"CBO conveyed two main points in its testimony: First, moving to a single-payer system would be a major undertaking. It would involve significant changes for all participants--individuals, providers, insurers, employers, and manufacturers of drugs and medical devices. Because health care spending currently accounts for about one-sixth of the nation's economic activity, those changes could significantly affect the overall U.S. economy. And the transition toward a single-payer system could be complicated, challenging, and potentially disruptive. Second, to establish a single-payer system, lawmakers would need to make many decisions and would face complex trade-offs."

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