Unlike just about everything Trump and company are proposing, Medicare for all is a substantively good idea. Yet actually making it happen would probably mean facing down a serious political backlash.

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On Wednesday Donald Trump demanded that Congress move quickly to enact his tax reform plan. But so far he has not, in fact, offered any such plan. Not only is there no detailed legislative proposal, his administration hasn’t even settled on the basic outlines of what it wants.

Meanwhile, 17 Senate Democrats — more than a third of the caucus — have signed on to Bernie Sanders’ call for expanding Medicare to cover the whole population. So far, however, Sanders hasn’t produced either an estimate of how much that would cost or a specific proposal about how to pay for it.

I don’t mean to suggest that these cases are comparable: The distinctive Trumpian mix of ignorance and fraudulence has no counterpart among Democrats. Still, both stories raise the question of how much, if at all, policy clarity matters for politicians’ ability to win elections and, maybe more important, to govern.

About elections: The fact that Trump is in the White House suggests that politicians can get away with telling voters just about anything that sounds good. After all, Trump promised to cut taxes, protect Social Security and Medicare from cuts, provide health insurance to all Americans and pay off the national debt, and he paid no price for the obvious inconsistency of these promises.

Hey, arithmetic has a well-known liberal bias — and the commitment of the mainstream media to “balance” virtually guarantees enough false equivalence to obscure even the most obvious fraud.

On the other hand, the ignominious failure of Trumpcare shows that reality sometimes does matter.

True, Republicans long paid no price for lying about Obama-care; in fact, those lies helped them take control of Congress. But when they gained control of the White House, too, so that the prospect of repealing the Affordable Care Act became real, the lies caught up with them.

Once the public realized that tens of millions would lose coverage under Republican plans, there was a huge backlash; that backlash may give Democrats the House next year, despite all the gerrymandering and other structural disadvantages they face.

The story of tax reform — actually, given the likely content of whatever legislative proposal may finally emerge, we should call it tax “reform” — is starting to look a bit similar. During the campaign Trump could get away with posing as an economic populist while offering a tax plan that would add $6 trillion to the deficit, with half the benefit going to the richest 1 percent of the population. But this kind of bait-and-switch may not work once an actual bill is on the table.

In fact, Trump himself seems to be experiencing cognitive dissonance. “The rich will not be gaining at all with this plan,” he declared Wednesday. Like his claims that Trumpcare wouldn’t cause anyone to lose coverage, this statement raises questions about what’s going on in his mind: Is he oblivious, lying, or both?

But in any case, such statements are going to make it even harder to pass anything: The contrast between what he’s claiming and anything Republicans in Congress will be willing to support is so great as to practically invite ridicule and another popular backlash.

I’d add that tax cuts for corporations and the rich have little popular support. Even many self-identified Republicans, especially among the working-class voters who supported Trump, tell pollsters that corporations and the wealthy pay too little, not too much. Trump seems to imagine that he can rally broad voter support for his tax plans, but it’s hard to see how.

But is the push for single-payer health care taking Democrats down a similar path?

Unlike just about everything Trump and company are proposing, Medicare for all is a substantively good idea. Yet actually making it happen would probably mean facing down a serious political backlash. For one thing, it would require a substantial increase in taxes. For another, it would mean telling scores of millions of Americans who get health coverage though their employers, and are generally satisfied with their coverage, that they need to give it up and accept something different. You can say that the new system would be better — but will they believe it?

Such concerns may not seem very salient right now: Given Republican control of the White House, single-payer is going to be at best an aspiration for the next three-plus years. But what if rigid support for single-payer — as opposed to somewhat flexible support for universal coverage, however achieved — becomes a litmus test? In that case, Democrats could eventually find themselves facing a Trumpcare-type debacle, unable either to implement their unrealistic vision or to let it go.

The point is that while unrealistic promises may not hurt you in elections, they can become a big problem when you try to govern. Having a vision for the future is good, but being real about the difficulties is also good. Democrats, take heed.