##lellan ( 2001 ). cbo ( 2007 ). for the purposes of this speech, " low income " means those in the bottom 20th percentile of the income distribution. health insurance and out - of - pocket payments will become increasingly unaffordable. 14 one way that society has addressed this problem in the past has been to expand government subsidies for health spending. the medicare part d program, which assists seniors with the costs of prescription drugs, is an example. however, to continue limiting the effects of rising medical costs on household budgets, the government may have to absorb an increasing proportion of the nation's total bill for health care, putting even greater pressure on government budgets than official projections suggest. taking on these challenges will be daunting. because our health - care system is so complex, the challenges so diverse, and our knowledge so incomplete, we should not expect a single set of reforms to address all concerns. rather, an eclectic approach will probably be needed. in particular, we may need to first address the problems that seem more easily managed rather than waiting for a solution that will address all problems at once. thinking about solutions in health - care reform, it is certainly easier to pose questions than to provide answers. moreover, even putting aside the scope and technical complexities of the problems we face, the types of reforms we choose will depend importantly on value judgments and the tradeoffs made among social objectives. such choices are appropriately left to the public and their elected representatives. consequently, i will have little to say here regarding specific proposals. however, i will suggest a few questions and considerations that those seeking reform might wish to keep in mind. regarding access, one important consideration is that people who are uninsured are not all alike. they include people who have low incomes, people who may not be poor but have costly pre - existing health conditions, those whose employers do not offer group health insurance and who cannot afford to buy insurance in the more - expensive nongroup market, and people who are eligible for medicaid or other programs but for some reason have not enrolled. some people who can afford health insurance do not purchase it, presumably because they do not anticipate having significant medical expenses. broadening access to health care may thus require us to consider a mix of policies. the following are some of the questions with which we will have to wrestle. first, should enrollment in a health insurance program be mandated, or at least strongly encouraged, for example, through tax incentives

that we have already received very positive response from the academia and have started the preparation work with these top - notch experts. the hkma will work with the expert group to study different important issues, such as privacy protection, cybersecurity, and interoperability, and other technical and business aspects surrounding cbdc. while members of the expert group do not have any 2 / 3 bis - central bankers'speeches formal advisory role, they will provide us with valuable insights and contribute to our future deliberations on cbdc. closing in closing, i would say that project e - hkd is a hugely complex and challenging undertaking. i said earlier that the project goes well beyond just technology. it will take our collective wisdom and effort to create innovative use cases so that in the end, if ehkd were implemented, there could be widespread adoption so as to achieve the network effect required of any successful retail payment instrument. this is going to be a long and winding journey. but as the chinese saying goes, " a thousand miles begins with a single step " ( ). we are grateful that you have all chosen to join us to take important first step in this meaningful e - hkd journey. i know you're all eagerly waiting to hear about the potential use cases, so i'll give the floor to each pilot group to share their creative ideas. thank you. 3 / 3 bis - central bankers'speeches