"We are still on a path toward some sort of socialized medicine by the end of the 2020s. We cannot sustain this present system much longer.... Taxpayers pay 70% of all healthcare costs in blue states and 65% in red states.... The impact of [the MLR] was to relax insurers' incentive to keep claim costs down. Why? Because the only way for an insurer to increase revenue is to glow the claims pie. 15% of a $4,000 MRI pays better than 15% of a $1,000 MRI."