Candidates who advocate single-payer on the campaign trail are increasingly balking once they actually get their hands on the levers of power. That’s because single-payer is cost-prohibitive. Even the most dyed-in-the-wool leftists admit as much, after they take office and have to figure out how to pay for their campaign promises. Single-payer’s champions generally paint a lovely picture of health care utopia. Patients go to see the doctor of their choice whenever they like, get treatment, and leave the clinic without paying a cent. No copays, no deductibles, no cost-sharing, and no referrals—health care is “free” at the point of service. In reality, health care doesn’t magically become free; people just pay for it outside the doctor’s office, in the form of higher taxes.