Well said. I actually took as a given that this system will disintegrate very soon. It was unraveling even in the best of times but the current economic conditions have set it up for the final collapse. I was thinking more about the difficult task of deciding what will take its place.

I'd wager that the only people left who don't think that the entire path that money takes between patients and doctors needs to be demolished and started over from scratch are lobbyists.

At this point, the parasites have more or less killed the host. If, in the unlikely event that we Americans make no real progress on this in the next couple of years, projecting out to 2043 and talking about sustainability is entirely moot. We'll have gone banana republic long before it matters.

Edit: Perhaps I over-emphasized the end-of-life part. Got it on the brain a lot these days. The perceived unfairness will permeate the entire system. Just put the Noble laureate and the truck driver in an accident with only enough resources to save one. Who will decide, and how. If they have the power to choose the scientist, they have the power to choose their roommates cousins nephew or a big campaign donor.

Government rationing seems like the best choice. It still sucks. Bummer.