There's a lot tied up in here, so I'm going to attempt to untangle. First, I don't think there is a universal model that we can apply to every possible case. B

There's a lot tied up in here, so I'm going to attempt to untangle. First, I don't think there is a universal model that we can apply to every possible case. Budgeting medical care, for example, will depend pretty heavily on funding cycles, and a surplus at the end of the quarter raises the question of "could this have been better allocated to serve patients' medical needs during the quarter?" Off the top of my head... I'm thinking that something like a lifetime maximum with some sort of payback mechanism may be the answer. E.g., you get $2M of medical care over the course of your life, but when the medical system has a surplus, those numbers are adjusted. Liability, on the other hand, is a whole 'nother ball game. A manufacturer that deliberately chooses not to implement a safety feature because "the lawsuits will be cheaper" is making both a moral and an economic choice, and that's something that needs to be addressed via both torts and corporate law. Broadly speaking, I think that putting the customer -- rather than the shareholder -- back in the economic drivers' seat would do a lot to remedy this.