"Although the rate of increase in the MMI has decreased to 5.4%, that is still a one year increase in health spending of $1,185.... [I]ncreasing proportions of the cost increases have nominally been shifted to the family -- through higher payroll deductions and greater out-of-pocket costs. In actuality, most economists agree that the employer's share of the costs is actually paid by the employee in the form of forgone wage increases.... Thomas Piketty's treatise on Capital in the 21st Century describes our inequality in income and wealth. It takes very little imagination to see how a publicly financed single payer system would slightly temper the inequities while ensuring health care for everyone."