I think the monopoly you are referring to is a single payer system which has always been the non stated vision. These are the incremental steps to get there.
It couldn’t be done in a single swipe back in 2009 but everyone knew that this would be the natural progression.
For all the engineers who think they are safe with the plans that their big corporate giants provide for them, in the long run it will be more profitable for these employers to opt out as well and turn all the employees over to the system.
Again, if you simply follow the path to highest returns for either the corporate entity or the healthy individual, dumping people into the system is the best alternative. In the long run the only alternative will be to have substantially higher penalties for those who do not opt in and for corporations or the system will break. Even without breaking, the system meanwhile will swell with millions of people each year (including those with fresh citizenship) and overall quality will diminish.
It is very simple, at some point the sheer numbers do not get supported given cost parameters, and the number of those contributing. The result is a ever lower bar that is the common denominator.
