Kinda like when the Republicans hooted down Clintoncare in the 90's with all their dire predictions and scare tactics. "Let market forces and capitalism work its way toward more efficient medical care delivery" was their rallying cry. In the subsequent years and prior to the ACA my health insurance premiums went up over 250% while my pay went up about 40%. The only efficiencies I noticed was with the Health Insurance industry's Deny, Delay, and Obfuscation departments. They got pretty darn good at that.