To hear some of the health care reformers tell it, American medicine is so badly broken it needs a total overhaul. Nobody would say it is perfect, but it's a nice little reminder of the strengths of American medicine that the Nobel Prize in medicine, announced today, went to doctors from Harvard, Johns Hopkins, and the University of California, San Francisco. All three institutions get lots of federal money. Harvard and Johns Hopkins are non-profits, and UCSF is part of the state of California's public education system, so it's not as if this is a victory for unalloyed free market capitalism. The scientists don't work as full-time employees of for-profit drug companies. But neither do they work for the national health service in Britain or Canada or Cuba.