Guy Adams: Visions of excess in US healthcare

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When a man in a surgical gown explains that he's about to cut open your loved one's eyeballs with a laser and re-arrange their cornea, it helps to be told that he previously did the same thing to Angelina Jolie, Nicole Kidman and Cindy Crawford.

It's even more comforting, as you write a cheque for $6,000 (£3,600) to Dr Robert Maloney, of the Maloney Vision Institute, to know that Michael Bolton, Barry Manilow and Kenny G also recently sat in his reclining chair.

So did Henry Winkler, who praised his "warmth, calm and gentleness". And since no one should argue with The Fonz, I settled into a leather sofa and waited for Maloney to fix my fiancée's knackered eyesight.

Like a well-established curry house, the waiting room was decorated with signed photos of celebrity clients: here a beaming Denise Richards, there William Shatner, thanking "the best doctor in town!"

To Angelenos, this isn't strange: celebrity endorsement is one of the best ways of picking a decent quack. But to a Brit, born into the mollycoddling arms of the NHS, it served to highlight the commercial excesses of America's privatised healthcare system.

As Barack Obama complained this week, the US spends more on healthcare, but dies younger, than any other comparable nation on earth.

In this context, spending thousands on Cindy Crawford's eye doctor is a frightful extravagance. It won't keep you up with the Joneses for long, either: at dinner on Tuesday, a friend pinged his wine glass and proudly announced that his wife had just hired the hottest doctor in town: Brangelina's gynaecologist.

Rare glimpse of Kev-Fed

On the subject of celebrity endorsement, the trade magazine BizBash, which caters for the party-planning industry, reports that the recession is eating into the "appearance fees" stars charge to walk down a red carpet.

Though top names like Zac Efron and Paris Hilton can still make six-figure sums for showing up at a party, the lower reaches of the pecking order have been well and truly credit-crunched. Last year, Kevin Federline, the ex-husband of Britney Spears, got $10,000 for going to a nightclub in Las Vegas. But this year, the magazine says, "he's not likely to command any fee at all". Sometimes, then, a financial crisis can be civilisation's gain.

Will Chastity take Jennifer?

Cher's lesbian daughter, Chastity Bono, revealed last week that she's planning to undergo a sex-change operation. Given California's furious same-sex marriage debate, this raises a pertinent question: when all is complete, will she, or rather he, be able to legally marry long-term girlfriend Jennifer?

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