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 are the only nation where paper is still the mainstay in the private insurance industry.

We Americans, or half of Americans, think health care is a commodity. Other countries view health care as a social service that should be collectively financed and available to everyone on equal terms. My wife and I just interviewed the German minister of health, and it was an exhilarating experience, because it was a totally different language. It was obviously important that everyone should have the same deal in health care.

The American people are not ready for the idea that everyone has at least a moral right to good, timely health care. They do agree they have a moral right, in critical cases, to have anything done to save their life, but they don't believe that anyone has a right not to fall that sick to begin with. So if you ask me, "Are we ever succumbing to some notions of solidarity as a nation?," I would say, "Not at all." I would describe us as a group of people who share a geography. That's a better description of Americans than that we're a real nation with a sense of solidarity.

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.

If you want to look at a purely socialized health care, you would have to go to the United States, where we have it. In particular, that's the system we reserve for our veterans. So if I hear politicians run down socialized medicine - and I have done that before the Congress - I say: Do you hate your veterans? Why do you reserve purely socialized medicine - there's only the U.S. and Cuba that have that - for the veterans? So getting the terms right would be very, very helpful in our national conversation on health reform.

The bad things are that our financing of health care is really a moral morass. It is a moral morass in the sense that it signals to the doctors and hospitals that human beings have different values depending on their income status.