After many years of Republican failure to “repeal and replace” Obamacare, it is bizarre to observe Democratic presidential candidates fighting their campaigns by proclaiming their desire to…repeal and replace Obamacare. In doing so, they have eagerly proposed an endless list of ideas for something much worse.

When Senator Bernie Sanders was on his honeymoon in the old Soviet Union, he fell in love with the magnificent subway tunnels and escalators that Stalin left behind. One wonders if Sanders also visited Stalin’s Gulag, which seems more likely to have inspired his sterile dream of a single, monolithic structure for medical care without freedom or choices, paid for with money the government first seized from us. Now it appears that the government did not seize enough.

Other candidates prefer to tell those currently on Medicare (after involuntarily having Medicare taxes withheld from their paychecks for fifty years) that the entire population plus new arrivals to the U.S. will be joining them in medical waiting rooms—without having paid a cent. Some politicians consider that to be “justice.” Politicians have not asked current seniors what they think of that, but hopefully seniors can express their opinion in the next couple of elections. Destroying Medicare for those who have been forced to rely on it is a cruel way to expand government control of American medicine.

On another side of the debate are those like Senator Elizabeth Warren who eagerly look forward to eliminating all health insurance companies. Among her many plans, she has yet to provide much detail about how that will be explained to current policy holders. Or to the hundreds of thousands who work for health insurance companies whose jobs will be destroyed. Or to the stockholders of those firms or to the policy holders who own “mutual insurance” firms. Or how Medicare that now uses insurance companies to process payments and bills will survive without them.

These politicians have also said nothing about how physicians will be expected to cope when their only paying customer is Medicare. Of course, the politicians do not remotely care. They see physicians as a natural resource that they can confiscate and redistribute as they like. They are obviously confident that physicians will remain content if they can no longer practice medicine as they think best in their own or their patients’ best interest.

Debates about health care policy must incorporate some aspects of the reality in which we live, not just the fantasy world of dueling socialists. Unfortunately for the Democratic presidential contenders, that reality includes some 50 million seniors on Medicare, millions of healthcare professionals, hundreds of thousands of insurance company employees, and everyone else whose taxes will have to go up to make real the fantasy of less freedom and fewer choices under Medicare for All.

All of the politicians so anxious to gain complete control of our medical system to enact this fantasy should be given one further test of their credentials to do that. They must explain what they are doing now for those currently in the hands of government health care: military veterans who have earned the best care the hard way. Ask every politician promising to take over your medical care what they are doing for the veterans now in their care, or for those veterans who have died while languishing on lists while waiting for it.

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Richard E. Ralston

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.

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