We are left, finally, with a so-called health care system so cruel and unjust that the Devil himself in consultation with the most demonic lobbyists, and perhaps a little input from historical politicians such as Caligula, Ivan the Terrible, Heinrich Himmler, and Pol Pot could not construct a worse way of deploying the fruits of modern science. It has gotten to the point for most of us where we dread a visit to the doctor more for the bureaucratic consequences than the health issues themselves. Your gall bladder may have to come out, but it's much harder to face the booby-trap clause in your health insurance that will result in you getting stuck with a $123,000 bill for surgery and attendant procedures (including the $500 tylenols). Three months later, of course, the re-po man is towing your car and the mortgage "servicer" has foreclosed on your house, and your life (even without that pesky gall bladder) has become a permanent camping trip next to a drainage ditch.

     I am personally not confident that we will do anything to address the failures and inequities of so-called Health Care. As a general thing, I have to say that this recent exercise only seems to prove the now permanent impotence and impairment of the federal government. In The Long Emergency we have entered, real governance is likely to devolve downward to the community level, and it may be unrealistic to expect any real action from on high. Things have just gone too far at this point. We have blown past the thresholds of hyper-complexity so that further hyper-complexity only make things worse. At more than 2,000 pages, the current Health Care Reform bill is surely an exercise in the diminishing returns of grotesque additional hyper-complexity.

Let's consider the health of two babies born into two different societies. Baby A is born in one of the richest countries in the world, the USA, home to more than half of the world' billionaires. It is a country that spends somewhere between 40-50 per cent of the world's total spending on health care, although it contains less than 5 per cent of the world's population. Spending on drug treatments and high-tech scanning equipment is particularly high. Doctors in this country earn almost twice as much as doctors elsewhere and medical care is often described as the best in the world.

Baby B is born in one of the poorer of the western democracies, Greece, where average income is not much more than half that of of the USA. Whereas America spends about $6000 per person per year on health care, Greece spends less than $3000. This is in real terms, after taking into account the different costs of medical care. And Greece has six times fewer high-tech scanners per person than the USA.

Surely Baby B's chances of a long and healthy life are worse than Baby A's?

In fact, Baby A, born in the USA, has a life expectancy of 1.2 years less than Baby B, born in Greece. And baby A has a 40 per cent higher risk of dying in the first year after birth than Baby B. Among developed countries, there are even bigger contrasts than the comparison we've used here: babies born in the USA are twice as likely to die in their first year than babies in Japan, and the difference in average life expectancy between the USA and Sweden is three years, between Portugal and Japan it is over five years.