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It doesn't claim to "pool risk" and then discriminate between the healthy and the chronically ill to minimize the risk that the insurance company will actually have to pay any bills, a method of cheating the sick out of receiving necessary care followed by insurance companies. It doesn't collect premiums and then invest them, in the hopes that the investments will not only cover the costs that the insurer can't possibly avoid, due to some error in writing the contracts, but also provide a tidy profit that management can boast about on Wall St. and reward to its CEO.
It just collects tax money and pays bills. I expect that there would be a fraud unit, to make sure that doctors, hospitals and such were not ripping off the taxpayers, and that criminally negligent or incompetent doctors were forever banned from the system for treating the ill. Perhaps there could be some negotiation on pricing, although the government has been abusive about that.
The only way that single payer government health care works is by the massive reduction in paperwork and paper pushers, the massive investment in citizens' timely health care, and the removal of the profit motive. It removes the incentive to cut corners, steal, cook the books, etc. It takes the American business manager out of the medicine business.
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