Universal HealthcareBy NextBestFit
Phase 1: Enactment & build · Step 1.11

Rewrite insurance & benefits law

Effective in stages with each enrollment wave · Congress; DOL EBSA; Treasury; state insurance commissionersDiscuss this step
marketlikelihood: mediumimpact: medium

Cash-only concierge tier grows

Opted-out physicians serve the wealthy for cash, recreating two tiers and draining capacity.

Early warning signs
  • Opt-out rates by region and specialty
Mitigation
  • All-or-nothing opt-out
  • Duplicative insurance ban (cash only, no insurance)
  • Rates competitive with cash practice

Implementation risks

RiskMitigation
Courts strike the duplicative-coverage ban.Severability clause; the wait-time guarantee is the strongest legal defense, since Chaoulli hinged on unreasonable waits.