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McSweeney's gave him room to opine:

The other day, Nurse Toadstool and I talked in the break room over reheated mushroom casserole. She appeared sad. She mentioned turning a Goomba away because his health insurance wouldn't give him enough gold coins for treatment. Then I realized why the same viruses continue to appear again and again. Each time we turn a patient away for financial reasons, not only are we denying care to the poorest creatures, who often need it the most, but we're putting the disease back into the world, where it continues to spread. Furthermore, the patients I do treat get hooked on my expensive medicine. Mushroom Kingdom's health-care system has turned into a sick, addictive game.Are we under one of Bowser's spells? A basic human need like health care should not be monetized. Even our pack dinosaurs and humanoid mushrooms deserve coverage—a healthy workforce generates more points and 1-ups, increasing the chances of long-term gameplay for everyone. Clearly, a forward-thinking health-care plan, as seen in other gaming systems, some of which I will outline below, is the right choice.His comments on the health system in Sonic's world are, I think, particularly incisive.