“But that's incredibly unlikely to happen under our political system.”

🤔

Yep. Our system makes it hard to impose large costs on a smaller group of people in order to support smaller benefits for a larger group of people.

In this analysis, you have to slash compensation to most of the health care sector in order to get even a partial reduction in health care spending. The trillion dollars in savings almost entirely consists of paying the health care sector about a trillion dollars less money for the same amount of services.

The people who work in the health care sector, about 10% of workers, will be very upset by that. The people who don't live in the health care sector who will see their medical expenses reduced (but by less than the health care workers have their incomes reduced) will be less pleased by that than the health care workers are upset by it. The health care workers will organize and push back against the reductions in their compensation rates - through not just PAC's and lobbying groups, but also through unions. Our political system magnifies intensity of opinion about public issues. The political dynamic will be difficult for elected officials to resist, just as they have were consistently unable to resist health care provider lobbying for the "doc fix" bills.