I really enjoyed Jeff Goodell’s Rolling Stone interview with Bill Gates, though I wish there were clarifying follow-up questions in two areas.

The first concerns Gates’ critique of Snowden’s info leak. Does he feel similarly about the Pentagon Papers? Would he also be opposed to an illegal leak if it exposed an Abu Ghraib situation?

The second regards the technologist’s comments about poverty in America. It comes across that Gates may believe that there aren’t Americans who are truly poor, but I doubt he really thinks that.

Here’s a rather technocratic exchange about U.S. healthcare reform and the impact new science and technologies will have on the system:

“Rolling Stone:

Well, there certainly is plenty of frustration with our political system.

Bill Gates:

But I do think, in most cases, when you get this negative view of the situation, you’re forgetting about the innovation that goes on outside of government. Thank God they actually do fund basic research. That’s part of the reason the U.S. is so good [at things like health care]. But innovation can actually be your enemy in health care if you are not careful.

 Rolling Stone:

How’s that?

Bill Gates:

If you accelerate certain things but aren’t careful about whether you want to make those innovations available to everyone, then you’re intensifying the cost in such a way that you’ll overwhelm all the resources.

 Rolling Stone:

Like million-dollar chemotherapy treatments.

Bill Gates:

Yeah, or organ transplants for people in their seventies from new artificial organs being grown. There is a lot of medical technology for which, unless you can make judgments about who should buy it, you will have to invade other government functions to find the money. Joint replacement is another example. There are four or five of these innovations down the pipe that are huge, huge things.

 Rolling Stone:

Yeah, but when people start talking about these issues, we start hearing loaded phrases like ‘death panels’ and suggestions that government bureaucrats are going to decide when it’s time to pull the plug on Grandma.

Bill Gates:

The idea that there aren’t trade-offs is an outrageous thing. Most countries know that there are trade-offs, but here, we manage to have the notion that there aren’t any. So that’s unfortunate, to not have people think, ‘Hey, there are finite resources here.'”