I’m on my way back to LA tomorrow after a quick trip to London. Today included a meeting with a senior figure in the crime-policy world here, who was reflecting on how hard it is to improve the British police service. He identified, as a central problem, what he called “BPW”: the need to start every speech about policing and crime with the (by now transparently false) statement that the UK has the “best police in the world.”

That reminded me of the American health care debate, where the opponents of progress always start out with the (again, transparently false) claim that the U.S. has the best health care system in the world, when in fact it’s a notable under-performer, despite its astounding financial bloat. We certainly have the best-paid hospital directors and health-insurance CEO’s in the world, and the best-paid specialists in invasive procedures. But it’s hardly the best system from the viewpoint of the patient’s wallet or the patient’s lifespan.

It’s the old story: the first step in fixing something is noticing that it’s broken.

[Cross-posted at The Reality-based Community]

Mark Kleiman

Mark Kleiman is a professor of public policy at the New York University Marron Institute.