Answer
Who will be "eligible" for a public subsidy to help them finance the cost of their health care, whether that is public coverage or a public subsidy to purchase private coverage?
Public resources are resources held in common and should be allocated in a way that benefits the larger population from which they flow. This can be done in one of three ways:
- Public resources can be used to finance a basic level of care ("core benefit") for everyone (the "public education" model);
- Public resources can be used to subsidize those with lower incomes to ensure financial access to the core benefit (means testing); or
- A combination of these two approaches can be used.
Regardless of which option is chosen, we cannot escape the fact that the "core benefit" – or the floor – is what we are willing to subsidize with public (or "pooled") resources.
Note: Although today the primary barrier to access is the cost of care, this is, by no means, the only barrier. Other barriers to access include transportation barriers, language and cultural barriers, mal-distribution of providers – especially in rural settings – physician office hours that do not coincide with peoples' work hours, lack of day care, etc. In other words, "coverage" does not necessarily mean "access" – and presumably what we want is for everyone to have timely access to needed care.
