I'm pointing out that the obstacles to making such a switch are not merely what The Powers That Be want, but also (and I think primarily) just basic political reluctance to inflict significant economic damage on large numbers of ordinary voters. I'm diagnosing, not advocating.

As I said, we seem to be at an impasse. In the Shinyland of today, how do the clerks, that populate the administrative overhead, have agency to guarantee their employment, as they are outnumbered more than 10 to 1, by the people paying high prices, because of the administrative costs? Proles, in general, have no agency in Shinyland today. Everything is run for the benefit of the "JCs". You reject the impact of "JC" money in the system, out of hand.

Another bit from the net sifter: Notice that, while the money skews a bit in one direction, plenty goes to the other side if the aisle. Recall, during the "shutdown", I was asking if Schumer's stand was for the benefit of the patients, or for the benefit of the insurance companies that might lose customers.

The health insurance industry donates tens of millions annually to U.S. politicians, with figures varying by election cycle, but recent data shows about$10-12 million from Insurance PACs to candidates in the 2023-2024 cycle alone, plus substantial lobbying spending, indicating significant influence through campaign contributions and lobbying, often favoring Republicans.

$10M divided 536 ways isn't that much. But concentrate that money in the hands of a few key people: House and Senate committee chairs, and the POTUS, and it starts to get traction.

Steve