It is amazing that people who think we cannot afford to pay for

Host: The rain had been falling since dusk, steady and unforgiving, turning the city’s streets into ribbons of mirror light. The hospital cafeteria was nearly empty at this hour — just the faint hum of the refrigerator, the buzz of a vending machine, and the occasional cough echoing down the hallway.

The fluorescent bulbs flickered, casting a cold, sterile glow over the tables, where the smell of disinfectant hung like an unseen fog.

Jack sat at one of the metal tables, his coat still damp, his hands wrapped around a paper cup of coffee that had long since gone cold. Across from him, Jeeny stirred a bowl of soup, though she wasn’t really eating — just moving the spoon in circles, as if trying to stir away her thoughts.

Host: It was the kind of night when exhaustion wears a philosopher’s face, and arguments begin because silence becomes too loud.

Jeeny: (softly) “Thomas Sowell once said — ‘It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it.’”

Jack: (grinning tiredly) “I remember that one. Classic Sowell. A clean stab right through the heart of government inefficiency. He wasn’t wrong.”

Jeeny: “You say that like it’s simple — like bureaucracy is just waste. But what if that structure is the only thing that keeps medicine from becoming a luxury?”

Jack: “Structure? You mean red tape. The endless forms, the waiting lists, the administrators making six figures while doctors drown in paperwork. Sowell’s right — it’s madness. We pay more to organize help than to give it.”

Host: The lights above hummed faintly, one of them flickering, as if the room itself were arguing in ** Morse code**. Jeeny looked at Jack — his grey eyes tired but still sharp, his face half-lit, half-shadowed.

Jeeny: “You sound like someone who’s never had to fight through the system to get care. Bureaucracy may be flawed, but it’s the only wall standing between patients and the chaos of unregulated markets. Do you think insurance companies are kinder than government?”

Jack: “No. But at least they compete. Government doesn’t. You can’t fire inefficiency when it wears a badge of policy. Look at the VA hospitals, Jeeny — delays, shortages, neglect. That’s bureaucracy at its purest.”

Jeeny: “And yet, every private hospital you defend still takes federal money. Medicare, Medicaid — without them, half the country would go untreated. You think the invisible hand writes prescriptions?”

Host: A silence fell, broken only by the rain drumming harder against the windows. In the distance, a nurse’s voice called over the intercom, followed by the echo of a gurney wheel.

Jack: “You’re romanticizing the idea of a moral government. Governments don’t heal people — people do. Bureaucracy breeds distance. You turn compassion into process.”

Jeeny: (her voice firm now) “And greed breeds deserts. You turn care into commerce. You think Sowell’s logic proves something, but it ignores the human cost. Efficiency means nothing when people are dying outside hospital doors.”

Host: Her words hit the air like glass breaking, and for a moment, even the machines in the corner seemed to pause. Jack looked at her, his jaw tightened, his hand clenched around the coffee cup until it crumpled.

Jack: “You think I don’t know that? My brother died in a hospital that was government-run. They lost his file — twice. When I got there, he’d been waiting nine hours for a scan. Nine. Bureaucracy didn’t save him. It buried him.”

Host: The rain softened, the sound now a steady whisper, as if even the sky had grown quiet out of respect. Jeeny’s eyes glimmered, and for a moment, her voice faltered.

Jeeny: “I’m sorry, Jack… I didn’t know.”

Jack: (shaking his head) “No. You didn’t. And that’s the thing — we talk about systems, about reform, about theory. But in the end, it’s always the patient lying alone in a hallway while some official checks a box.”

Host: The clock on the wall ticked, each second louder than the last. Jeeny took a slow breath, her fingers tapping against the table, the sound like a quiet apology.

Jeeny: “You’re right about the system’s flaws. But you’re wrong if you think the alternative is better. I worked in rural clinics, Jack — no insurance, no government aid, just people begging for antibiotics. Children dying because the medicine was too expensive. You call that freedom?”

Jack: “I call that failure. But not of freedom — of balance. Bureaucracy doesn’t fix poverty, Jeeny. It just hides it behind paperwork. What people need isn’t more forms — it’s access, efficiency, accountability. And you don’t get that by feeding more money into the same machine.”

Jeeny: “Then what do you propose? Privatize compassion? Let the market decide who deserves care? You think a spreadsheet can price human dignity?”

Jack: (leaning forward, voice rising) “No! But neither can a bureaucrat who’s never met the patient. Both systems dehumanize — one for profit, one for procedure. That’s the tragedy Sowell was talking about. We’re too blind to see we’re paying for both monsters at once.”

Host: The air felt tense, charged, as if the fluorescent lights themselves were buzzing in disagreement. Jeeny’s eyes filled with emotion, her voice a mix of anger and pleading.

Jeeny: “Then stop choosing monsters. Choose humanity. The bureaucracy you despise can be reformed. But the profit motive? It doesn’t reform. It consumes. Look at insulin prices, Jack — tripled in ten years. People rationing doses. Dying to save the company’s quarterly margin.”

Jack: (quietly) “You’re right about that. But tell me — how many lives do we lose waiting for governments to ‘reform’ themselves?”

Host: The question hung in the air, heavy as the storm outside. Jeeny looked down, her fingers trembling slightly against her bowl. The steam had faded, leaving the soup as cold as their arguments.

Jeeny: “Maybe the answer isn’t government or market. Maybe it’s accountability — from both. Maybe we stop worshipping systems and start listening to people again.”

Jack: (sighing) “Maybe. But people build systems. And systems build walls. It’s a cycle.”

Host: A nurse entered, nodding at them before disappearing down the hall, her footsteps echoing like the echo of unfinished thoughts.

Jeeny: “You know what I think, Jack? Sowell wasn’t mocking the cost of bureaucracy. He was warning us — that logic without compassion becomes cruelty. It’s amazing, he said, that we can’t pay for healing — but we’ll pay to measure it.”

Jack: (after a long silence) “Yeah. Maybe he meant both sides of the coin. Maybe he was amazed not by government waste — but by human hypocrisy.”

Host: Outside, the rain had stopped. The windows were fogged, and the streetlights glowed through them like orbs suspended in mist. The cafeteria felt warmer now, though neither of them had moved closer. It was a quiet warmth, born not from comfort, but from shared exhaustion.

Jeeny: “Maybe someday we’ll figure it out — how to heal people without drowning in either greed or bureaucracy.”

Jack: (half-smiling) “Maybe someday. Until then, I’ll just try to keep the paperwork from killing anyone else.”

Host: Jeeny smiled, faintly, her eyes soft yet steady, as if she could see through his weariness to the truth beneath.

The intercom crackled, announcing another emergency in Ward 3. Jack stood, his coat creaking as he pulled it back on.

Jeeny: “You going back up?”

Jack: “Yeah. Someone’s got to make sure the bureaucracy doesn’t forget the patient.”

Host: He walked away, his steps echoing down the hall, merging with the sound of machines, footsteps, and the soft hum of life continuing.

Jeeny watched, her reflection faint in the window, her thoughts like the rain that had just ceased — still, but far from gone.

The clock ticked on, its hands moving like a quiet reminder that while systems may fail, the struggle to care — and to question — never really does.