The Wall Street Journal Opinion page’s July 6 “Best of the Web” column offers afamiliar comfort to its subscribers. James Freeman, assistant editor of the editorial page, takes a real, documented, horrifying scandal — women injured and babies dead in NHS maternity units in Nottingham, regulators and trust administrators looking the other way — and uses it to perform an operation the column itself never names. The author bio says financial journalism: Yale, the SEC, Fox News, Fox Nation’s “Deep Dive.” The bio does not say healthcare policy. The bio is the first receipt.
The operation is frame-engineered relabeling, WSJ §A.1 — the substitution of one term for another, where the substitution carries the conclusion. The column’s binding word is socialism. Socialism is stapled to the British NHS, to Senator Sanders’s Medicare for All formulation, and, by the column’s third paragraph, to the U.S. Office of Personnel Management’s Federal Employees Health Benefits Program. Three structurally distinct designs — a nationalized delivery system, a single-payer insurance proposal, and a federal-employee benefits procurement program — collapsed into one word. The word does the work the argument would otherwise have to do. The reader who finishes the column walks away with a single mental category: anything the government touches in healthcare is the NHS, and the NHS is what the column just spent five hundred words denouncing. The category is the argument. The argument is the category.
The threat-inflation closer arrives in the column’s second sentence: “In the U.S., socialist Sen. Bernie Sanders aims to force all doctors and patients into a government-run plan he calls ‘Medicare for all.’” The verb force is the work, WSJ §A.13 — the misrepresentation that makes the policy easier to refute than the actual policy is. The original Sanders proposal does not force any doctor or any patient into anything; it provides a single-payer plan that, in Sanders’s design, would compete with private insurance and eventually replace it for those who choose it. The proposal retains private providers, private hospitals, and most delivery infrastructure. What it changes is the payer. Force converts a payer-side policy into a totalitarian threat. The consequence: the reader who has been told force does not have to think about what a single-payer system actually is.
The historical anachronism does the rest. The column compares the NHS to “British health care of the 1530s.” Tudor England had no anesthesia, no antibiotics, no antisepsis, no obstetrical forceps, no blood transfusion, no NICU. The NHS has all of these. The comparison is not an argument; it is an association. The consequence: the reader feels the seventeenth century, and the reader is not invited to think about the twenty-first. The technique is the standing move of the editorial page — deployed on climate policy, on gun policy, on school choice, on every Democratic policy since 1980. The same old trick in a new wrapper.
The dispositive marker, WSJ §3.4, is the column’s mid-piece turn: “Of course the U.K. government has issued yet another report after yet another series of revelations of horrific failures with yet more recommendations of how the aging system will be reformed with new people in charge.” Of course is the word that says the proposition that follows is not up for debate. The editorial-board voice uses of course to mark its own position as the reasonable consensus and the contrary position as the eccentric one, without producing argument for either. The reader is told: this is the obvious reading; the obvious reading is the only reading.
The categorical claim lands next: “socialized medicine always has the same results: shortages, political rationing of services, misallocated resources and patient suffering.” The word always is the move. The word fails the moment a counter-example is named, which is why the column does not name one. The ACA added roughly 20 million insured Americans in its first decade, with a measurable reduction in medical-bankruptcy rates. The WHO’s 2000 World Health Report ranked France first in overall health-system performance, with universal coverage at roughly half the U.S. per-capita cost. Neither appears, because the appearance of either would force the column to argue with the evidence. Shortages, political rationing, misallocated resources, patient suffering — each item is delivered without a number, without a baseline, without a comparison to the U.S. system, without a definition. The consequence: the U.S. healthcare system rations by price — tens of millions uninsured or underinsured, the only developed nation where medical bills are a leading cause of personal bankruptcy — and that rationing is not rationing, it is the market.
The OPM/FEHB handoff is the inter-article relabel, the place where the conflation is most visible. OPM runs a market in which private insurers compete to provide FEHB plans to federal employees. It is not a single-payer system. It is not nationalized healthcare. It is a procurement operation. The piece’s category is government, not single-payer or nationalized delivery or public option. Whatever the government does in healthcare is, in the piece’s accounting, socialism. The word is the category. The category is the argument.
The author bio is the credential ledger, WSJ §3.7, deployed at the byline level. Yale, the SEC, Fox News, Fox Nation — credentialed sources authenticating an operation the credentials do not cover. The piece did not have to be by Freeman. The piece got Freeman because Best of the Web is the format in which the editorial page runs pieces too thin to clear the unsigned-board standard. The unsigned-board editorial is the institution’s standing voice; Best of the Web is the format in which the institution gets to perform the same operation below the threshold where the standing voice would be exposed. The wrapper is the operation. The piece is the daily product of the institution’s standing answer to every question about what the U.S. healthcare system could be.
The column is supposed to be about the NHS. It is also supposed to be a critique of Bernie Sanders’s Medicare for All proposal. The piece does neither. The piece defends the American healthcare system without arguing for it. The defense is the word socialism. The word is doing the work the argument would have to do if the argument were there. The argument is not there.
The piece never names what it is defending. The piece never names that the United States spends more per capita on healthcare than any nation on earth. The piece never names that U.S. maternal mortality is several times higher than peer nations’, per the Commonwealth Fund’s 2024 international comparison. The piece never names that U.S. life expectancy has been falling while peer nations’ has been rising. The piece never names that roughly two in five American adults skipped or delayed care because of cost in 2024, per the Commonwealth Fund’s 2024 Biennial Survey. The piece is performing a defense of this system. The defense is the word.
Freeman has just spent five hundred words describing a fire in a London apartment building to argue against installing smoke detectors in New York. The American system denies care to roughly two in five adults because of cost, bankrupts families at a rate unmatched in the developed world, and extracts nearly a fifth of every premium dollar for administrative friction and profit, per KFF and CMS national health expenditure data. But sure — the real tragedy is that a hospital in Nottingham has to reschedule a maternity ward.
This is the face in the mirror the column forces you to look at: a pundit class so captured by the beneficiaries of the American healthcare racket that they will literally import a seventeenth-century British analogy to avoid talking about the twenty-first-century American grift. The socialism isn’t failing; it is the only word they have left to protect the shareholders. They build a cathedral of citations around a foreign ruin to hide the rot in their own foundation, praying the congregation forgets to look at their own medical bills.
But we know the fucking scam. We know they’re peddling absolute bullshit to protect a cartel of parasites who would rather watch you bleed out on a GoFundMe page than lose a single basis point of margin. It’s a cowardly, spineless, dick-sucking tribute to the insurance lobby. They want you staring at a broken ward in Nottingham so you don’t notice the motherfucking toll booth they built in your own backyard. Fuck their “best of the web.” It’s a racket, it’s a grift, and it’s a miserable, soul-crushing fucking lie.
— Phukher Tarlson