“The next question is, who will pay for catastrophic care? The answer: the government-run catastrophic health-fund. Such a fund would be supported by a mandatory contribution of approximately 10 to 15 percent of profits of each health insurance company, including managed care operations.”

The essay also features a particularly sharp passage about how Americans view health care for the elderly and very ill.

“Unlike many other advanced nations,” Carson wrote, “American society has not yet come to terms with the fact that it is not unreasonable to keep simply someone comfortable at home when catastrophic illness occurs rather than putting them in an intensive care unit, poking and prodding them, operating and testing them ad nauseam, why not allow them the dignity of dying in comfort, at home, with an attendant if necessary?”

One solution, Carson wrote, would be to establish “national guidelines” for care, noting at one point in the essay that if the government provided for catastrophic care, it “would facilitate a national debate on what catastrophic conditions should be treated and to what extent.”