I have heard that the standard "punishment" on this is to just confiscate people's tax returns and then hand the money over to the health care "system". How much you want to bet not a single clinic or hospital will be constructed or refurbished with the money, but lots and lots of government upper middle class wage positions will be created and paid. More desk jockeys and still fewer actual qualified medical care providers.

Then as the public demands actual medical care providers, they will be outsourced to third world education systems. More Cuban, Chinese, African and Indian doctors, while Americans get employed only on the basis of what "the system" thinks of them, not actual merit or qualifications.