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I'll be curious what @SimpleStacker thinks, but that's a bleak trajectory.

I think we live under a biomedical tyranny

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If I'm correctly interpreting the "Professional Services" dominating Virginia employment, that's even worse than the medical takeover everywhere else.

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Professional Services is the most likely sector to contain non value adding "growth"

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Health care spending subsidized by Medicaid and Medicare and Obama care

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Obamacare seems like a symptom of already failing society-wide health.

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Obama care doubled down and exacerbated all the problems with the previous status quo

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I agree, it made everything worse, but the fundamental problem was already deeply embedded.

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The biggest problem now is every thing is ludicrously expensive

One big change was "essential health benefits" that eliminated 'cheap' catastrophic options

At least before 2013, when Obama care took effect, the health care system was barely functioning. Today it is completely dysfunctional.

I think that was the plan