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of the University of Barcelona have demonstrated that the figure-eight orbit is stable . The mediator is neutral and helps the parties to a discrimination dispute identify the important issues and work out a solution that is agreeable to both sides . I conclude nonetheless that Petitioner has not shown that it is unable to pay the civil money penalties that HCFA determined to impose and which I sustain . Indeed , there is evidence that encouraging people to join such health plans will exacerbate some of the very maladies that undermine our health care system 's ability to perform at its highest level.Many Americans Are Already Burdened by High Health Care CostsAmericans already pay far more out-of-pocket for their health care than residents of other industrialized countries , and real per capita out-of-pocket spending has been steadily rising since the late 1990s.The Commonwealth Fund Biennial Health Insurance Survey found that in 2005 , 60 percent of working-age adults with private insurance with annual household incomes of under $ 40,000 spent 5 percent or more of their income on out-of-pocket expenses and premiums , and 40 percent spent 10 percent or more.There is considerable evidence that high out-of-pocket costs lead patients to decide against getting the health care they need . Because contract law , not copyright law , governs electronic ( born-digital ) resources being increasingly acquired by libraries , libraries are not able to rely on Section 108 ( g ) ( 2 ) to make and send copies to fill ILL requests .