It's more than cheap doctor visits

This is an excerpt from an article in the Wall Street journal on reasons why countries adopt - or don't adopt - universal health care:

I discovered Victor Fuchs's analysis during a dive into my PC's hard drive, where years ago I stored a paper the Stanford economist did in 1976 called "From Bismarck to Woodcock: The 'Irrational' Pursuit of National Health Insurance." That it was delivered to mark the 65th birthday of the conservative economist George Stigler suggests the eclectic flavor of the liberal Prof. Fuchs's thinking.

His paper is mainly a meditation attempting to explain why so many countries adopted national insurance programs, and why it is resisted in the U.S. Several broad points help explain the tides running against the Obama plan.

He notes, for instance, that the national health insurance movement rose alongside a larger transfer of responsibility from the family to the state: "Every time the state assumes an additional function such as health insurance, child care or benefits for the aged, the need for close family ties becomes weaker."

But even the state must bond: "It may be that one of the most effective ways of increasing allegiance to the state is through national health insurance." This would have been Bismarck's purpose. "We live at a time when many of the traditional symbols and institutions that held a nation together have been weakened and fallen into disrepute. A more sophisticated public requires more sophisticated symbols, and national health insurance may fit that role particularly well." Updating the public symbols, Mr. Obama says health care is one of the two "pillars" of U.S. prosperity in the 21st century.