Here are some key questions.
Purpose of Health & Healthcare
- What is the meaning of health? Is it just physical? Should it include mental health? What about social and family relationship health, and overall wellbeing?
- What is the purpose of healthcare? Is it just to maintain or restore ability to work? Or does it entail “pursuit of happiness” and societal participation? To what extent is the purpose to give health workers employment or to earn profits for investors or researchers?
- Who should have access to healthcare? Should access be determined by income, ZIP code, health status, employment? Or should all citizens have access as part of the “social contract”?
- Should society provide for disabled? Catastrophically ill? If so, to what extent?
Paying for Healthcare
- Who should pay? Rich/poor? Healthy/sick? Young/old?
- How should we finance healthcare? Rely on employer-based insurance? Provide subsidized public insurance options? Fund a single-payer system with taxes?
- If we choose commercial insurance funding, what is the purpose? Is the purpose profit, cost minimization, or subscriber health? Should commercial insurance be non-profit?
- If we choose commercial insurance, may insurance companies exclude chronic care (pre-existing conditions)? Low-value services? Expensive services? Who defines “essential benefits”? Who ensures fairness?
- If we choose public financing (taxpayer-funded), how can we ensure accountability, transparency, performance?
- Is the for-profit “free market” more important than administrative efficiency? If so, is “free market” inefficiency worth the cost of a half trillion dollars, $1 trillion, $1.5 trillion?
- How to fund innovation and research? Set up research as public “moonshot” programs or competitive profit-for-risk-taking?
- What is economic trade-off between healthcare and other public goods? How to balance healthcare against education, defense, infrastructure, security, social order, environment sustainability?
Title: Freedom of Speech
By: Normal Rockwell (Public domain via Wikimedia Commons)