If a handful of extreme Republicans in Congress get their way, the government will be shut down unless Obamacare is defunded.

Enough of their own party realizes that such a temper tantrum would damage the GOP’s 2014 efforts, and so it will not actually happen; but consider just how ridiculous the very idea is. These Republicans so want to prevent a program that will help millions from taking effect that they are willing to shutter the entire government and hurt millions upon millions more people in the process.

It is common knowledge that we have a healthcare cost problem. Whether you have health insurance or not, and almost 50 million of us do not, you know how insanely expensive any sort of medical procedure is.

You know this even if you have health insurance because you most likely have gone through all the rigmarole of getting a health insurance company to actually pay for what they are supposed to cover.

Health insurers are in the business of getting us to collectively overpay for already ridiculously overpriced healthcare, and to top it off, they use every trick that they can think of to deny as many claims as possible. They might want to use other words to describe how they make their billions in profit, but window dressing aside, we all know that this is their business model.

As a country, we needed a solution, not just to the problem of the uninsured, but to the high costs of healthcare and the routine abuses cast on everyday Americans who have health insurance.

We could have done what almost all of the rest of the world’s advanced economies have done; we could have instituted a single payer system, Medicare for all. Medicare isn’t perfect, but note that people who have it, seem awfully politically motivated to keep it.

This approach would have covered literally everyone and done the most to reduce healthcare costs. If you look at countries that have such a setup, you can find supplemental health insurance and high priced private clinics that operate outside the system, but they are a niche market at best, and for good reason.

We could have used the basic framework of Obamacare, but included a public option. This would have given people a not-for-profit choice, and the low cost of that program would have forced private insurers to keep their prices low in order to compete for customers.

Not as good of an outcome as single payer, because people could still choose not to buy healthcare and just pay the tax penalty, but overall at least the focus is on cost reduction.

We didn’t get either of those approaches though. What we got was a nationalized version of the plan Mitt Romney signed into law in Massachusetts. A plan that was celebrated at the time by the conservative Heritage Foundation for being “patient-centered and consumer-based.”

This is the approach that does the most to protect health insurers. Democrats made sure that it includes a significant redistribution of wealth so that the working class can afford to buy health insurance, but otherwise, this is the Republican plan; from back when there were a handful of Republicans who actually thought that millions of uninsured Americans presented a problem.

If this was their plan, then why is it anathema to Republicans today? Why have they held 40 useless votes to repeal it? Why would some radicals be willing to deny seniors their Social Security checks, and soldiers their combat pay, and the myriad other day to day things that would not happen given a complete government close down?
They hate it that much because they know once it actually comes into effect and starts helping people, it is going to be popular.

Just like Social Security and Medicare, once it gets started it is not going to go away easily. In fact, the opposite is true. It will be all too easy to add in the public option a little later down the line.

And once people get a taste of how inexpensive and effective health insurance can be when it is focused not on making profits but instead on getting people the care they need at the lowest possible cost, then single payer comes back on the table.

Nothing scares Republicans more than government being given the opportunity to show how well it could work.