Under Medicare for All, if you like your private insurance plan, you can't keep it.

When President Obama made the case for the Affordable Care Act, he said on dozens of occasions that anyone who likes their doctor or their insurance plan would be able to keep it under the new law. That proved untrue when the law resulted in several million people losing access to their existing plans. But the promise was made because Obama and his advisers believed it was necessary to maintain public support for the law. Two decades earlier, President Bill Clinton's effort to remake the U.S. health care system failed after industry-funded advertisements drove public opposition by warning that some people would lose their existing insurance plans.

Obamacare's backers thus believed that promising to avoid disruption was a key—arguably the key—to ensuring the law's initial political success. Without it, the whole effort would collapse.

Heading into 2020, single-payer proponents appear to be adopting essentially the opposite strategy. The national health care plan put forth by Sen. Bernie Sanders (I-Vt.) would eliminate all current private insurance over a four-year time frame. And at a town hall event last night, Sen. Kamala Harris (D-Ca.), who recently launched her presidential campaign, said she wants to eliminate private insurance entirely, which would mean that about 177 million people would lose their existing plan.

After noting that the Sanders-sponsored Medicare for All legislation that Harris supports would totally eliminate all private insurance, moderator Jake Tapper asked, "So for people out there who like their insurance—they don't get to keep it?"

Harris responded with a somewhat winding answer that amounts to a yes.

"The idea," she said, "is that everyone gets access to medical care and you don't have to go through the process of going through an insurance company, having them give you approval, going through all the paperwork, all of the delay that may require. Who of us have not had that situation where you have to wait for approval and the doctor says, 'I don't know if your insurance company is going to cover this.' Let's eliminate all of that. Let's move on." (Emphasis mine.)

It's worth taking a moment to think about what Harris is saying here, and just how condescending it is.

She is not just saying that dealing with private insurance is sometimes annoying, which most people would agree is true, and that this should be fixed. Nor is she saying that private insurance has limitations or is insufficient, that it sometimes leaves people and conditions untreated. She is not making a case against private health insurance that is dysfunctional or disliked; she is arguing for the complete elimination of insurance plans that people have had positive experiences with—plans that, as Tapper says, people like.

In other words, if you like your private health insurance plan, you can't keep it, because the plan that you like is bad, and politicians like Harris will decide what you really need instead. A majority of Americans with employer-sponsored plans are satisfied with their insurance coverage, according to an industry survey. Harris is starting her 2020 campaign by telling them they are wrong.

Perhaps the politics of health care have changed since Obama made his pledge; I suspect not. Just last week, a survey found that that only 37 percent of the public supported Medicare for All when told it would eliminate private health insurance. The disruption of existing coverage remains broadly unpopular.

Harris is not only promising disruption (and on a far larger scale than what occurred under Obamacare), she is promising to fully eliminate coverage arrangements that millions of people are happy with in order to radically expand political control of the provision of health care. What she is saying is that it doesn't matter if you like your health care plan if she doesn't.