Oh yes. Think of all those poor railroad brakemen, who were put out of work by George Westinghouse.

It's not railroad brakemen. Although that's not inconsiderable - there's probably about 1.5 million people who work either in the health insurance industry or in the medical billing positions in doctor's offices that single-payer will ostensibly put out of work. That's more than a few brakemen.

But the more significant groups are much, much larger:

About 10-15% of the population has super-generous employer-based health care benefits - beyond platinum, with employers paying nearly the whole freight. These are mostly union folks, and especially public sector unions. That's why Abdul El-Sayed, a deeply progressive candidate, has to put "Medicare for those who want it" rather than "Medicare for All" in his platform. Because unions are too important in Michigan to run on taking away their private health care plans.

The other big group is retirees. They've already paid into the Medicare program. They spent their lifetime essentially pre-paying their later year health care costs. They paid taxes to fund their health care during their working years. They've planned that once they retired they would only have to pay a modest premium and no more taxes. They didn't plan on that being switched over to a VAT. They're going to be beyond enraged if you impose a big 'ol healthcare tax on them.

And, of course, there's all the workers. If you don't do a VAT and you're not setting benefits low enough that 10-15% of the population has their coverage worsened and you're not slashing provider compensation....well, then you're doing a massive payroll tax.

Unlike the brakemen, these folks get to exercise political power over the decision-makers. George Westinghouse didn't have to worry about losing his job if he pissed off 10% of the voters.

Plan Steve is the most gradual phase in I can think of. The alternative is the status quo, where Proles take it up the rear, paying for massive, redundant, unproductive, bureaucracies, that do nothing but increase cost.

That's why we're likely to stay in the status quo.