Harris of California, a supporter of “Medicare-for-all,” told CNN’s Jake Tapper, “Who of us has not had that situation, where you’ve got to wait for approval, and the doctor says, well, I don’t know if your insurance company is going to cover this? Let’s eliminate all of that. Let’s move on.”

“Medicare-for-all’s” advocates promise a health care system that’s free at the point of service – no co-pays, no deductibles, no coinsurance.

They tend to be less upfront about how they’d pay for it. Independent estimates from both the right and the left peg “Medicare-for-all’s” cost at about $32 trillion over 10 years. Doubling what the federal government takes in individual and corporate income tax revenue wouldn’t be enough to cover that tab.

That’s assuming “Medicare-for-all” is able to implement its financing strategy. The bill proposes reimbursing doctors and hospitals at Medicare’s current rates, which are 40 percent below what private insurance pays.

Less than a month after Democrats—many of them running on “Medicare for All”—won back control of the House of Representatives in November, the top health policy aide to then-prospective House Speaker Nancy Pelosi met with Blue Cross Blue Shield executives and assured them that party leadership had strong reservations about single-payer health care and was more focused on lowering drug prices, according to sources familiar with the meeting.

The pre-existing condition scare tactics continue.

I testified yesterday—as the sole witness called by the Republican minority—during a House Education and Labor Committee hearing on “Examining Threats to Workers with Preexisting Conditions.” 

It was the first hearing of the new Congress under the new Chairman Bobby Scott, D-VA, and virtually all members on both sides of the aisle stayed to ask questions. (The hearing lasted for three and a half hours!)

Consider what the average American thinks they hear about “Medicare for All.” They probably think everyone would get the same Medicare coverage currently going to their parents and grandparents. Not so. Despite the clever branding, the Medicare for All plan that Harris has supported is actually a universal coverage plan that covers more services than Medicare while eliminating deductibles, co-insurance, and co-pays. Indeed, once more Americans hear about Medicare for All, they might start wondering how total healthcare spending would be the same or ever less under such a regime.

Academic justifications for 70% marginal tax rates, such as Peter Diamond and Emmanuel Saez’s, are nothing more than a veneer intended to deceive a wider audience that doesn’t know better. Diamond and Saez’s original argument for a 70% tax rate—that it would enhance both tax revenue and social welfare—ignores the long-term consequences of high tax rates on growth. They assume that taxing, redistributing, and consuming income that taxpayers would otherwise invest doesn’t reduce investment. While admitting that taxes discourage work, they similarly assume that a reduced supply of properly trained talent has no effect on the willingness of investors and entrepreneurs to take risks that grow the economy.

At a town hall event, Sen. Kamala Harris (D-Ca.), who recently launched her presidential campaign, said she wants to eliminate private insurance entirely, which would mean that about 177 million people would lose their existing plan.

After noting that the Sanders-sponsored Medicare for All legislation that Harris supports would totally eliminate all private insurance, moderator Jake Tapper asked, “So for people out there who like their insurance—they don’t get to keep it?”

Harris responded with a somewhat winding answer that amounts to a yes.

“The idea,” she said, “is that everyone gets access to medical care and you don’t have to go through the process of going through an insurance company, having them give you approval, going through all the paperwork, all of the delay that may require. Who of us have not had that situation where you have to wait for approval and the doctor says, ‘I don’t know if your insurance company is going to cover this.’ Let’s eliminate all of that. Let’s move on.”

“Medicare-for-all” makes a good first impression, but support plunges when people are asked if they’d pay higher taxes or put up with treatment delays to get it.

The survey, released Wednesday by the nonpartisan Kaiser Family Foundation, comes as Democratic presidential hopefuls embrace the idea of a government-run health care system, considered outside the mainstream of their party until Vermont independent Sen. Bernie Sanders made it the cornerstone of his 2016 campaign. President Donald Trump is opposed, saying “Medicare-for-all” would “eviscerate” the current program for seniors.

House Speaker Nancy Pelosi is laying out her strategy on health care and first up is improvements to “Obamacare” and legislation to lower prescription drug costs. “Medicare for all” will get hearings.

Pelosi and President Donald Trump have been sounding similar themes about the need to address the high drug costs. But her plans to broaden financial help for health insurance through the Affordable Care Act are unlikely to find takers among Republicans.

Either way, Democrats believe voters gave them a mandate on health care in the midterm elections that returned the House to their control.

Last year, Canadians waited a median of almost 20 weeks to receive specialist treatment after being referred by a general practitioner, according to a new report from The Fraser Institute. In practical terms, that’s the equivalent of getting a referral this week and waiting until May for treatment.

Such waits are endemic to government-run healthcare systems.

Canada’s single-payer system, which prohibits private insurance for medically necessary procedures, is a prime example of the pitfalls of total government control. Twenty weeks of waiting is bad enough. But some areas in Canada fare even worse. The median wait for treatment from a specialist following referral from a GP in New Brunswick is nearly a year.