We Brits fail to recognise just how deeply ingrained the American spirit of individualism, entrepeneurship and self-reliance is. For millions of Americans (and many here in the UK) there is a belief that justice is something that happens naturally, not something to be distributed by a state. At this ideological level I don’t believe people will be converted from one side of the debate to the other, and therein lies Obama’s biggest problem. No matter how much evidence you present about the benefits (or otherwise) of sharing the burden of healthcare costs by progressive taxation and distributing it according to need guided by scientific evidence, the argument will be won or (more likely) lost on moral grounds. Things are, of course more complicated than that as i’ve already said, but like most debates, this has already degenerated into hammer vs. tongs.
Of course the confusion caused by attributing moral values to material facts is by no means restricted to Americans, though being a vast and varied country its quite easy to find examples. One of the more extreme, but nevertheless infuential and wide ranging is Prosperity theology. According to this reasoning success is a sign of God’s approval and failure a sign of His disapproval. Hence the successful deserve wealth because they are good and the unsuccessful deserve poverty because they are bad. Newspapers and politicians who would most likely choose to distance their politics from prosperity theology, still share the same moral reasoning. The secular version lies at the heart of Social Dawinism which has been enormously infuential in American and right wing European politics, based on the principle that social stratification will happen according to natural merit so long as governments don’t interfere.
The shocking conclusion of this way of confused moral reasoning is that despite the advances of science and modern theology illness remains as much now as it did in ancient times, a divine punishment for evil and according to simple capitalist rationale, if you’re sick you deserve to pay for it.
A Better NHS 
some would say an inherent individuality and self reliance, I’m more inclined to view it as an intrinsically myopic selfishness of American culture.
Our first born, Billy came on wednesday morning. Still mulling over Job as a middle name. Nothing in fact to do with this article, just an old family tradition. But a curious coincidence nevertheless.
jt