Regarding the Dec. 12 editorial “Making 'more skin in the game' work," the points are well-taken, as what's left of the middle class already seek grafts for the amount of their “skin in the game.” Those who still have any modicum of health insurance as we once knew it have no say in the changed health cost structure that has transformed the system into an economic enigma.
For example: Many pay hospitalization costs at full “rack rate” for what was not covered by their insurance, but would have been billed at a severe discount; They pay higher outpatient costs for the same physician practices and services now purchased by the hospital and charging higher costs; The cost of drugs has exploded thanks to dealing by Big Pharma for Medicare Part D and the Affordable Care Act; that barn door remains wide open to any market-imposed solutions by payers or even Congress.