“Ben [Carson] wants to knock out Medicare,” said Donald Trump. “I heard that over the weekend. He wants to abolish Medicare. Abolishing Medicare, I don’t think you’ll get away with that one. It’s actually a program that’s worked. It’s a program that some people love, actually.” [Newsmax.com 10-27-15]

Actually, Carson does not propose abolishing Medicare. According to DailyCaller.com, he says he would not end Medicare and would use health savings accounts, which would eliminate “the need for people to be dependent on government programs.” Carson wants to “provide people with an alternative” that he describes as “so much better than anything else,” but added he doesn’t plan on ending Medicare completely.

Carson is under fire not for suggesting that we should privatize and phase out Medicare — which we should — but merely for hinting that we might provide an alternative to the coercive, government-run program. He’s under fire not just from Democrats, but from fellow Republicans, particularly Ohio Governor John Kasich and apparent front runner for the nomination, Donald Trump.

Is Trump right? Is Medicare popular and, if so, does that automatically make it morally right and fiscally sustainable?

Can’t a majority be wrong? And if they are, isn’t it the job of a leader — in politics, or anywhere else — to educate that majority as to why they’re wrong, and what the consequences of their errors are? Even if that means losing an election in one case (Republicans already lose anyway, even when they win), might it not become an advantage a few years down the road, when they’re shown to be right?

Medicare is a single-payer, socialized insurance plan for those 65 years and older. Back in 1965, Congress would have passed a single-payer plan for everyone, if they thought they had the votes. Even in 2010, Obama and the Democratic Congress would have passed a single payer plan, if they thought they had the votes. (Obamacare was the next best thing).

What nobody seems willing to examine — not even Ben Carson, who’s at least willing to slightly hint at it — is whether single-payer insurance is ever morally right, for seniors or for anyone?

Medicare is a coercive government monopoly. It’s even more communistic and socialistic than, say, public schools. With public schools, you can opt out. Granted, private schools are more expensive and in shorter supply than they otherwise would be, because government dominates the market with federally funded public schools. But it’s not against the law to send your child to a private school, or even home school, in many cases.

Not so with Medicare. With Medicare, once you turn 65, you’re on Medicare, like it or not. You have no right to purchase an alternative plan in the marketplace (or to have planned on one years before), because there is no marketplace, and it’s against the law. While there are “Medigap” plans (Medicare secondary insurance) available through quasi-private insurance companies, most people do not understand that those plans follow the rules of Medicare and the government, not the market. In other words, if your doctor or health provider does not participate with Medicare, then your secondary “Medigap” insurance will not cover that provider, either. And all the rules, edicts, regulations that apply to Medicare likewise apply to the secondary insurance.

Medicare is a monopoly. It’s a coercive, one-size-fits-all single-payer system. If Republicans running for President will not acknowledge this, then I don’t know who will. It’s a fact, all the same.

Is Medicare popular? Well, of course it is. People have no other choice. But “popularity” implies a willingness to choose one option over all others. If there are fifty restaurants in a town, one or two restaurants might draw 60 or even 75 percent of the diners. We’d call those restaurants the most popular, with good reason. Medicare is, according to the law of the land, the only option for seniors in health insurance. By what stretch do you call that popular, or say that people “love” it?

It’s reasonable to assume that most people on Medicare would not want the plug pulled on it overnight. I don’t know of anyone who’s proposing that. The only rational and just way to handle the problem is to phase Medicare out. Put young people on notice there will be no Medicare program for them, because there most certainly will not be anyway, given the fiscal unsustainability that its morally wrong and coercive approach creates. Unless the U.S. economy can find a way to sustain debts and deficits too high for economists or computers to calculate, or tax rates so high that the economy will grind to a complete halt, Medicare (like Social Security) cannot go on forever.

Debate should be open to how best, or in what way, start privatizing Medicare and all of health care in America. Until or unless we get to that point, no discussion of the subject makes any moral or economic sense. Even flailing about Obamacare does not address the core issue. If you want to privatize health care in America, you’ve got to take on Medicare.

Medicare’s fiscal unsustainability (freely acknowledged by the government, including Obama’s own Treasury Department) is not the worst thing about it. The worst thing about it is that it’s forced. It prevents people from freely acting as they otherwise would. Why are proponents of Medicare, Donald Trump included, so afraid of a free market, or even an alternative market as Ben Carson suggests we might need? If Medicare is as beloved and as great as they assume, nobody will ever opt out of it. Of course, even if we established health savings accounts for seniors as Carson proposes, it’s still not a fair competition, because government would still have the upper hand with its federally funded (albeit bankrupt) programs. Yet nobody can tolerate even this much competition with the government in health care, not even the vast majority of Republicans. It’s pathetic.

Donald Trump is supposed to be such a smart businessman, and so willing to speak his mind. Both of these things may be true. But his comment that Medicare is popular and beloved by seniors is laughable. If the government passed a law that people may buy only one kind of car — same size, color and model for everyone — would you call that brand and style of car popular? Even though that’s the only one they’re permitted to buy or own?

That’s exactly what Donald Trump and other Republicans are saying.

Without any meaningful or principled opposition to Medicare, Republicans are dead in the water on health care. We might as well have the Democrats in charge. These are their programs, and if socialism is morally justified in health care, then socialism is morally justified potentially anywhere. If Republicans really opposed socialism in principle, they’d be willing to take on or at least question the sacred cow of Medicare.