I just find it incredible that over the last 6 years of looking to replace the Affordable Care Act there is no mention of the public health system. Los Angeles County New York and Cook County (Chicago) collectively cover over 4 million people and have done so for decades. The public health system is funded by local tax payers and is required by Federal law. The systems operate in the large metropolitan areas and work with the population and typically work in between Medicaid eligible and private insured populations. Depending on the what numbers of the uninsured are accurate, 4 million people would be 20 to 30 of the that population. Cook County Health Care System has expanded its doctor and hospital network to included several highly reputable facilities to it’s patients.So you have healthcare systems already operation in the major populated areas and no one is looking at including them into healthcare reform.  The Federal government would be well advised to consider  coordination and expanding systems that have worked instead of throwing the baby out with the bath water. I am encouraged to hear that the Fed says healthcare should be done locally ny the States. I propose that we take it a step farther and make the delivery system more local  at least in the areas that are already working.  Contrary to popular belief fixing the Affordabe Care Act is not as complicated as the politician make it out to be

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