Sen. Elizabeth Warren (D-Mass.) on Wednesday made an impassioned vow to protect Obamacare from Republican attacks, but she implicitly acknowledged that the historic reform has failed.

Warren praised former President Barack Obama for the “game-changer” Affordable Care Act.

“We will not back down in our protection of the Affordable Care Act,” she told an enthusiastic crowd in Washington. “We will defend it at every turn.”

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But it is Warren and other senators gathered at the event who would inflict the fatal blow on Obamacare if they get their way. She said they would “take another step” toward the Medicare for All bill introduced by Sen. Bernie Sanders (I-Vt.).

What not too long ago was a fringe position rapidly is becoming mainstream within the Democratic Party — even if party leaders in the House of Representatives and the Senate are keeping their distance for now. Sanders has gained 16 cosponsors, including nearly every Democratic senator who has even thought about running for president in 2020.

“Today, we begin the long and difficult struggle to end the international disgrace of the United States, our great nation, being the only major country on earth not to guarantee health care to all of our people,” he said. “As proud Americans, our job is to lead the world on health care, not to be woefully behind every other major country.”

“It’s convincing unless you’re familiar with how it works, in which case, it’s not convincing at all.”

Sanders held his event on the same day that a group of Republican senators attacked Obamacare from the opposite direction, proposing to convert the Affordable Care Act into a giant block-grant program to the states. The radically different visions for the future of American health care highlight the dwindling support for Obamacare and set up what could be a front-burner issue in next year’s midterm elections.

The Medicare for All Act would start with a transition period, during which the eligibility age would be reduced to 55 and would eliminate deductibles for Part A, Part B and Part D. In the second and third years, the eligibility age would be reduced to 45 and 35, respectively. By year four, every single resident of the United States would receive a Universal Medicare card to use for a long list of medical services.

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Proponents argue that the system would greatly reduce the cost and improve the quality of health care. The federal government would be empowered to use its monopoly power to negotiate lower prices for prescription drugs. In addition to a suite of services, the law would guarantee benefits that Medicare does not currently provide, including dental care, hearing aids, and vision care.

At the same time, the bill would maintain the current Department of Veterans Affairs and American Indian Health Service systems as they are.

Sanders Brushes Off Higher Taxes
At Wednesday’s kickoff event, Sanders was light on details about how to pay for such a massive expansion of the federal government. But he suggested that most people would come out ahead since they would not have to pay private insurance costs.

“While, depending on your income, your taxes may go up to pay for this publicly funded program, that expense will be more than offset by the money you are saving by the elimination of private insurance costs,” he said.

A number of health care experts said Sanders and other supporters are glossing over the enormous tax increases that would be required to finance a single-payer health care system.

“That does not bother the proponents, but the leadership of the [Democratic] party … is concerned that’s not going to fly with voters.”

Edmund Haislmaier, a senior research fellow at The Heritage Foundation, said he is skeptical that a government monopoly on health financing would dramatically reduce overall costs. But even if it succeeded in reducing spending from its current 17 percent of gross domestic product to 15 percent, he said, it would require an additional payroll tax of 8 to 10 percent.

The costs are too high to be able to simply tax wealthier Americans, Haislmaier said. He said the government would have to tax people at all income levels.

“That does not bother the proponents, but the leadership of the [Democratic] party … is concerned that’s not going to fly with voters,” he said.

Robert Graboyes, a senior research fellow at George Mason University’s Mercatus Center, said it is “single-payer mythology” that the United States spends more on health care and gets worse results.

“It’s convincing unless you’re familiar with how it works, in which case, it’s not convincing at all,” he said.

Graboyes said countries with single-payer health systems achieve lower costs from rationing — reflected by long wait times for procedures that can be scheduled a few days in advance in the United States — and by skimping on comforts that Americans find essential. For instance, he said, American patients expect private rooms when they are admitted to hospitals. Foreign countries often have crowded hospital wards with beds separated by curtains.

“It is delusional to think just because Congress passes this stuff, Americans are going to be willing to put up with what Canadians and Europeans put up with,” he said.

U.S. System Better Than Advertised
Graboyes said the American health care system performs far better than many international studies suggest. For instance, he said, many peer countries have high life expectancies than Americans. But those differences mostly disappear after subtracting people who die instantly by homicide and violent accidents, he said.

The United States also often scores worse in infant mortality studies because some other countries count babies who die soon after birth as stillbirths, but in the United States they would be counted as infant deaths, he said.

Graboyes said a similar misreading of data also makes Medicare appear far more efficient than it actually is. He said Medicare supporters often point to a low ratio of administrative costs versus medical expenses. But that is skewed by the fact that Medicare recipients are older and incur far higher medical expenses, on average.

Medicare, Graboyes noted, also spends less than private insurance on fraud prevention and, as a result, has a fraud rate in the range of 10 percent.

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“That is not efficient,” he said.

A parade of liberate Democratic senators was undeterred on Wednesday, however. Sen. Jeff Merkley (D-Ore.) painted a soothing image of worry-free health care if the government is put in charge. He compared the current system unfavorably.

“It’s stressful. It’s inefficient. It’s ineffective. And we can do far better with Medicare for All,” he said.

Sen. Richard Blumenthal (D-Conn.) was one of several senators who described health care as a basic government responsibility.

“Health care should be a right, not a luxury,” he said.

(photo credit, homepage image: AFGE, Flickr; photo credit, article image: Gage Skidmore, Flickr)