I meant it as an executive order, which is really the only stroke of a pen that would work. Otherwise you’d have to build the political capital to get enough representatives to sign on, and that’s exactly the non-simple task I was alluding to. Those are the same reps who make the rules you’re complaining about, and the same ones who can’t agree on a budget when we don’t have a massive increase in Medicare entitlements. Maybe I’m too cynical, but pretending like there’s the political capital to do it just in the horizon feels like a pipe dream to me. I’m old enough to remember politicians talking about a single payer system in the 1990s and yet here we are.