Anthony DiGiorgio, DO, MHA

$300 billion for Iran, but student loan forgiveness is absolutely impossible

1. It’s not about “needed care won’t be denied “. It’s about implementing the MOST COMPLICATED OPERATIONAL TRANSITION in the history of the world. Moving from the mixed system we have today to a system that is run by the feds is a lot harder than implementing high speed rail. Who does it ? How do they do it. What’s the actual plan ? Anyone who thinks the transition can happen in two years is an idiot. Truly. This will be so complicated, if it’s done in ten years, with only a few dozen patients getting lost in the system and dying , it would be a miracle. Companies have a hard time restructuring in two years. You are asking thousands of hospitals, thousands more clinics, practices , and doctors to restructure how they do business. You are asking EVERY BUSINESS IN THIS COUNTRY , to restructure how they do benefits. It’s easy to say they won’t have to do anything. BUT LET ME GIVE YOU AN ABSOLUTE FACT. BIG COMPANIES WONT CHANGE THEIR BENEFITS PLANS TO SAVE THEMSELVES TENS OF MILLIONS OF DOLLARS OR MORE, because dealing with care navigation can be difficult. Where in that legislation is there a transition plan for patients to move from the care they are getting today to what is available via your legislation ? Do you really think those hospitals getting paid a premium to do things that only our hospitals can do are just going to accept a fraction of the amount for patients they already have ? Where is your plan for these patients ? Who helps them when companies disband their benefits people and their TPA/Care Navigation people are fired because the Feds are now in charge ? 2. CBO Projections are ALWAYS WRONG. It is literally impossible to get the projections right. What happens if they are off by tens or hundreds of billions of dollars ? 3. How many years of litigation do you think there will be ? Have you noticed the shifts in our courts and the reality you face there ? Then of course there are the political realities. Now and in the uncertain future. Legislation is not a plan. Implementation is not easy. Leadership for anything like this is hard to hire. There are so many challenges that no one in your party even begins to address There is a path to universal care. But as I have posted,IMO, it starts with either Breaking Up the Big Medicine bill and/or working with the largest employers and providers to eliminate the friction and cost of all the middlemen involved.

Grady Hospital almost shut down. Flat broke. Then a new CEO walked in and said: "Wait a minute — look at all this stuff we're not billing for." They started billing aggressively. Pursued philanthropy. Built a stroke center. Grady became profitable. Dr. Sanjay Dhall on what operational discipline can actually fix.

Sanders plan would mean: ✅ No hospital A deductible. Zero ✅ No Part B deductible for doctor visits. ✅ Expanded dental, vision, hearing ✅ No co-pays ✅ No Medicare Advantage upcoding, ripping off taxpayers.