Eideard

Most people can probably remember the moment when they first realised the seductive power and global pervasiveness of American culture.

I had bought a bootleg CD of The Beach Boys’ surfing songs in the remote north-eastern Russian republic of Sakha and had my photograph taken with a goat herder in Djibouti who was wearing a Six Million Dollar Man T-shirt…

After all, even when you’re watching a Chinese flat-screen TV and driving an Indian car powered with Brazilian biofuels you almost certainly won’t be wearing Indian-style clothing or humming Chinese pop songs as you go. Or watching Brazilian movies either.

Next time you see television pictures of an anti-American demonstration anywhere on earth look closely at the crowd. Among the flag-burners you’ll almost certainly see someone wearing an LA Lakers shirt or a Yankees baseball cap.

My first exposure to American culture came back in the Doris Days of the early 1960s, growing up in a Britain that was still shaking off the lingering effects of rationing and the costs of post-war reconstruction.

We had Elvis, of course, and Hollywood but the world was a lot less global then. It was still possible, for example, for British recording artists to have hit records by simply recording their own versions of songs that were already hits for American stars on the far side of the Atlantic.

But the flagship of American influence in my own life was Spam, the bright-pink pork luncheon meat that was a staple of the British working-class diet for several decades.

It’s still going strong in many markets around the world – including the United States – and although the odd concession has been made to changing times (it’s less fatty and salty than it used to be) it’s still essentially the same as it always was.

I came to know it in the early 1960s, in the days before the invention of obesity. In common with millions of other British families we used to slice it, coat it in batter and then deep-fry it, thus producing that miracle of British culinary ingenuity known as the spam fritter.

RTFA. At least as funny as Monty Python. And I should be the last to complain having spent a certain portion of my misspent youth lunching on sandwiches of fried Spam with melted Velveeta “cheese” on top.

The well-worn notion that patients in the United States have unfettered access to the most expensive cancer drugs while the United Kingdom’s nationalized health care system regularly denies access to some high-cost treatments needs rethinking…

Critics of the U.K. system say care there is rationed — that patients are denied some expensive therapies so that better health care can be provided to the nation as a whole. Critics of the U.S. system say care is rationed here, too — that only those with the very best insurance and those who can afford sky-high out-of-pocket expenses have meaningful access to any and all high-priced therapies, especially at the end of life.

The authors found that with regard to very expensive cancer drugs, both characterizations are largely correct. “The issue is not whether rationing is a good thing or a bad thing,” Doctor Ruth Faden says. “The issue is what we should do about extraordinarily expensive treatments, some of which do very little to improve how well or how long people live.” At the same time, she adds, “there is no ethically defensible reason why some Americans have access to expensive cancer drugs and some do not.”

“Policy makers and our society now need to do the hard work of developing a reasoned, evidence-based system of using health care resources wisely, and the first step is to engage in an honest and transparent conversation about the values that should guide these decisions, a conversation that is informed by facts, not politics,” she says.

RTFA. Doctor Faden goes into the details.

The fact remains, unless you have the bucks – here in the States – you are screwed.