If ACA mandates are upheld, we won't get Medicare-for-All and better health care for a generation.

[TheKentuckian]

75. I already said the option is to let it crash sooner rather than later.

The short term profits for the cartel are beside the point, I'm talking systemic costs. No amount of short term profits will change the dynamics. Did you just post a random response appropriate to the broad subject?

The profits are not sustainable, the resources aren't there and are diminishing. There is no question that an environment that allows the full avarice of the cartel but does not compel people to take coverage and does not subsidize them will collapse it faster. They will price the population out in short order. The many have too little and it dwindles for the game to work. You are thinking in terms of the perpetual motion machine and seem to be caught up in the narrow focus of the cartel's profits within those terms, which is essentially magic.

The pie is only so large, if one person eats too much there isn't enough to go around. The MIC needs theirs, the banks need theirs, there is a massive security complex that needs theirs, people demand housing and that is profitable, people eat and that makes money, people buy consumer goods, the coal barons need you to have lights on, the frackers need you to turn on the furnace, big oil needs folks driving cars, and it goes on and on.

The economic system cannot tolerate the cancerous growth, it plays havoc with the government deficit due to healthcare commitments, and the big shadow of individual affordability means people will self select out which will raise costs for the fortunate and desperate that remain which in turn repeats the cycle. Cascade failure becomes unavoidable.

Make it real simple and personal, how long till you are priced out? It starts getting clearer once you understand that you have a breaking point. Then all you have to do is get a handle on what percentage of the population prices out quicker and how many price out when you do. Unless you are fairly fortunate or would be homeless before you would drop coverage you will see a pool in a sure death cycle, probably one dead as fried chicken.

Once you can grasp that then you can start accounting for other variables. You'll see the percentage of the economy already occupied by this area and the rate of inflation and it will be scary projected over a fairly short span of time.
The money isn't there for them to suck in for any length of time.

As for the vaunted MLR, even if it works perfectly it is a stupid plan to manage the purse holder. The cartel sets the allowable charges. If the MLR actually worked and was strictly adhered to the cartel only needs to allow more of what they are billed and in response to increased allowables providers raise charges.
There is a fair amount of play between what is allowed and charged anyway.

An MLR type device for providers would be a cost container, one on the gatekeeper is asking for higher systemic costs.