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2018-07-16 08:50 by Karl Denninger
in Health Reform , 131 references
[Comments enabled]  

There comes a point where you must conclude that Donald Trump never meant a word he said about breaking the medical monopolies -- or fixing the underlying problem with health care in the United States, which has nothing to do with insurance and everything to do with cost.

He could have directed Jeff Sessions to go after the entire industry under 100+ year old existing law, 15 USC, which make a criminal felony any attempt to monopolize trade, fix prices or restrain competition.

He could tell Congress to send to his desk a bill removing all constraints on "reimportation" or any drug that is FDA approved, irrespective of the source nation -- and that he won't sign anything else from Congress until that appears on his desk.

But he hasn't done anything of the sort.  He likes to take credit for Pfizer's "rollback" of intended price hikes, but reality is that this tiny little concession in the grand scheme of things means zippity do-da, while the screwing goes on daily in both hospitals and the pharmacy.

The simple reality is that nearly everyone would not need "health insurance" for anything other than major catastrophic events if this crap was stopped.  A routine childbirth would cost under $1,000.  Insulin would cost less than a pack of cigarettes.  Virtually all medical treatment could be bought for cash by all but the poorest Americans.

Look at this record -- drugs that have been off-patent for decades, approved in 1950 and available for under $10 around the world -- but $38,892 here.

Or try insulin.  Over less than 20 years it has gone up in price by about 700%.  Is it a different drug?  No.  It's the same drug.  Is insulin new, novel or under patent?  No.  Why did this happen?  Because there are basically two formulations and the companies have raised prices in lock-step since the second was introduced with an ever-increasing scale over the last few years.

This is black-letter illegal and yet there has not been one indictment leveled but there has been billions stolen from Type 1 diabetics who have exactly zero choice on buying said drug.

If the government will not do their ****ing job and stop this then the FDA must be abolished by whatever means are necessary along with every law and regulation pertaining to same.  In this world of the Internet where anyone with a cellphone can research whether some compound has been studied, what it's properties and risks are, and decide for themselves to take the risk (or not) of consuming same for some condition if the government is going to do nothing more than enforce and enhance a racket that screws everyone out of billions then the enablers of that racket must be destroyed and the racket torn down.

There are already existing laws sufficient to do so.  We need no new ones.

But if we cannot expect actual faithful enforcement and execution of the laws from our government then we need a new government.

Trump promised to fix this and he lied.  Either crap or get off the pot Donald.

It's that simple.

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I've written much on the health scams -- especially pricing.

10x or even 100x as much for a drug here in America as in Canada, France, England, Spain, anywhere else -- all made by the same company.

10x as much paid by one person for the same procedure as someone else.

3-4x as much for an MRI in Michigan if you need it due to a car accident as opposed to falling while walking your dog.

A local hospital here that has been repeatedly accused of gouging people for 200, 300% or more the price of the same procedure performed in a hospital 15 miles south in the same county.  This, incidentally, is the closest hospital to a county jail -- recently our county commission claimed that six-figures worth of medical care for two people detained there -- along with medical costs for their employees, many of whom live near that hospital -- as justification for an 11% property tax hike.

All of this is contrary to 100+ year old felony anti-trust law in the United States, which makes criminally illegal any attempt to fix prices or restrain trade (15 USC Chapter 1.)

NOT ONE PROSECUTION HAS BEEN LEVELED AGAINST ANY OF THESE PEOPLE AND IN FACT DRUG REIMPORTATION WAS MADE EXPLICITLY ILLEGAL TO PROTECT AND LEGALIZE THIS CRIMINAL, FELONY BEHAVIOR JUST AS OPEC WAS SPECIFICALLY EXEMPTED FROM THESE VERY SAME FELONY CRIMINAL ANTI-TRUST PENALTIES IN 1976.

Now let me add to this.

There are a fair number of individuals who have intentionally, through their own hand, destroyed their own health.  They then successfully go on disability.  Once being on disability they are entitled to Medicare, even if not yet 65.

These individuals then can, and do, often run up six figure or more medical bills which occur entirely because of their own lifestyle choices. 

I am talking about people who literally drink or drug themselves to death and the slow destruction that occurs lands them in the hospital repeatedly with life-threatening conditions, from congestive heart failure to cirrhosis, liver cancer, sepsis and similar.

They have no money to pay for any of this and it all gets billed back to the taxpayer with the damage continuing to mount both personally and in medical bills for which they are not responsible in any way as a direct result of their refusal to make any lifestyle change -- including ceasing their extreme consumption of alcohol and/or drugs.

We are told we must be "compassionate" and yet this "compassion" comes with forced payment by others at extortionate pricing for whatever it is they might need on any given day.

There are those who claim this isn't all that frequent.  Oh yes it is; never mind that at a half-million a crack 2,000 such people nationally wind up running a billion dollar tab.  May I remind you that last year somewhere between 40,000 and 60,000 people killed themselves with opioids and most of them managed to do a lot of damage and run up a hell of a bill first?

Does anyone honestly think this isn't a $50 billion a year problem -- that would be 10,000 such people nationwide.

Of course it is.  Indeed that's probably a low estimate.

Now add to this Type II diabetes, most of which is directly caused by insane consumption levels of carbohydrates and sugars and which, for 90+% of the people involved, can be either completely mitigated or substantially alleviated by simply stopping that, exactly as someone who is trashing their body through excessive alcohol consumption can stop accumulating more damage by ceasing the consumption of booze.

Again, when you begin to suffer the severe consequences of Type II diabetes, such as blindness, amputations and similar you also become unemployable, you thus qualify for disability and Medicare.

At that point you can mass 500lbs and yet are not responsible for a single nickel of your medical bills, which will inevitably total well into six figures by the time they get done cutting off both your feet and you go through dialysis (the final stage) and die, all of which is quite miserable to boot.  The cost of this is well into the hundreds of billions every single year.

We cannot, in a free society, tell people they cannot drink or eat lots of carbs and metabolically destroy themselves.  Freedom includes the freedom to kill oneself, whether immediately or via slow destruction and lifestyle choice.  We can argue morality and such all we wish but in the end only a fascist government can prevent someone from undertaking such lifestyle decisions.

But it is indeed another form of fascism to force others to pay for these choices and those of us who do so must refuse to do so including enforcing that refusal by any means necessary.

In addition, we must refuse to allow rampant price-fixing, extortion and monopolist felony conduct, all of which is illegal at a criminal level under 100+ year old law, to continue onward and enforce that refusal as well by any means necessary.

In a nation with a Rule of Law those means are quite simple, since law enforcement and judicial process at local, state and federal levels are all sufficient, since these acts are crimes, to put a stop to it.  Every State has an anti-trust law similar to the Federal laws on the same subject they can apply to commerce within their borders -- including medical care, never mind licensing processes at both state and local levels that can be conditioned on non-discriminatory conduct.

In a nation without the Rule of Law it is inevitable that you will eventually have a Civil War if you do not resolve this problem because as these acts of extraction and extortion continue in the name of "profits" and "stock market support" the inevitable point is reached where the majority of the population is unable to retain anything approaching a reasonable standard of living.  When, not if, this occurs -- and it already has occurred in the United States today -- it is merely a matter of time before some material percentage of those permanently suppressed by these scams and schemes decide that if they are going to die destitute, demoralized and destroyed by such policies, corporations and individuals they will make damn sure as many others as possible go to Hell with them.

We are not far from that happening folks and once it does there is no way backMedicare goes broke in under 8 eight years and that assumes no recessions, which never is the case.

When the next recession occurs that timeline will be shortened, through a lack of tax receipts, to an essential zero.

We either act to fix this problem now before that occurs or it isn't going to make a damn bit of difference who you vote for.

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2017-11-01 12:14 by Karl Denninger
in Health Reform , 500 references
[Comments enabled]  

Ok, so I have the APTC for a single person who has reduced income to right near $20,000 a year for 2018.

In Florida it is now $760/month, or $9,120 a year.

This is wildly up from $446 for last year; in fact it's up 70%.

This means I can now have a Silver plan for about $15/month, as opposed to a very low-level Bronze plan for under a buck.  I can also choose virtually all the Bronze plans for zero (since the cost is lower than the APTC), but that would be insane since I'd be leaving a huge amount of your money on the table.

The actuarial value of a "Silver" plan is wildly better than any of the Bronze plans.

There is one "gotcha", which is hospitalization co-insurance that does exist on the Silver plan but not on the Bronze.  But the Silver plan in question has a zero deductible, so even with 20% "coinsurance" you'd have to run a hell of a bill to lose that bet especially considering that you get the insurance-company racketeering-deduction price.

Folks, you have to be flat-out nuts to work harder and run into the subsidy phase-out, especially if you have a spouse, even if you do need routine medical services since you can now buy zero-deductible Silver plans for less than the cost of a burger-and-beer in your local pub!

QUIT ****ING WORKING AT $20,000 A YEAR OF INCOME, FIGURE OUT HOW TO MAKE YOUR LIFE FIT IN THAT EARNINGS LEVEL AND YOU WILL NOT ONLY PAY BASICALLY ZERO FEDERAL TAX (OTHER THAN EMPLOYMENT TAXES, OF COURSE) AND YOU WILL GET CLOSE TO $10,000 OF "HEALTH INSURANCE" WITH A ZERO-DEDUCTIBLE PLAN  FOR UNDER $200 A YEAR.

No, you probably can't do this in high-cost-of-living areas without living in a slum.  Yes, you can make it work perfectly-well in lower-cost-of-living areas and be perfectly fine.  I'm doing it and you can too.  Yes, it means you have to change your lifestyle but I'll be double-******ned if I'm going to go out and earn a six-figure income and then have government thieves not only tax more than half of it away (which they will) but then double-monkey-**** me by extracting approximately $10,000 in after tax money in addition from me for "insurance" that, unless I have some sort of medical catastrophe in the next 12 months in fact provides zero value to me.

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Here it is:

"Notwithstanding any other provision in state or federal law, a person who presents themselves while uninsured to any provider of a medical good or service shall not be charged a price greater than that which Medicare pays for the same drug, device, service or combination thereof."

That's it.

One sentence.

If you want to add a penalty clause with it I propose the following:

"Any bill rendered to a person in excess of said amounts shall (1) be deemed void, with all services and goods provided as a gift without charge or taxable consequence to said consumer but not deductible by said physician or facility from any income or occupational tax and (2) is immediately due to the customer in the exact amount presented as liquidated damages for the fraud so-attempted."

It ends the "Chargemaster" ripoff game.

It ends the $150,000 snake bite or the $80,000 scorpion sting.

It ends the $500,000 cancer treatment.

It ends all of that, immediately and instantly.

I remind you that Medicare is required to set pay rates by law at a level that in fact are profitable -- that is, above cost by a modest amount -- for everything it covers.  Further, those pay rates are audited regularly to prove that they in fact are above cost.

Does this solve every problem?  No, and in fact that would leave alone the existing monopolistic pricing systems that many medical providers, whether they be drug makers, device makers, service providers or otherwise have in place.  It would do exactly nothing to get rid of the 10 paper pushers hired for every doctor or nurse, none of whom ever provide one second of care to an actual person through their entire time of employment.

But it would instantly end walking into an emergency room and getting hammered with a $50,000 bill for something that Medicare will pay $5,000 for.

I remind you that even quite poor people can manage to come up with $5,000 in a life-threatening emergency.  Sure, they might wind up paying 25% interest on the credit card, they might have to stop smoking their $5 pack/day cigs, and it might take them three or five years to pay it off, but they can probably do it.

It's not an answer to the problems the mediscam imposes on society, but it would sure as hell bring down costs for people instantly and permanently, and would make the decision to not carry insurance one that people could opt for while having a rational shot at paying cash -- at least for those in the middle class or better, for whom a $5,000 surprise would be bad, but bearable.

More to the point with the crazy deductibles today the $5,000 would actually buy care and eviscerate the insurance ripoff at the same time, because today you get to pay the $5,000 plus another $10k/year in "premiums" -- for exactly nothing.

This matters because most of the argument for so-called "health insurance" is actually about extortion -- either buy the product or be ruined with charges that are 5, 10 or even 100x what someone who has bought the product will pay.

Ending that will force health insurance companies to actually provide a product that is affordable and provides a reasonable set of benefits -- or people can simply stick up the finger and pay cash.

Pass that, which should take no more than 30 seconds to introduce and put on the floor of both the House and Senate and then we can debate this as a permanent solution.

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2017-04-04 09:16 by Karl Denninger
in Health Reform , 911 references
[Comments enabled]  

Let's talk about the implementation of my model bill that I recently posted to reform health care on a permanent basis.

It's fairly easy to envision timelines based on complexity.  Simply put, most of this isn't complex because providers have price lists now -- you just can't see them.  So with that said, let's look at an example and assume The Bill was passed and signed somewhere around 30 September -- or the close of the fiscal year.

What's next?  The following timeline appears to be reasonable.

Beginning immediately on signature with implementation required on or before 1/1/2018:

  • CMS (Centers for Medicare and Medicaid Services; the existing federal agency) would be required to spin up the interface for Treasury to verify whether someone who presents credentials as a US citizen or lawful permanent resident is, in fact, a citizen or lawful permanent resident.  Treasury already has this via the Social Security Administration, since they have the records of all issued Social Security numbers and addresses from tax filings.  In fact you can get at this right now (for yourself) via http://ssa.gov.  CMS also already has an electronic interface system for all medical providers who are registered in order to submit Medicare or Medicaid billing; ergo, the infrastructure is already in place along with access credentials.  Medical providers who wish to avail themselves of the ability to bill Treasury for indigent patients would have to register, but the number of providers currently not registered is a tiny minority of the whole.

  • CMS begins publication of Medicare reimbursement rates for all procedures, drugs and devices.  CMS already has developed and maintains this information so this is simply a publication of existing data and can be done very quickly.  The list may be updated annually as is now the case however with Medicare being a reimbursement source but not a direct billing source as of 1/1/2019 fair notice to all non-Advantage Medicare recipients so they can start shopping providers and services is necessary. (Medicare Advantage customers will have this data from the Medicare Advantage company they select and it may well be different between different Medicare Advantage providers.)

  • Providers must put together their price lists.  They have three months to do so; failure to have and post one as of 1/1/2018 means you're closed!

On 1/1/2018:

  • Providers must post their prices and on demand honor them, along with affirmative consent requirements.  A customer may present him or herself on January 1st 2018 and request the published price.  If they do so then binding, fixed-price treatment per the price schedule and treatment consent rules in the bill must be honored.  Note that all such binding prices must include any consequential events or complications (e.g. those caused by the treatment or the facility in question.)

  • No event caused by a provider or treatment may be billed to the customer.  Alignment of the customer's interest in NOT having an MRSA infection, for example, with the provider's interest in reducing their cost must take place on an expedited basis.

  • "Most favored" nation pricing for drugs begins.  No exceptions, no apologies.  Drug prices drop like a stone.

  • Open testing begins.  If you wish to purchase a test or other diagnostic without invasive exposure beyond a blood draw and not bearing radiation or similar exposure, you may -- for cash and without a prescription or doctor's order.  Since all medical providers must have posted prices on 1/1/2018 you have a list of prices available to you and places to shop from.

  • Auxiliary services must be open.  You can buy said test wherever you want and bring the results to your doctor for consultation or treatment, without limitation.

  • A 365 day period begins during which medical providers may continue to maintain records and coding, but they must also provide human-readable records at the point of service to the consumer.  Since there is basically no medical office in the nation that doesn't have PCs or similar this is trivially done; 3 months is more than enough time to put in place the policy to provide records at the time of treatment to the consumer.

  • CMS and Treasury continue their tax processing and billing integration work with a start date of 365 days hence, or 1/1/2019.  This will be necessary to deal with EMTALA repeal and related from the bill.

  • A 180 day notification period begins during which lifestyle modification is mandatory for those with existing conditions on public medical assistance in order to receive Treasury Billing (and potential medical debt forgiveness at death due to their indigence.)  This specifically applies to Type II diabetes suffers on publicly-funded health programs, although the list of conditions will likely expand.  Those who claim that cessation of eating carbs and PUFAs are not sufficient to bring their blood glucose either under control or materially improve their condition may challenge the individual applicability to them during this time, and must prove same via isolation test (which will likely take less than 48 hours!) with them bearing the cost of the testing in cash if they lose.  Since nearly all of these people either have or should have home instrumentation (e.g. a blood glucose meter), and those who don't can certainly buy one for a few dollars at any drug store including such outlets as WalMart over the counter, they ought to have damn good evidence before attempting to claim an exemption.  These people will also know in advance, or easily be able to determine, if they're going to get caught if they try claiming an exemption and are lying.

  • A 180 day period begins during which Health Insurance companies are required to put together true insurance offerings as required under the Bill to continue selling any health-related policy with effect beyond 12/31/2018.  Since state regulators typically require some notice period (usually six months) this means they must submit same by 6/30/2018.

On 7/1/2018:

  • Medicare and Medicaid recipients with diabetes who have not made the lifestyle adjustments required are cut off from further government funded or transferred billing for their condition until and unless they make the required lifestyle change for at least six months.  They had six months warning and ability.  For the last six months of 2018 the Federal Government, during the remainder of the transition, will see approximately $200 billion in reduced spending. 20% of the adults in the United States have had their pants fall off.

  • Health insurance companies must have posted to the states their catastrophic plan pricing and coverage, along with whatever other offerings they wish to make for the 2019 calendar year.

  • All providers who intend to bill indigent customers must be registered with CMS to provide CMS with sufficient time to process any pending applications and resolve questions prior to 1/1/2019.

On 1/1/2019:

  • Level pricing and quote-before-service (and the procedures for exigent circumstances) for all customers is mandatory.

  • Centralized medical record and coding requirements end and all customers must receive their medical records at the point of service.  The AMA's monopoly on coding revenue (which, IMHO, should have resulted in them being indicted years ago) ends.

  • EMTALA repeal is effective; illegal immigrants no longer can access emergency services at the public's expense.

  • Medicaid repeal is effective at both State and Federal levels; all Medicaid spending ends.

  • Medicare Part "B" repeal is effective.  For "HMO" or "PPO" style coverage post this date Seniors can buy Medicare Advantage policies as they do now but they are not compelled to do so (as they are now.)

  • PPACA repeal is effective; all Obamacare policies, taxes and tax credits end.

  • US Code and CFR amendments to remove the PPACA, Medicaid, and Medicare Part "B" components become effective.

  • Lifestyle requirements continue.  Again, this specifically applies to Type II diabetes where a zero-cost lifestyle change simply comprised of what one eats is sufficient to reduce or eliminate drug and procedure requirements along with the degenerative effects of the condition.

  • All citizens or permanent residents who assert inability to pay a provider now have their bills submitted to Treasury for payment within 30 days.  The customer can choose any provider but the price charged must be level as for anyone else.  Providers who have more than 50% of their customers submitting invoices to Treasury on an annual dollar-billed basis are subject to audit for charges being reasonable and non-collusive (see below.)  The 60 day "no fault cure" policy begins for those who have bills submitted to Treasury due to a claim of inability to pay and tax liens begin to accrue on March 3rd, 2019.

  • For those on Medicare CMS continues to provide the payment rates it will cover to the public for Parts A and D but the customer must submit claim for payment and is responsible for the difference should the price charged be higher than the reimbursement amount.  Medicare customers thus now have an incentive to shop and no restriction on which provider they use for services.  For Medicare customers not using an "Advantage" plan Medicare Part "B" ends both as to the premium collected and benefit disbursed since Part "B" has been deleted.  For Seniors who find themselves unable to afford the portion of payment they must make even with Medicare's typical 80/20 split due to indigence they may assert that indigence just as can a former Medicaid customer and as such low-income Seniors are protected to a much greater extent than is currently the case with Medicare since they enjoy 100% access to all medical providers -- a huge increase in choice compared to today and they have access to the same billing deferral via Treasury that former Medicaid consumers have.

  • For former Medicaid consumers they may assert indigence and thus may access any medical provider as may anyone else who can pay cash.  This is a massive improvement in their access to health services over today as many providers today refuse Medicaid patients (other than via the ER!), but it comes with a tax lien that, should their economic circumstances improve in the future or should they have refundable tax credits, they will be expected to pay.  As a result former Medicaid recipients will, for the first time, have an incentive to both shop and consume medical services wisely.  Many former Medicaid consumers will choose to pay cash, especially for drugs, since a large variety of drugs will be available at monthly costs similar to that of a cup of coffee from McDonalds, but for services where they cannot afford to pay directly the safety net will be available via the Treasury.

  • Private and corporate-funded catastrophic plans, along with any new "PPO" type plans, take effect.  
    With price transparency and no billing obfuscation or "hiding" insurance costs drop like a stone.  Typical "catastrophic" coverage will be available for a few hundred dollars a year.

  • Direct and hidden billing of insurance companies of all sorts, along with "explanation of benefits" nonsense and the implied extortion attendant with same ends.  The customer is billed at a level price as with all other customers for the same good or service; whatever insurance they may have, whether it covers the service(s) provided and how much it will cover is between only the customer and the insurance company.  Collusive behavior, hidden pricing, performance of procedures without prior consent (except in exigent circumstance) and price-fixing disappears entirely.

  • For the first time in 30 years real competition breaks out in the medical field -- not just on price but also on quality of service.  With cost and outcomes exposed customers will be able to research and choose just as they choose a cellphone or automobile today.
  • Non-citizens/non-green-card holders have no right to treatment of any sort nor does any provider have liability for refusal to provide it without payment.  Non-citizens and non-green-card holders (visitors, illegal immigrants, etc) may purchase services and products for cash should they be willing and able to do so.

  • State CON laws and similar are all pre-empted.

  • Mandatory enforcement of 15 USC and the civil rights of action for individual consumers against medical providers for price-fixing, collusion and similar offenses begins.  Note that providers who collude or attempt to defraud Treasury and allegedly low-income customers claiming indigence (who really aren't) are subject to mandatory prosecution and punishment under the Bill.

And.... it's done.

The medical scam has ended.

There are no more Federal Deficits; in fact, we run a perpetual budget surplus and begin paying down the national debt.

Your standard of living starts going up every year even without a raise by about 1% each and every year instead of going down as it does today.

We no longer pay for illegal immigrant medical care at all from public funds.

You get a price that is the same as everyone else for the same good or service in the medical field just as you do at the grocery store, the gas station and the local restaurant.  The outrageous price discrimination (sometimes as much as 10, 20 or even 100x or more) served up on some people -- discrimination that usually bankrupts the consumer in question -- ends permanently.

You know exactly how much you will be billed for a medical procedure, drug or device before you choose to undergo that procedure or accept the treatment.  Your insurance company, if you have one, will have to make available what they will pay and the hospital, doctor or pharmacist must tell you what they will charge.  You will thus know what the total cost to you will be -- before you sign a consent form or have a procedure done.

If you get an infection from a hospital you cannot be billed for the drugs and time to treat that which they gave you due to their incompetence.  That risk and cost is finally on them, which will drive innovation and greater care to prevent such infections that harm and even kill Americans today.

If you can't pay you will still be treated and can still choose your doctor, but you will be responsible to cover the (much more-reasonable) bill if you become able to pay it in the future.  This will permanently put an end to the practice of poor people using the ER like a doctor's office since this sort of abuse will no longer be advantageous compared against going to a regular physician.

Drug prices fall in the United States by at least half (and more likely by 80% or more on an average basis) and for those with chronic diseases that have been sucking down drugs and procedures while refusing to make simple, zero-cost lifestyle changes they finally have a strong incentive to both do so and have their health improve materially at the same time.

There will be no more $300,000 snake bites, $150,000 scorpion stings and $1,000-per-stitch fees that get lumped on you without any way to prevent them when something bad and random happens.  Any medical provider who tries it will find their bill void and they will be prosecuted for fraud.

Obesity and diabetes incidence falls dramatically since it is now strongly in everyone's best interest to practice simple changes in their lifestyle.  An epidemic has broken out -- of people having their pants fall off.  It's a good epidemic and America is noted and lauded as being the first nation to have reversed the increasing rate of obesity and Type II diabetes.

The nation becomes far more productive as the cost of employing someone drops by a solid 15% and America becomes the place to put a multi-national business.  In short labor expense drops tremendously and productivity soars.

If you're not a currently-overpaid administrator you get a raise; for a typical median family it will be about 10% immediately as your employer's cost of having you on staff will drop by at least that amount.  For the average family of four you will see, net of your medical expenses, roughly $7,000 richer in cash spending power after tax each and every year.

Those who are currently-overpaid administrators in health care will find jobs in other sectors.  It may take a while but it will happen, as the economy comes roaring back with the newfound efficiency and productivity improvement from deleting the fraud currently consuming almost one dollar in five.

State and local pensions and budgets stabilize and, over time, taxes come down at the state and local level as the levies put in place to try to stay ahead of the pension destruction are no longer necessary.  Specifically, property taxes decrease materially which will cause both the cost of owning a house and rents to decline.

Your car insurance gets cheaper as your liability policy, much of which covers medical expenses coming from accidents where you are at fault, along with uninsured motorist coverage, will decrease dramatically in cost.

Federal Spending will contract to something similar to this -- and I note that this chart presents a pessimistic estimate. We would almost-certainly do better than what is depicted here and, I remind you, both Seniors and indigent citizens would receive better care and more choice than they have now.

And we prevent this -- our federal debt -- from blowing up in our face as the CBO currently predicts -- an event that, if it occurs, will destroy the nation just a few years from now.

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