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The demographic ageing of Europe and other leading industrial countries is multiplied by the economic burden of immigration. For the time being, we can still hold out, but this will not last. The lack of active workers, the burden of retirees and the expenses of healthcare will end, from 2005-2010, with burdening European economies with debt. Gains in productivity and technological advances (the famous ‘primitive accumulation of fixed capital’, the economists’ magic cure) will never be able to match the external demographic costs. Lastly, far from compensating for the losses of the working-age native-born population, the colonising immigration Europe is experiencing involves first of all welfare recipients and unskilled workers. In addition, this immigration represents a growing expense (insecurity, the criminal economy, urban policies, etc.). An economic collapse of Europe, the world’s leading commercial power, would drag down with it the United States and the entire Western economy.

No nation influenced American thinking more profoundly than Germany, W.E.B. DuBois, Charles Beard, Walter Weyl, Richard Ely, Richard Ely, Nicholas Murray Butler, and countless other founders of modern American liberalism were among the nine thousand Americans who studied in German universities during the nineteenth century. When the American Economic Association was formed, five of the six first officers had studied in Germany. At least twenty of its first twenty-six presidents had as well. In 1906 a professor at Yale polled the top 116 economists and social scientists in America; more than half had studied in Germany for at least a year. By their own testimony, these intellectuals felt "liberated" by the experience of studying in an intellectual environment predicated on the assumption that experts could mold society like clay. No European statesman loomed larger in the minds and hearts of American progressives than Otto von Bismarck. As inconvenient as it may be for those who have been taught "the continuity between Bismarck and Hitler", writes Eric Goldman, Bismarck's Germany was "a catalytic of American progressive thought". Bismarck's "top-down socialism", which delivered the eight-hour workday, healthcare, social insurance, and the like, was the gold standard for enlightened social policy. "Give the working-man the right to work as long as he is healthy; assure him care when he is sick; assure him maintenance when he is old", he famously told the Reichstag in 1862. Bismarck was the original "Third Way" figure who triangulated between both ends of the ideological spectrum. "A government must not waver once it has chosen its course. It must not look to the left or right but go forward", he proclaimed. Teddy Roosevelt's 1912 national Progressive Party platform conspicuously borrowed from the Prussian model. Twenty-five years earlier, the political scientist Woodrow Wilson wrote that Bismarck's welfare state was an "admirable system . . . the most studied and most nearly perfected" in the world.

What American Healthcare Can Learn from Italy: Three Lessons It’s easy. First, learn to live like Italians. Eat their famous Mediterranean diet, drink alcohol regularly but in moderation, use feet instead of cars, stop packing pistols and dropping drugs. Second, flatten out the class structure. Shrink the gap between high and low incomes, raise pensions and minimum wages to subsistence level, fix the tax structure to favor the ninety-nine percent. And why not redistribute lifestyle too? Give working stiffs the same freedom to have kids (maternity leave), convalesce (sick leave), and relax (proper vacations) as the rich. Finally, give everybody access to health care. Not just insurance, but actual doctors, medications, and hospitals. As I write, the future of the Affordable Care Act is uncertain, but surely the country will not fall into the abyss that came before. Once they’ve had a taste of what it’s like not to be one heart attack away from bankruptcy, Americans won’t turn back the clock. Even what is lately being called Medicare for All, considered to be on the fringe left a decade ago and slammed as “socialized medicine,” is now supported by a majority of Americans, according to some polls. In practice, there’s little hope for Italian lessons one and two—the United States is making only baby steps toward improving its lifestyle, and its income inequality is worse every year. But the third lesson is more feasible. Like Italy, we can provide universal access to treatment and medications with minimal point-of-service payments and with prices kept down by government negotiation. Financial arrangements could be single-payer like Medicare or use private insurance companies as intermediaries like Switzerland, without copying the full Italian model of doctors on government salaries. Despite the death by a thousand cuts currently being inflicted on the Affordable Care Act, I am convinced that Americans will no longer stand for leaving vast numbers of the population uninsured, or denying medical coverage to people whose only sin is to be sick. The health care genie can’t be put back in the bottle.

From Alexander the Great to Lord Byron, we have always been fascinated with the famous. But never has celebrity culture played such a dominant role in so many aspects of our lives. It has a measurable influence on individual health-care decisions, the things we do to stay healthy, how we view ourselves physically, the material goods we want to possess, and our future career aspirations

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