Recently, there's been renewed interest in reviving the "public option." Loosely, the public option is a policy proposal to create a giant government-run health insurer that would compete with private insurers. The rationale behind it is that a publicly run insurance company would be able to operate on lower overhead and provide health coverage significantly cheaper than private insurers.

The idea, which was dreamed up by Yale political science professor Jacob Hacker, first really came to public attention when it was bandied about in the run-up to Obamacare, before being dropped as too radical. However, with the Obamacare insurance exchanges in a precarious position because private insurers are losing money and dropping out of the system, President Obama has renewed calls for a "public option" to provide insurance coverage. Democratic nominee Hillary Clinton has also come out in support of a public option, in part because she was pushed to the left on health in her bruising primary with socialist Bernie Sanders. (Sanders called his program "Medicare for all," and Hacker calls the public option "Medicare-like.") And just today, Hacker has an op-ed at the New York Times touting the public option as the cure to what aiils Obamacare.

There are a great many obvious reasons to oppose the public option. Perhaps the most neglected reason to oppose it is that the people arguing for the public option aren't telling the truth, because what they really want is not a publicly funded insurance plan that's serves as an alternative to private insurance. They want to crowd private insurers out of the marketplace altogether, leaving the government as the sole provider of health care, a.k.a. a "single-payer" system. Despite the obvious evidence that this is what they want, they insist that the public option is some sort of sensible middle ground and not the radical proposal to destroy private insurance that it is.

Now watch this video from Jacob Hacker, "father of the public option," speaking at the Tides Foundation in 2008:

If you can't watch the video here's what Hacker says:

Someone once said to me, 'Well, this is a Trojan horse for single payer.' Well, it's not a Trojan horse, right? It's just right there! I'm telling you, we're going to get there over time, slowly, but we'll move away from reliance on employment based health insurance as we should. But we're going to do it in a way that we're not going to frighten people into thinking that they're going to lose their private insurance.

At the time the video first surfaced in 2009, Hacker attempted to clarify his remarks. "I do not see my 'Health Care for America' proposal as a route to single payer," he told He further claims that he was simply trying to argue that he's open about his ambitions for the success of the public option, rather that trying to be deceptive.

Maybe that's true, but explicitly making a meta-argument about not wanting to frighten voters by discussing the end goal of destroying the private insurance system is troubling on its own. Hacker's too clever by half; he's being honest—but only about the fact the public option will be sold to the public in such a way they won't understand the long-term consequences.

Besides, we've already seen the consequences of this argument. Not wanting to "frighten people into thinking that they're going to lose their private insurance" is likely the reason why President Obama deliberately and repeatedly lied about "if you like your health insurance, you can keep your health insurance" under Obamacare, when some eight million Americans lost their insurance as a result of the law. Further, another much celebrated liberal health care wonk, M.I.T. economist Jonathan Gruber, has been caught lying about several aspects of Obamacare and mocking the "stupidity" of voters when it comes to health care policy.

But say what you want about this approach—the lying worked. Obamacare was passed, and media organizations went to the mat to defend these lies. (Politifact repeatedly defended "if you like it, you can keep it," before they got so much egg on their faces they made it "Lie of the year.") By the time the lies were exposed, Obamacare was entrenched.

After the experience with Obamacare, surely Hacker must understand that there's no reason to trust him or other health care wonks on the public option. Further, it's worth noting that many on the left, to their credit, don't like the public option. Why? As Mark Schmitt wrote in the American Prospect, "the political process turns out to be as resistant to stealth single-payer as it is to plain-old single-payer." They feel they'd be better off arguing for single-payer from the get-go, instead of waiting for a political backlash that will come with people realizing that the public option is a matter of bait-and-switch.

To understand what's going on here, it helps to explicate the policy arguments against the public option. To think the public option is a good idea, you have to believe that, while private insurers with decades of experience in health care administration can't make money under Obamacare's mandates and coverage requirements, somehow a new government insurance enterprise built from the ground-up and run by federal bureaucrats would be much more efficient. There's a lot of health care wonkery one could descend into at this point to rebut the public option, and for more on that see this recent Bloomberg column where Megan McArdle did an excellent job systematically dismantling arguments for the public option. But it's worth just pointing out just a few basic things.

First, health insurers operate on very narrow profit margins, so the amount of money saved by eliminating profits isn't as great as many imagine. Two, once you eliminate profits you also eliminate any incentive for an insurer to increase efficiencies or otherwise save money. In this respect, our current forays into government insurance are telling. Aside from tens of trillions in unfunded liabilities, Medicare loses $60 billion to fraud every year and there's little interest in fixing the problem. Arguing that eliminating profits would lead to better administration in government-run health insurance seems dubious.

Finally, as McArdle notes, one of the most powerful arguments in favor of the public option is the belief that the "public option can force providers to accept below-market reimbursements for their services." Already government insurance programs are attempting to set rates below market cost, and it's not going well. If you're on Medicaid, good luck getting an appointment. Consulting firm Merritt-Hawkins periodically surveys major health care markets in the U.S. to examine average wait times for doctors. In their last 2014 survey, over 50 percent of doctors would not accept Medicaid patients and that percentage has increased significantly. Similarly, one in five doctors are now rejecting new Medicare patients.

With private insurance paying better rates, it's become increasingly hard for government programs to force physicians to accept reimbursements that are below-market. Ah, but what if the government didn't have to compete with private insurance? Then they could set rates at whatever they wanted and save all kinds of money. (Of course, there are broader ramifications to government price controls. Specifically, they lead to rationing – and if those consequences aren't clear enough, I encourage you to try and schedule an MRI in Canada where health care prices are tightly controlled. They have fewer MRI machines in the entire country than Pittsburgh.)

Because the idea that the public option will prove well-administered and fiscally sustainable is too laughable to entertain, let's imagine the following scenario: Say Trump craters in November, the GOP loses control of the House and Senate and Democrats have a free hand to create the public option. The government starts offering cut-rate insurance to millions of Americans who sign up for it. Unlike the Obamacare exchanges, which depend on third party private insurer participation, the government would now be directly responsible for the health care of the people in the program. When the public option starts inevitably hemorrhaging money, there will be tremendous political pressure not to leave these people without health care.

At the same time, if doctors start refusing ever larger numbers of patients covered by the public option because they don't want accept below market rates, there will also pressure for a political solution to force doctors to accept price controls and treat these people. If the government gets away with forcing doctors to accept below market prices, it will encourage more people to abandon more expensive private insurers when they can pay less and still get treatment through the public option. Eventually over time, private insurers can't compete. At some point, America transitions over to a health care system where that is, for all intents and purposes, single-payer.

There are many different political and pragmatic reasons I don't think it will play out this way. Liberal health care wonks also predicted many would flee private insurance for Obamacare's exchanges, but Obamacare remains broadly unpopular and, so far, most Americans have had a stubborn and sensible aversion to letting go of their employer-provided health insurance for a government alternative.

But there can be no doubt liberal health care wonks are working hard to kill off private insurance and create a single-payer health care system run by the government. If Jacob Hacker or another public option proponent tells you any different, they're lying.

This post has been updated.