Medicare for All Isn’t Happening (Soon)


I hate to have to start this way today after
the Thanksgiving holiday. But if you’re watching on YouTube at least
wait, please don’t hit [inaudible] the dislike button just yet. Consider watching this video first. Before you do that. I am here to talk about the unfortunate reality
that a national Medicare for all is not happening anytime soon. And I’ll explain why and I’m not here as an
opponent of Medicare for all. I’m not someone who wants it to fail. I’m an advocate of Medicare for all, but I’m
also an advocate of being realistic with you if we want to make things happen. And the reality is that without me attacking
Medicare for all, without me attacking the concept of Medicare for all, I recognize that
national Medicare for all isn’t happening anytime soon. I’m not here to say we should advocate for
centrist policies that are more realistic, that we should advocate for the policies we
think are the right ones. And the right progressive policy is Medicare
for all. But I’m not here to tell you unrealistic things. Like if Bernie gets elected, we’ll have Medicare
for all in four years. We won’t. And I’ll explain why in a second. Our politicians do enough of the unrealistic
stuff. I’m here to discuss the realities and I’m
here to tell you today that because national Medicare for all simply isn’t happening anytime
soon, even if the next president supports it. We need to be smart, so let’s go through this
piece by piece and once we’re done, rather than, you know, calling me a shill or whatever,
tell me where you think I’m wrong on the reasoning because that’s really what this is about. It’s about talking about the facts and reality. Number one, I’ve already talked about some
of the areas of concern around Medicare for all plans, but that’s not really what this
segment is about. Yes. I’ve talked before about how most of the plans
for how to pay for Medicare for all are unrealistically optimistic about how much healthcare spending
per person will go down. If we switch to Medicare for all. In reality, it could take 10 or even 20 years
to see those costs reductions. I’ve talked about that before. That’s not what I’m talking about today. There are political considerations. Even if Democrats take the Senate in 2020
which would be by the slimmest of margins as I’ve outlined for you before, it’s not
going to be enough to pass Medicare for all because number one, even if Democrats do take
the Senate by a few seats in 2020 you need 60 votes in order to pass something like Medicare
for all which Democrats are not going to have after this upcoming election, and not all
Democrats even support Medicare for all in the Senate. You can then look at 2022 but then if you’re
only starting the conversation again, you still need 60 votes in the Senate to pass
this. It’s a question Mark whether Democrats could
even get a 60 vote majority in 2022 and of course the alternative would be get rid of
that 60 vote requirement. You can do that with a one seat majority,
but even Bernie Sanders has hesitated to say we should get rid of that a 60 vote requirement
because it could massively backfire if Republicans take control again when Republicans take control
again. So that’s a serious political obstacle. It doesn’t matter whether Bernie’s president
or Warren’s president or whoever, it’s just a real obstacle and then imagine that you
solve that problem. You have some bigger issues to deal with. We have a conservative Supreme court. We are going to have a conservative Supreme
court for some time. Why does that matter? When we talk about Medicare for all two different
reasons, number one, if you don’t make private insurance illegal as some want to do, it significantly
hurts the financial viability of Medicare for all. Making private insurance illegal would be
almost impossible under the current Supreme court or any Supreme court that’s like it. It will be fought endlessly by moneyed interests
up to the Supreme court. This is not a Supreme court that will say
private insurance is now illegal. It’s just not going to happen and that is
something that will hurt the financial viability of Medicare for all and realistically will
make it not happen politically. Issue number two, you aren’t going to be able
to force doctors to accept Medicare for all. Many doctors will choose to accept private
insurance because again, it’s not going to be illegal and you will see more of a move
to what’s called self pay. We already see self pay more and more in the
mental health field. We see it in dentistry because dental insurance
is terrible in the United States. We could spend much longer on this Supreme
Supreme court issue, but again there is no way that a Supreme court that is even remotely
like the one we have right now would rule. Doctors have to accept Medicare for all. That will be a major problem for the financial
viability of Medicare for all, but it won’t even get to that because it is not going to
be something that you will get 60 votes in the Senate for under these parameters. So what I want to talk about is not that I
think Medicare for all is bad. I think it’s good. I like it. I do see it as a drastic and maybe the best
improvement over the system that we have. I don’t want to suggest to you that it doesn’t
matter if a candidate supports Medicare for all it does. We should. We should support candidates who see Medicare
for all as the gold standard and who see it as the goal, but you and I have to be realistic
that it’s not happening anytime soon. So before we even talk about candidates, let’s
talk about what could happen. Number one, it’s important to get some wins
that demonstrate that conceptually Medicare for all or something. It would work. These include, and this, this is so lame. I’m almost like going to throw up in my mouth
a little, a little bit saying it. We need to support some version of a public
option as an eventual point that we get to. I said during Obamacare, Barack Obama should’ve
started the negotiation for Medicare for all so that at minimum we end up with a strong
public option. We didn’t. He started with the public option and we ended
up with just a massive handout of tens of millions of new customers to for-profit insurance
companies. I know it’s so lame and milk toast to talk
about a public option. And as I said before, all the public option
will do is estimate, say it’ll reduce the cost of private insurance by seven to 9% because
of its impact on the market. But if we end up with the best possible version
of a public option, ideally it will work well because it will be properly set up and funded. We can then point to it and say, look, that
was an improvement. Let’s keep going to the next step. That’s number one. But that’s not all. Number two, it might be possible to make a
change to the Medicare eligibility age, which won’t totally rock the boat. Like for example, lowering the age to 60 or
maybe to 58. This is actually step one in some people’s
plans for Medicare, for all Elizabeth Warren for example, it talks about let’s lower the
age eligibility, the eligibility age, better said in steps and uh, that might actually
be a viable first step. There would probably have to be some kind
of trade though because again, even many Democrats in the Senate don’t support Medicare for all. That’s not going to change in 2020 and it’s
unlikely to change in 2022 third and this is to me the most exciting. What about state single-payer? Vermont wanted to do this, but it ended up
failing for a variety of reasons that we could explore in a different segment. If Medicare for all succeeds at the state
level, a serious conversation about national Medicare for all would hopefully be able to
start Obamacare mirrored years later. In many ways, the Romney care system that
started here in Massachusetts, it falls way short of being what we want, but the point
is state level success can actually push nationally implementing some of these policies. So please don’t kill the messenger. This is not me attacking Medicare for all. I like Medicare for all. I want Medicare for all this is the reality. So that doesn’t mean that we now say, Hey,
you know what? If either way, the best we can get as a public
option or low lowering the eligibility age for Medicare a few years, you might as well
vote for Joe Biden. No, that’s not what I’m saying at all. What I am saying is that there are a lot of
people out there and they’re emailing me regularly who seem to be making arguments and decisions
based on the idea that if Bernie wins, we get Medicare for all in four years. That if Warren wins for the people that believe
she’s for Medicare for all, and she does seem to be, um, uh, then we get it within four
years. We just don’t, and I’m not being defeatist. Let’s strategize around what we can do. Let’s make it happen. And if you disagree with me, tell me where
I’m wrong on the facts. Not that I’m a shill or whatever. I want Medicare for all, but I need to be realistic about how we
get there.

Maurice Vega

100 Responses

  1. Great segment, David & crew! The angry comments on here are not even paying attention to what you say in the video. I say this with all love, but come on people! Your comments show your lack of understanding and comprehension of a very simple worry that David lays out. Get real and get serious or things will never change. Loved the video, sad about the horribly disappointing lack of reasoning in most of the comments. It makes me wonder how many of you are actually good faith viewers of the show.

  2. Hi David, I appreciate you bring up this conversation. I think you're wrong because, in your reasoning, you let some parts change over time, while you ignore (likely) massive shifts in public discourse, political discourse, and reelection in case of a Bernie/Warren presidency. In short, I believe you're overestimating the importance of the current MC4A standpoints of senators and representatives, while underestimating the shift in public discourse if a progressive were to win the White House. With a real progressive becoming president, a lot of political playbooks will have to be rewritten. Currently, for many congressmen, MC4A is just one of many progressive policy issues that they don't really have to think about as long as (1) their party leadership and the White House don't push it and/or (2) there is no threat of losing reelection. This will likely change in case of a Sanders presidency (maybe also Warren).

    In case of a Bernie/Warren presidency, many progressive policies will be heavily criticized by corporate politicians and even some mainstream media. But at the same time, senators and representatives will really have to deal with the fact that MC4A is simply polling quite high — and that the current president (i.e. Sanders, Warren) got there because of this massively popular policy proposal. Some of them will notice that reelection is going to be an uphill battle if they don't start supporting it, for good reason. This is true exactly for the (senate) seats that will have to move in order for MC4A to pass, namely the corporate Dems and even Republicans in purple states, especially the ones that'll be up for 2022: Arizona, Florida, Pennsylvania, maybe Maine, Wisconsin etc. Related to that, Bernie has said he'll continue to use his grassroots as engines for public support for MC4A. Of course, one doesn't know how succesful that is going to be. But if there's going to be one policy issue for which a mass mobilization of the public is possible, it's this one. I'm thinking about rallies in exactly the purple states or corporate Dems areas.

  3. These comments and dislikes just go to show the short attention span and eye candy based audience you've grown. Probably 90% of the dislikes and negative comments are from folks who just saw the thumbnail and didn't even watch the video. You make it VERY clear that you are FOR medicare for all, and that it is the correct progressive policy, yet you are setting realistic expectations. I guess people don't like to hear the truth.

  4. The pathway to making M4All happen is if Bernie calls for a general strike. If you give up like Pakman has then it definitely won't .

  5. TLDR- Be honest about the obstacles, but show some spine. Every major advancement that this country has made was equally difficult. Opportunities to win will present themselves, but energy needs to be maintained for when those opportunities arise. That energy won't be maintained if you convey the daunting challenge without inspiring people to fight for what's right. Commentators like you need to keep people energized. Don't just dispirit people. Embolden them

  6. Yang is the answer to every one of your points. Pass UBI, and whatever the administration proposes will have huge leeway quickly to pass the next agenda. Pass democracy dollars, then game over. 🤷‍♂️. Yet, you’ve been shilling for Warren and created a community of haters, and sleep on the bed you made. 🤷‍♂️ And please get off the Warren train, she’s tanking in polls. People have wised up.

  7. When Obama came into office, single-payer wasn’t even on the table. His campaign had already had discussions with the insurance industry about what they would allow to be passed. No single-payer supporters were even allowed to testify at the Obama Care hearings. Some were even forcibly removed from the hearings.

    When Sanders began his campaign for the 2016 election he was ridiculed for his crazy ideas like healthcare for everyone. Now it has overwhelming popular support.

    If Sanders wins the primary, he will raise money and fight to get a progressive Congress elected in the 2020 election and in the midterms — something Obama didn't do.

    I don’t know what your game is, but it sure as hell isn’t getting us an efficient, effective, less expensive, healthcare system that covers everyone.

  8. bernie has said fives times by now that he would attempt to push it through reconcilliation.
    it will most likely fail because it would require 50 dem senators to vote for it (+VP as tie breaker).
    but at least it will be a teachable moment for the american public.
    we get to take names.

  9. M4A can require that doctors accept medicare reimbursement or have their licenses revoked.
    it's not complicated – it's called governing

  10. Stands to reason, not surprised, and have been thinking along these lines for a very long time. It just makes total sense. The dream is that it will happen quickly, and that gives us hope, BUT it is not realistic. So hope that will not be the truth in the end, but be prepared for it to run true to form. Sad, but most likely true.

  11. This new beta defeatist mentality you developed is why Dems always lose..

    Who gives a shit if Bernie lowers the vote from 60. "but the Republicans will do it" Pakman the Republicans will do it with or without Dems consent…

    If you wana avoid GOP takeover, GROW SOME BALLZ and push for policy even against all odds! That's how you win and keep republicans out of office David.

  12. Well Bernie has said every Democrat that is not for Medicare for all he will personally campaign in there state to get them kicked out of office and Medicare for all is so popular(60-70%) in some polls so Republicans are going to have to explain to their constituents why they are for the cooperation and not them, listen nobody said it's gonna be easy but for Medicare for all we need to be optimistic about the fight to come if burned becomes president

  13. We need people to unapologetically appeal to the morality of this issue. People are dying in war like amounts. I don't disagree about the uphill struggle we face but videos like this one do NOTHING to help the cause we are meant to fight tooth and nail for.

    Edit: I just watched your upload from today and again, while I agree with your stance 100% I am left still questioning the usefulness of this particular video before Sanders is even remotely elected. When have you ever heard a single Sanders supporter claim how "easy" this is going to be? Most of us know the practical reality without your paternalistic speech at this juncture. Your headline was click batey yet you don't even seem to acknowledge that reality. I like you as a person David and I believe you are genuine and are always coming from a place of good faith but that does not negate how regressive I feel this video is at this time.

  14. i disagree with the negociation strategy. If you are aiming at a Universal system, negociating a "midway" option is demobilizing and unconvincing. Would Bernie and other supportrers have to start saying healthcare is "half a right" or that we are all half human? In most places where it has been implemented, it has been done in one go (as far as i know) and there has not been much added to the original coverage. For exemple, dental and optometrists are still not covered in Canada.

  15. pathetic video really. david is giving up without a fight. hes completely scared by the optics. im actually really disappointed. compared davids video to this one, then drop kyle a like and davids a dislike. i like him overall, but david is seriously pussing out way way way way way to early here. "if we dont get medicare for all, it will be because of democratic weakness" -kyle
    https://www.youtube.com/watch?v=xN8pRMQP3ko

  16. Do any of the MFA plans plan to force doctors to take MFA? I didn't think they did. It would be silly for most doctors not to take it, but if you're a Dr. Strange level neurosurgeon or similar than simply taking cash would make sense.

  17. If the Rs actually get Ocare repealed, root and branch (as they are trying to do with lawsuits), then we may get a nice uprising for Medicare For All

  18. Go get a job at MSNBC already dude.

    Your smug arrogance and inability to understand the perspective of the working class are glaring and you're beginning to look like a bigger grifter than Jimmy Dore.

  19. HI GUYS LETS SIDE WITH THE MODERATES AND THE CENTRISTS ABOUT "PRAGMATISM", WITH KNOWN LIARS LIKE BUTTIGIEG, KLOBUCHAR, BIDEN, ETC ETC, BY THE WAY DONT MIND ALL THE MONEY WE ARE MAKING!!!

  20. You are a lying fucking scumbag david pakman. Wow, you pretend to be informed knowing how Bernie will pass Medicare for all with 51 votes with his vice president! You are a sell out piece of shit! Bernie 2020!!!!!!

  21. I appreciate the pragmatic approach. Not a fan of the time line. I just want my healthcare to be affordable. I can't pay 1300 in rent AND 500 for healthcare plus another 1000 in other living expenses. I only make 11.00/h couple that with fibromyalgia, I work to pay my rent and feed myself. This is rediculous. Top it all off with a severe learning disability and my ability for greater income diminishes.

    Depressing info David, but unfortunately realistic. I wish I had a better suggestion but I don't.

  22. You might as well say this about ANY of the Progressive policy platforms. Why single out Medicare for All? If you don't try, guaranteed, it won't happen. Bernie has already articulated a plan for how to get this and other popular Progressive policies; you take it to the electorate.

  23. MLK didnt stop fighting for the civil rights act because it was gonna be hard to get. We are going to get Medicare for all whether it takes 4 years or 40

  24. Oh dear oh dear even when the party in power says they are going to make something happen u still have to hurdle more stumbling blocks that will stop it .
    Who on earth decided on a government system like this and why don't u change it ??

  25. It’s going to get passed just like every movement has happened: mass mobilization. Think back to the civil rights movement

  26. Listen I mostly agree with you but I don’t think it’s as unlikely as you predict.Firstly Bernie Sanders has said he would use a nuclear option to pass medicare for all(he would only need 50 votes through budget reconciliation for example).secondly on what ground would the supreme court declare that the provision of medicare for all is unconstitutional?(simply a question). Most presidential candidates have suggested some judicial reform.Thirdly If Bernie is elected president he will come in with high approval rating (like almost every president in elected history) especially with other dems allowing him to apply political pressure to get enough votes to back Medicare for all.(not ever Dem but enough to get at least 50). So at surface level your analysis holds true but in my view if you account for the political pressure we can push through activism and intense political pressure there is a path, not saying it’s likely but there is a way.

  27. Every time you open your yap with concern trolling about issues that leftists hold dearly you lose huge amounts of credibility.

    You’re starting to strike me as a neoliberal type, Thanks god for fighters like Kyle Kulinski, Cenk Uygur, Ana Kasparian and others that don’t bend over before the fight has even started.

    You’re an embarrassment to the lefty movement, Could you imagine if during the women’s suffrage some a-hole who claims to be “on your side” starts saying ya know, I’m for the whole women rights thing but everyone in power is men so like ya women’s rights are never gonna happen and you basically gotta accept it and lower expectations now.

    F.U David, Millions have died because of this system and your fake concern trolling on the subject is helping keep the status quo in order.

  28. I understand what you are saying David.. The people on here are living in La, La, Land thinking Bernie will get it past.. Well, not unless there is a Full Democrat House and Senate.. Or bribing a RepubliCon.. Especially in a Mid-Term Election where most Democrats don't go out and vote like they do in the GE.. It happened with Obama and Clinton.. Big turn out for the both of them in the GE yet when the mid-term elections happened there was crickets and the RepubliCon's won..

    The other thing is, most young people don't understand how it all works.. The President is only one piece of the pie and he can't do it alone.. He needs support from both the House and Senate.. Which unless you have a Full Democrat House and Senate its not going to happen.. NO RepubliCon will vote for that!!!!… Unless you bribe them and even at that it might not work..

    Thats the reality…

  29. Pack the court and become active. These speculations aren't helpful, David. The same thinking that has stopped us from joining the rest of 1st world countries. You say, maybe the best (Medicare 4 all), system, and not mention national health care, but Romney Care? Unsubscribing. I'm realistic. Not waiting. We are ready for the political revolution. Adiós. When the will of the people is reflected the change happens… and very quickly.

  30. Vermont and Massachusetts failed on a state level and you still believe that it is a good idea and sustainable on a national level. You're AMAZING David. You're pretty fucking stupid for such an intelligent guy.

  31. Already compromising before negotiations begins. This is a centrist POV. My guts are correct to unsubscribe. Get ready for a warren endorsement.

  32. Pro-establishment, anti-Tulsi, pro-Republican-lite talking points, partnering with Ayn fuckin' Rand Institute, weaksauce on Bernie, pro-Warren talking points, IDW-friendly, what are you doing, man?

  33. Sahil of Akkad brought me here since I don't watch David Crackman anymore just so I can dislike it. It's seems Crackman is forgetting that Bernie wrote a damn bill that would've ended the war in the Middle East because he manage to get the house and senate to vote for it but the only reason why that didn't pass is because of trump. That was when he was a senator, imagine if he was president. The stuff he can get done.

  34. If Trump really wants insure he gets reelected, he’ll institute Medicare for all via executive order and then the Congress will look like a sequel to scanners.

  35. I agree with David on this. Bernie is the only one who really supports actual M4A. If he doesn't win in 2020, he won't have another chance to run, and no young politician with a chance supports it. Yes, it's the best policy. But too many people here are idiots.

    Besides, America is a right wing country. It's more likely that we eventually lose the ACA entirely and future laws are deemed unconstitutional. 2016 solidified this country as conservative for the next 40-50 years (because of Supreme Court)

  36. He has a point. Even if we win in 2020, a Medicare for All success will only come if we are strategic and deliberate! Let’s not underestimate the opposition like we did for Obamacare.

  37. To be clear, If a medicare for all/single payer type healthcare system is implemented the fight will not be over with. Just as other laws enacted require continued fight. Such as Roe v Wade, minimum wage, the list can go on and on. Even country's that have public healthcare the capitalists look for and actively engage in ways to profit more from it.

  38. Me: watches WHOLE video
    Okay, David. That’s makes perfect sense. I can get behind that.

    You idiots: sees video title, clicks, watches .3 seconds, dislikes and write angry comment

  39. Maybe it's a good time to say this stuff after the primary.

    I know initially you try to be neutral on things like this.

    I suspect if a Bernie Sander wins, we won't get Medicare for all soon, but we're going to see a lot of primaries and AOC coming into the picture — and that would be the point.. a revolution.

  40. In 2010 the Republicans threw all of their ethics and ideals out the window and focused on winning at any cost. The result? They swept the election, gerrymandered the hell out of the country, stacked the courts with dangerously right-wing judges, put massive tax cuts for the rich onto America's credit card, and got pretty much anything they wanted for the following eight years. They played the long game and it worked. The only thing that has slowed them down is the Democrats winning the House in 2018, but they've still been stacking the courts and blocking any legislation the House passes. Democrats need to win. Above all else, Democrats need to win.

  41. The single payer system in Vermont didn't fail. It wasn't even implemented because hospital groups and private insurance companies fought really hard against it. In the end the state government deemed the system "politically infeasible" and abandoned it. Any push towards a single payer system, either on a national or state level, comes down to a fight against capital, which isn't confined by state or even national borders. If you aren't even confident that we could win the fight as a nation, how come you believe that we could win the fight as individual states?

  42. Remember the Tea Party and all the attempts to repeal Obama Care. They didn't have the votes at first but they kept fighting until they had enough votes. They didn't end Obama Care, but they could have.

    You fight for what you believe in and don't give up. And the reality may change. Unlike ending Obama Care, I think people who vote against M4A would need to explain exactly why they're against it. There's not a lot of good reasons why.

  43. Day 1 in office Warren intends to lower drug prices..she will keep her promise to expand coverage for all..even Republicans

  44. Medicare-for-all is inevitable, but will not happen in the next decade unless Bernie wins this election (which he will if he gets the nomination). The democratic party is a bigger road-block than the republican party.

  45. The bolivia take was basically the last straw for me but this video showed me I was totally right in unsubbing from this channel. David is trying to grift hard

  46. You're unbelievably smug to be so fucking stupid. Lately you've been acting like a cnn host. Also fix your hair. Wayyyyyy too much gel. It's not the 90s. You should keep that in mind in terms of both your politics and your fashion sense

  47. So you think, that we think, that we can give med4all instantly? This is a long fight Pakman and many things go without saying. Med4all could take 4 years or 4 months.

    It'll take 4 years with people like you muddying the water with your "REALITY." You're the paralysis by analysis type so follow on this one.

  48. Calif DEMOCRATS voted down state single-payer and universal last year!! They're corrupt and so are you for thinking it's still an option to be LESS CONFRONTATIONAL and meet halfway

  49. We NEED the fire of hope in our hearts if we are to stand ANY chance of thwarting the corrupt. Instead, David is here to tell us that hope is a four letter word, and we should just settle for whatever scraps the masters might allow us to have, because that's an excellent bargaining posture, apparently. Let's give up the fight before it's even begun, because "facts and logic." Well, if David with his 'realism' wants to slump defeated in the corner because the fight is EXTREMELY daunting, I guess that's his business. I'll be over here, reading about that time Ghandi gave up because the British Empire was simply too large and too powerful to defeat. I hear India is still the Jewel of the Empire. Good thing Ghandi's level-headed pragmatism prevented him from making a fool of himself by taking on the British. That would have been so embarrassing for him, because "facts and logic." SMMFH.

  50. Hey David no Republicans will support any form of socialized healthcare. A lot of house democrats don’t support green new deal, free college, they don’t support bds. This incremental argument falls flat on its face when you consider how real change happens.

  51. David what you say does make sense but I’ve come to understand that sense isn’t primarily what needs to happen here. In Many ways M4A represents a pure expression of political will. I believe you may be underestimating the movement’s understanding of how truly monumental the task is. But perhaps not. My one specific question is how would you guarantee that a public option was not merely 1/2 under funded nightmare and 1/2 private insurance subsidy? I see many more paths to that outcome than to paths to a viable interim solution.

  52. Cmon Bernie is coming with a yuge grassroots movement. The conservatives got hateful laws and hateful judges. The elite establishment dems and ‘cons had their fun poking holes in our legal system making corporate bribery legal literally attaching litigation decisions based on the size of the donor. Normally you don’t get these kind political capital of grassroots small dollar donations and no Corp pacs. Bernie topping 4 million is a yuge movement. Obama had a movement of change and he squandered it once sworn in. Bernie will put the smack down with this movement. Bernie 2020

  53. With Sanders as president a huge tipping will be reached.The political landscape will change dramatically and M4all is imminent.Positive attitude please.

  54. What the fuck?
    I lost all respect for this dude. He either has NO balls, or he is just another establishment shill. I shouldn't be surprised considering where he gets some of his money from.

  55. I wonder when the last time David paid out of pocket expenses for anything. I’m gonna guess, best case scenario, not recently.

  56. I get from where you draw those conclusions , gona b long hard process to vote out bad congressman and to flip senate but it IS NOT TRUE that you can't force doctors to apply M4A. I just don't understand where you got that info. You think that French doctors give you the finger when you show up ? Government makes sure that healthcare providers are respecting the law .

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