This is called the zero-sum turtle shell game. It ignores the reality that, with the population aging and Medicare and Medicaid demands peaking, the turtle will surely grow over time and expand outside its shell. The turtle will stick its neck out in search of other turtles, with whom it will procreate.
As the Mock Turtle in Alice in Wonderland remarked, It’s simply a matter of Arithmetic, “Reeling and Writhing, of course, to begin with, and the different branches of Arithmetic – Ambition, Distraction, Uglification, and Derision.”
By Mary Agnes Carey