There's a basic problem with these programs, the employee and employer each contribute 1.45% of their salary, up to about $106,000 of said salary. So if the average salary is about $60,000 then the combined average contribution per year is about $1,700. Not very much money compared to medical costs. One solution by politicians is to squeeze the medical community via reductions in payments for services. So if you are a doctor, you either decide to accept payments at a loss, or you stop accepting mediXXXX patients. It's a huge problem.
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