The boogeyman of Socialized Medicine is being dragged onto the field of rhetorical combat to block the move toward anything smacking of Single Payer Health Care in the United States. The argument is old and hoary by now, that adopting a system like that available in Canada or the United Kingdom would lead to a collapse of American health care. Somehow the fact that expenses might be shared and disbursed through the government will render the world’s best health care system somehow crippled inside a generation is not seriously questioned by most people. Because most people don’t know. You can find case after case of anecdotal evidence to support the notion that British health care is worse than ours. Someone knows someone who, as the argument goes. And there is something to that. The waiting periods alone, the pigeonholing of treatment—horror stories abound which we glimpsed here when HMOs were instituted and accountants seemed to be in charge of medicine. There is, in fact, too much information for the average American to digest much less make sense of. Technologically, the United States has an extraordinary medical system. Unmatched in the world, despite some annoyingly negative statistics. That we achieve what we do in a country peopled by citizens who do the least for their own health than in any other country comparably empowered is amazing. Americans eat too much. Medicine can only do so much against a rising tide of obesity related illnesses. The tradition of the doctor giving you a physical and then telling you to eat right and get some exiercise is not a quaint leftover from an age that didn’t know as much as we do—that is sound advice and more than half the battle in maintaining good health. The explosion of Type 2 diabetes in children has been alarming, and this can be tied directly to diet and exercise. We also work longer hours under higher stress than almost anywhere else in the developed world. The need for vacations and long weekends is acute. This may sound sarcastic, but the link between stress and several major illnesses is no joke. We are also a violent society. If one looks at emergency room statistics, it becomes quickly clear that we are a people who like to beat, stab, and shoot each other at higher levels than almost anywhere else. What makes all these factors so overwhelming is that we have the means to do all this. Because a certain percentage, a significant percentage, of the population can afford to go to the doctor and have the consequences of all these lifestyle disasters “taken care of.” I put all this out front because the one factor that is muted in the national debate over the rising cost of healthcare is the fact that we are, collectively, idiots. We do not do, statistically, the simplest things to avert the need for medical intervention. The last detail in this litany has nothing to do with idiocy but with sentiment and perspective. It has been said for decades and it is true—80% of individual health expense in this country is spent in the last two years of life. We are, as a people, loathe to die and we will direct our health services to do absolutely everything to give us another day. In Europe, such people are told to go home and die. That sounds cold, I know, and I’m sure there are people in France and Germany and Italy with the resources to reject this advice. But the nations as a whole are not expected to pay for it. Here we are. Through health insurance.