On Thursday, a panel of health, business and advocacy leaders gathered in Lancaster for a public town hall on health care.

The event covered a wide range of topics within health care.

Here are three key questions that arose.

Would Medicare for more be better?

Dr. David Silbert, a local ophthalmologist, told panelists Medicare seems to be effectively controlling medical costs, and he thinks expanding the program could be helpful.

If Medicaid pays 30 cents on the dollar, she said, everyone ends up paying the remaining 70 cents, because that cost gets distributed for other people that are paying for health insurance and buying health care services.

Chuck Pennacchio, executive director of Healthcare For All PA, said Medicare having much lower administrative costs than other payers makes a good argument for expanding it.

Akash Chougule, deputy director of policy of Americans for Prosperity, said government underwriting things automatically makes them more expensive.

Can people make good enough health care choices?

One audience member questioned whether its possible for individual choice to result in good overall outcomes for Americas health care, given the complexity of the issues.

Another person from the audience said as she has seen more and more people left behind by the choice model, she has begun to view health care as a moral challenge confronting America.

Do we need to do better on health insurance literacy and understanding? Absolutely, said Paula Bussard, chief strategy officer of the Hospital & Healthsystem Association of Pennsylvania.

But, she said, the industry also has to do more to empower patients.

Marc Stier, director of the Pennsylvania Budget and Policy Center, said America collectively pays for health care, including the tax deduction that benefits everyone who has job-based health insurance, and thats an argument for universal health care.

Would more local control be better?

Asked what they liked about the recent American Health Care Act proposal, the panel had little to say.

Lifting taxes was a positive, said Gene Barr, president & CEO of Pennsylvania Chamber of Business and Industry. Taking coverage away from people was problematic.

Bergen said while shes wary of the impact of block-granting Medicaid, the effort to try to drive decision-making, control, etc. at the state and a more localized level could have some very tremendous benefits that should be fully considered.

Pennsylvania Auditor General Eugene DePasquale, who organized the event with Treasurer Joe Torsella, asked later about regulations.

How do we get to a place politically where we actually go through the regulatory process to see what works and what doesnt? he said.

Barr said he sees a need to frame the conversation in terms of tradeoffs, instead of good and bad.

With economic regulation, theres almost always going to be a drag on economic development, he said. Am I willing to accept additional protection for a little less economic development?

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3 key questions from the health care town hall in Lancaster County - LancasterOnline