We economists, in our classes, teach students that to some degree, price discrimination is actually a good thing; that it allows you to serve lower-income people. Take Africa, with AIDS. They could never finance what an AIDS cocktail costs here, over $10,000 a year. But if you sold it to them for $300 a year, which just barely covers cost, they could probably serve quite a few of their citizens, with World Bank help. We economists say that will be beneficial. But it's a two-tier system; yes, African people pay less than we would pay.

The issue of universal coverage is not a matter of economics. Little more than 1 percent of GDP assigned to health could cover all. It is a matter of soul.

The good things at the U.S. health care system are that we have a well-trained labor force, particularly physicians; I don't think any nation trains doctors better. We have the latest technology, simply because we throw so much money at it. We are really technology-hungry in this country. That's a good thing. Our system more treats patients like customers, which is a good thing; that it's very customer-friendly. And it's very innovative, both in the products we use, in the techniques we use and the organizational structures we use. Those are all very good things, highly competitive.

Everybody should have health care, on the one hand. But on the other hand, if you ask Americans, "Are you willing to pay for it?," they say no. So I've never been able to understand this contradiction.

We have a nation where the elite thinks it's OK to advocate a war and send the lower-income people to do the fighting. It's natural for such a people to think that the lower-income people should also have a worse health care experience. And the other countries are not there - I always say, not there yet. I tell the Germans and the Swiss, "You're not there yet, but if you're not very, very careful, if we Americans come over there and rearrange ... your health care system, you will be just like us."

There are libertarian values which say private property is the overarching value, the sanctity thereof, and there are egalitarians who say health care should be shared and so on. That's fair enough.

The bad things the U.S. health care system are that our financing of health care is really a moral morass in the sense that it signals to the doctors that human beings have different values depending on their income status. For example, in New Jersey, the Medicaid program pays a pediatrician $30 to see a poor child on Medicaid. But the same legislators, through their commercial insurance, pay the same pediatrician $100 to $120 to see their child. How do physicians react to it? If you phone around practices in Princeton, Plainsboro, Hamilton - none of them would see Medicaid kids.