Katha Pollitt and Andrew Sullivan

Katha,
No, I'm in favor of abolishing the British National Health Service altogether, and letting the market take care of most people's healthcare, and the government coming in to rescue those who fall through the cracks. This would probably lead, I'd guess, to more social spending on health-care as a percentage of GNP, and would more accurately reflect people's real balance of needs and wants. What it would avoid is the impossible politicization of health-care. In Britain, you regularly have parliamentary debates in which some limit is imposed on health-care spending and some huffy back-bencher (once Labour, now Tory) demands why the minister for health just murdered his grandmother. It's an impossible position to put politicians in, and brings out their worst instincts, of pandering, emotionalism and over-spending.

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Yes, yes, I know, because of insurance and third parties, there is no true market for healthcare, but we should try to approximate one as best we can, so that people's real desires (and not some political hack's view of them)determine the structure of healthcare. And yes, health is not a good like, say, computers, and the state should step in and help those who really can't help themselves - but as a last resort. As for AIDS, the new treatments--mainly pioneered in the US by big drug companies trying to make profits, not do good--are far cheaper than the alternative of doing nothing and so economics should and will guarantee that most people who need them (and can take them responsibly) should get them. The notion that large numbers of people who need the meds can't get them is, I think, overstated. Some of the biggest drops in death rates have been among the poor and racial minorities. But do some people fall through the cracks? Yes. Should we do all we can to find them and help them? Yes. But can state-of-the-art treatment of every illness be guaranteed to every citizen? Not in a universe of limited funding, which is the universe we live in. But without the US freeish market health system, there would be far less effective treatments to give people in the first place.

As to Japan, I don't think our cultural differences are merely related to media distortion. Lots of people I know who have lived there concur. It sounds like a living hell. And the only way I have ever enjoyed eating fish is deep fried in batter, wrapped in newsprint. And lots of vinegar.

best
Andrew

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