National health care policy: the moral issues

To be human is to frame projects in the face of ineradicable limitations. The beginning of sound health care policy is the recognition that one must accept some risks of death, suffering, and disability, and that one should forgo attempting to prevent death, suffering, and disability when the costs are high and the likelihood of success low. Sound health care policy requires recognizing the extreme burdens that would be incurred if one truly attempted to save lives at all costs. Framing realistic health care policy also requires taking account of the circumstance that being rich is positively correlated with living longer, and that the secular moral authority of the state to remedy this circumstance is limited. After 15 years of an all-encompassing health care system, Canada still had striking differences between the life expectancies of highest-earning and lowest-earning citizens. The second challenge for secular health care policy is: To what extent may the state forbid individuals, after they have paid their taxes, from using their private resources to buy better health care so they can live longer than the poor who lack such resources? Or should one focus instead on determining which interventions are most cost effective in narrowing the gap in life expectancy and morbidity statistics between the rich and the poor?