Sublime

Professor William Hsiao, the Harvard economist, has helped design health care systems for more than a dozen nations. He says the creation of a national health care system involves political, economic, and medical decisions, but the primary decision to be made is a moral one.

As a result, the Canadian health system now relies on a patchwork of provincial plans, population-specific federal plans, private supplemental insurance plans, and out-of-pocket payments to cover outpatient pharmaceuticals and other services not deemed medically necessary.

But some Americans have been pressing their countrymen to deal with that “first question” as a foundation for building a new national health care system. Professor Uwe Reinhardt, the economist at Princeton University and global leader in the field of health care economics, argues that U.S. policy makers have deliberately avoided the moral question.