Earlier quoted context omitted.
Here in Australia the state funds most medical care. In this case the blackmail vector, if we use that interpretation is the taxation system.
Blackmail with a bit of overhead tossed in then. At least most hackers keep the costs down and pass the savings on to you!
Note that a mixed economy (combined public/private funding, like the french and australian systems) are probably for the most part the most economically efficient. A big problem in australia is over-provision of services, especially ending up getting more pathology tests than strictly necessary.