Lack of trust, payment facilities and logistics, all of which are prevalent in the U.S., are just now being overcome.

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According to the Medicare Trustees, Medicare payment reductions under the new law will cause hospitals, nursing facilities, and home health agencies to operate at a loss- 15 percent lose money by 2019, 25 percent by 2030, and 40 percent by 2050.

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And the penalty for violations would be steep: Nursing facilities would lose up to 3 percent of their Medicare payment.

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