I always serve the writer first because I'm English trained, even though I'm American.
People are so busy dreaming the American Dream, fantasizing about what they could be or have a right to be, that they're all asleep at the switch. Consequently we are living in the Age of Human Error.
Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that's where you see the sharp limitations of market-based health care.