The unicorn of progressive health care reform – the single-payer – is back in the news. This past Sunday. Sen. Bernie Sanders released his “Medicare for All” single-payer health care reform. The sales job is seductive: “As a patient, all you need to do is go to the doctor and show your insurance card” and you get “the entire continuum of health care, from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments” with “no more copays, no more deductibles.”

But it’s not just cheaper for families, it’s cheaper for everyone! “Bernie’s plan will cost over $6 trillion less than the current health care system over the next ten years,” it says.

Time for a reality check. The first claim is that a single-payer “significantly reduces overhead, administrative costs and complexity.” Perhaps, but in 2014 the U.S. spent $3.3 trillion on health care. Of that, only $195 billion was the overhead and profits of private insurers. But even that overstates the potential savings; government programs have significant overhead as well, and those administrative costs are rising rapidly. Claiming to lower the national costs of health care by focusing on administrative costs is like going on a diet by cutting back on Splenda.

Second, price controls means that there will be little or no return to innovation. American health care has many challenges, but it has maintained the finest medical science on the globe and made it a magnet for those seeking high-quality treatments. Making innovation and medical technology production less attractive in the United States – the world’s medical innovation superpower – will mean that the patients around the world will see cures and treatments later than they otherwise would.

Third, the fact that exclusively the government will control scarce treatment and research dollars raises the specter of massive cronyism. The politically connected will get treated, the effective lobbyists will get their companies reimbursed, and the average American – the supposed beneficiary of this system – will be powerless. To the extent that the current system lacks the sort of competitive market forces and transparency that would actually “bend the cost curve,” giving the government exclusive control will only exacerbate that tendency.

A single-payer is substantively flawed and would never survive as a general election policy proposal. Why, then, has it emerged as a focus of the Democratic primary? The simple answer is that the Affordable Care Act (aka Obamacare) is just as unpopular on the far left as it is on the right. Supporting a single-payer isn’t a realistic proposal, but it is a good way for Democrats to show that they understand just how unpopular the Affordable Care Act is.

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