Americans believe that the private sector is always more efficient and cheaper than big government, and particularly when you go among Republicans, even after five beers, they still believe it. But I always say, "If it's really true, why would they need that 12 percent extra on a traditional government program? Explain to me why something that costs more saves me money as a taxpayer.".

Americans keep telling me they hate government. I always tell them: "Man, I've got a country for you: Go to Afghanistan; they don't have one." So if you're of that ilk, yes, you can have your private paradise, but if you're comfortable with government, then go with government.

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.

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 ACA is an ugly patch on an ugly system - and I don't think it's worth mentioning in the context of price or quality transparency.

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.

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.