EconLog’s Arnold Kling, who is doing some of the best thinking these days on reforming America’s dysfunctional health care finance system, identifies in this TCS Daily op-ed the five big questions in health care:

1. What will we do about the large projected deficit in Medicare?
2. What can we do to reduce government subsidies for extravagant use of medical procedures with high costs and low benefits?
3. What should we do about the health care needs of the very poor?
4. What should we do about the health care needs of the very sick?
5. What should we do about a scenario in which both income inequality and the share of average income devoted to health care rise sharply?

Kling goes on to discuss our social fetish with health insurance, which is really not insurance at all:

If you ask me what kind of health insurance I would like for my family, my instinct is to answer, “None.” The only reason we have health insurance now is to avoid the stigma of being called “uninsured.”
Somehow, health insurance has become a social fetish. I could travel to the far reaches of the globe, and almost everywhere I would find merchants where my credit is good and my dollars are welcome. But here at home, trying to enter a local hospital with nothing but a wad of cash and a credit card would be like urinating on the sidewalk.

Read Kling’s entire piece. As the WSJ’s ($) Holman Jenkins pointed out awhile back, government policy has exacerbated these issues and is unlikely to solve them through greater involvement in the system:

The tax code is the original hectoring mommy behind our health-care neuroses. It gives the biggest subsidy to those who need it least. It pays the affluent to buy more medical care than they would if they were spending their own money. It prompts them to launder our health spending through an insurance bureaucracy, creating endless paperwork. It prices millions of less-favored taxpayers out of the market for health insurance. It fosters a misconception that health care is free even as workers are perplexed over the failure of their wages to rise.