What do you think are the top three most important issues in health and medicine in the United States today?
The single most important issue in health care in the United States is economic. Although the United States possesses the best possible health care in the world for the very wealthy, money is still a huge obstacle to health care for most people. Although the Affordable Care Act, popularly known as Obamacare, has made health care accessible to many people who previously lacked health insurance, many Republican governors have tried to block use of federal money to help the poor people in their states obtain medical care. Also, unlike the single payer systems in Britain and Canada, even with the ACA or employer-sponsored plans, access to health care remains quite expensive in the US, despite the fact that the US government actually spends more money on healthcare than any other wealthy country.
The second major issue is demographic. Longer life spans means that the US health care system needs to increase capacity for end-of-life and supportive care outside hospitals. It is far less expensive, and far more pleasant, for an elderly person recovering from hip or heart surgery to stay at home or in an assisted living facility than to recuperate in a hospital, and yet much of the current health care system prioritizes short term fixes over long term care.
A final issue is prevention of infectious diseases. Many of the common causes of illness and death such as measles, mumps, and rubella have been almost eradicated in the US, and much of the increase in life expectancy over the past century has been due to the use of vaccination to provide "herd immunity" against infectious diseases. Unfortunately, the scientifically ungrounded anti-vaccine movement is jeopardizing theses gains. While people injuring their own health is a matter of individual choice, threatening the health and lives of their children and members of their community is ethically unsupportable; the US needs to uniformly enforce regulations that prevent anti-vaxxers and similar members of the lunatic fringe from endangering the health of others.