>>I wish you could spend some time with the seniors here whose medicare premiums are deducted from their social security income. For some, that is their only means of support. Any increase in premiums would be devastating to them.

Which is why it doesn't occur. I get it. But it also means the cost is foist on some future sucker. Sorry but it's not fair to focus exclusively on the plight of the elderly. It's not the fault of the young woman with a big student loan that oldsters failed to pay enough early enough to cover their predictable future costs of care and now can't afford to balance the books on the services they want to consume. Why is it fair or noble to keep loading straws onto the young camel's back?

>>I'm amazed that you focus on the revenue side of the issue, while the expense side is running away with all the cash.
Any CFO of a serious company who took that position wouldn't last 5 minutes.

So you completely missed my commentary about cost of care and outcomes? Easy for both of us to poke fingers from our comfortable chairs: not so easy to figure out what to do with it. My "take" is that because that dreadful ACA capped health insurer % profits, increasing the cost of care increases premiums and therefore $ profit. If you're allowed a 20% profit, doubling the cost and premiums also doubles your allowed $ profit and shareholders celebrate. Where is the victim: to them there isn't one. Unfortunately there are numerous perverse incentives for rising cost in the US and the beneficiaries are past masters at directing attention onto nits like physican and CEO revenue rather than the deafening slurping and gulping in various other quarters.