Sublime

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.

But the 2010 reform law did little to reduce the fragmentation of American health care; if anything, it will give us a system that is even more complex.

At the Veterans Health Administration, Ken Kizer, appointed by Bill Clinton in 1994, inherited an antiquated, inefficient health-care system. The VA faced changes in its client population, the competitive healthcare environment, and modalities for delivering care.2 In just five years, Kizer instituted an electronic medical record system, made struc

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.