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"cost controls the paper appears to advocate for literally mean someone is making less money"

Reference Table S1.

Cost controls would account for ~14.5% of the total savings.

Hardly seems onerous. Medicare's medical loss ratio is approx 4% (?), whereas ACA caps private insurers at 15%. So clearly there's plenty of fat to be trimmed.

TL;DR: Single payer is cheaper, people live longer. Transition will be painful.




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