Thanks to President Barack Obama’s debut as a contributor for the Journal of the American Medical Association (JAMA), the ‘public option’ has made its way back into the great health care debate. Democratic presidential candidate Hillary Clinton approves of it as well. Why not make Obamacare’s health insurance exchanges more robust by offering a public health plan that can compete alongside private health plans? In the words of our president, it will ‘help keep the private sector honest.’

For those who want to move more quickly towards a single payer health care system, implementing a public option is the way to do it. For the rest of us who are fed up with Obamacare’s fallacies and false promises of affordable health care for the masses, Megan McArdle at Bloomberg rattles off reasons why the public option will create more problems for patients, providers, and the insurance market:

The less wonky supporters of the public option — and that’s most of them — were generally under the impression that private insurers had bloated administrative costs and obscene profits, so that a public insurer which could streamline overhead would easily be able to offer better prices. But while Medicare’s overhead costs are lower than those of private insurers, that doesn’t mean that the public option policies would be cheap. For one thing, one of the reasons that Medicare’s overhead is low is that it doesn’t do annoying things such as sell policies to consumers, who require a lot of expensive hand-holding and bill-collecting. As one of many players in the marketplace, the public option would need to have all those service staff, just like the insurance companies do.

For another thing, there’s a credible case that Medicare lowers its overhead by inadequately policing fraud, which is not necessarily a net savings to the whole system, but does lower the amount captured in that one budget line. Medicare’s overhead—which is expressed as a percentage of total expenses — also looks artificially low because the population it covers is so sick. Expressed as a hard number rather than a ratio, its administrative expenses per enrollee are arguably higher than the private sector’s.