“In time, high taxes, large subsidies, and extensive mandatory contractual terms in tandem could well drive most private plans out of business… Where and when the tipping point comes, no one can say in advance, and perhaps some tenacious and well-run private plans may ultimately survive. But in the end, our gloomy prediction is that in the absence of a major change in course, a regulatory cascade will first force some plans to fail, after which other private plans will topple like tenpins.”