1. The insurance industry plays a major role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system, whether it is a private company or the US government, would eliminate the complex insurance paperwork burden and free substantial funds that could be diverted to support care for the under-served. In ACA debates, a “public option” was defeated by lobbyists. Identify some reasons why resistance to a single-payer concept, used in every other developed country, has continued in the U.S.
2. Almost every medical or technological advance seems to be accompanied by new and vexing ethical dilemmas. Yet, the United States has no structure in place to resolve such issues. Should the federal or state governments take responsibility for ethical decision-making and for protecting the public? If neither, what might be other options for providing ethical guidelines and oversight?
3. As strongly evidenced by the ACA and prior legislative attempts to address the problems of the health care system, these attempts are always met by shifting alliances among well financed and, often, self-serving lobbying groups. How, in the American system of politics, can health care get more objective support on behalf of consumers?
4. Every 10 years, the public health sector creates an elaborate set of targets for health status improvements in the United States. Healthy People 2010 failed to meet 85 percent of Healthy People 2000’s goals. Is there merit for establishing several hundred more objectives for Healthy People 2020, or are these simply academic exercises? What are your opinions about how to energize the “Healthy People” goals among providers and the American public?