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."

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.

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.

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 rich are becoming richer, and the gap between the rich and the poor is getting bigger.

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.

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.