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Public v. Private HealthCare

1) Is healthcare a right that should be provided by the state? Privatizing health care makes it a commodity, but socializing health care leads to over-burdening the doctors, as described by the man who said "I stopped going to the state hospital. If something big happens, I will sell everything and go to the private doctor." (p.141).  What explains this poor marginalized man's priviledging of the private healthcare over the public healthcare? Along with that, what types of healthcare should be public? Given the current debate about making birth control available with insurance, does a neoliberalist reading of poverty shed any light on the correct approach?
2) The culture-centered approach priviledges an idea that the people who want to change their situation know what they need better (or as well as) the people from the dominant discourse, but the counter-argument is often given to similar ideas that just being in the situation doesn't necessarily make you better qualified (although it can). How would you respond? Can people help themselves change ever or do they always need others to effect a change (such as improving their health, poverty, etc. situation)?
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