{
  "as_of": "2026-10-16",
  "analysis_year": 2023,
  "latest_cost_year": 2024,
  "scope": "Historical national spending and tax-return funding feasibility. Not a citizen-specific actuarial price model.",
  "sources": {
    "cms": "https://www.cms.gov/files/zip/nhe-tables.zip",
    "irs": "https://www.irs.gov/pub/irs-soi/23in12ms.xls",
    "cbo": "https://www.cbo.gov/system/files/2020-12/56811-Single-Payer.pdf",
    "lancet": "https://pubmed.ncbi.nlm.nih.gov/32061298/",
    "ftc": "https://www.ftc.gov/news-events/news/press-releases/2025/01/ftc-releases-second-interim-staff-report-prescription-drug-middlemen",
    "rand": "https://www.rand.org/content/dam/rand/pubs/research_reports/RRA1100/RRA1144-2-v2/RAND_RRA1144-2-v2.pdf"
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      "category": "Hospital care",
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      "category": "Physicians and clinical services",
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      "category": "Other professional services",
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      "2024": 184900000000.0
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    {
      "category": "Dental services",
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      "2023": 177500000000.0,
      "2024": 189200000000.0
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    {
      "category": "Other health, residential and personal care",
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      "2024": 320500000000.0
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    {
      "category": "Home health",
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      "2023": 153600000000.0,
      "2024": 169400000000.0
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    {
      "category": "Nursing facilities and continuing care",
      "source_excel_row": 14,
      "2023": 205000000000.0,
      "2024": 219900000000.0
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    {
      "category": "Retail prescription drugs",
      "source_excel_row": 16,
      "2023": 432900000000.0,
      "2024": 467000000000.0
    },
    {
      "category": "Durable medical equipment",
      "source_excel_row": 17,
      "2023": 81900000000.0,
      "2024": 86400000000.0
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    {
      "category": "Other nondurable medical products",
      "source_excel_row": 18,
      "2023": 123300000000.0,
      "2024": 128699999999.99998
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  "national_2023": 4925300000000.0,
  "national_2024": 5278600000000.0,
  "personal_healthcare_2023": 4162800000000.0,
  "personal_healthcare_2024": 4510200000000.0,
  "irs_brackets": [
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      "label": "No adjusted gross income (includes deficits)",
      "returns": 2180146.0,
      "agi_dollars": -144194936000.0,
      "source_excel_row": 10
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    {
      "label": "$1 under $5,000",
      "returns": 7357751.0,
      "agi_dollars": 17450063000.0,
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      "label": "$5,000 under $10,000",
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      "agi_dollars": 60949546000.0,
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      "agi_dollars": 112353814000.0,
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      "label": "$15,000 under $20,000",
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      "agi_dollars": 151828408000.0,
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      "label": "$20,000 under $25,000",
      "returns": 7925999.0,
      "agi_dollars": 178000708000.0,
      "source_excel_row": 15
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    {
      "label": "$25,000 under $30,000",
      "returns": 7594157.0,
      "agi_dollars": 208919443000.0,
      "source_excel_row": 16
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      "label": "$30,000 under $40,000",
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      "agi_dollars": 531782365000.0,
      "source_excel_row": 17
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    {
      "label": "$40,000 under $50,000",
      "returns": 13519034.0,
      "agi_dollars": 606242938000.0,
      "source_excel_row": 18
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    {
      "label": "$50,000 under $75,000",
      "returns": 24135884.0,
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      "source_excel_row": 19
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    {
      "label": "$75,000 under $100,000",
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      "source_excel_row": 21
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    {
      "label": "$200,000 under $500,000",
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      "agi_dollars": 3153877437000.0,
      "source_excel_row": 22
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    {
      "label": "$500,000 under $1,000,000",
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      "agi_dollars": 1194934962000.0,
      "source_excel_row": 23
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    {
      "label": "$1,000,000 under $1,500,000",
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      "label": "$1,500,000 under $2,000,000",
      "returns": 147290.0,
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      "label": "$2,000,000 under $5,000,000",
      "returns": 203230.0,
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      "source_excel_row": 26
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    {
      "label": "$5,000,000 under $10,000,000",
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      "agi_dollars": 336334760000.0,
      "source_excel_row": 27
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    {
      "label": "$10,000,000 or more",
      "returns": 30382.0,
      "agi_dollars": 907900917000.0,
      "source_excel_row": 28
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  "income_above_25000_per_return": 11975324830000.0,
  "income_above_200000_per_return": 4185336389000.0,
  "policy_test": {
    "allowance_per_return": 25000,
    "base_rate": 0.03,
    "revenue": 359259744900.0
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  "budget_tests": [
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      "budget": 1000000000000.0,
      "rate_above_25000": 0.08350504175843722,
      "monthly_at_65000": 278.35013919479076,
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      "extra_rate_above_200000_to_keep_65000_at_100": 0.6309505400905064
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  "flat_100_test": {
    "people_assumed": 320000000,
    "annual_revenue": 384000000000.0,
    "share_of_2023_care_spending": 0.09224560392043817
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  "formulas": {
    "excess_income": "sum(bracket AGI dollars - threshold * bracket return count), over brackets at or above threshold",
    "monthly_contribution": "rate * max(0, AGI - allowance) / 12",
    "revenue": "rate * aggregate excess income",
    "extra_high_income_rate": "(target budget - base revenue) / aggregate income above $200,000",
    "fund_budget": "care payments at negotiated prices + added use and benefits + fund operations + reserve addition + transition costs - committed outside funding"
  }
}