In Focus delivers deeper coverage of the political, cultural, and ideological issues shaping America. Published daily by senior writers and experts, these in-depth pieces go beyond the headlines to give readers the full picture. You can find our full list of In Focus pieces here.

What happens when the American Left gets the socialized healthcare they dream of, along with the open borders policy that Joe Biden successfully unleashed during his presidency? Across the pond, Britain’s National Health Service provides a pretty solid preview of the future AOC administration.

Recommended Stories

• The Democratic doomsday cult's decade of delusion
• Trump's ambitious Gaza peace plan is fraught with complexity
• RFK Jr. steps into the liberal-created void on autism

On its blog late last September, the NHS’s Genomics Education Programme responded to Tory calls to ban marriages between first cousins with the retort that actually, the practice comes with “including stronger extended family support systems and economic advantages (resources, property and inheritance can be consolidated rather than diluted across households).”

TRUMP’S AMBITIOUS GAZA PEACE PLAN IS FRAUGHT WITH COMPLEXITY

While the GEP guidance concedes that first-cousin marriage is linked to progeny with double the risk of genetic abnormalities, “there are many other factors that also increase this chance (such as parental age, smoking, alcohol use, and assisted reproductive technologies), none of which are banned in the UK.”

Ultimately, the GEP warns against banning first-cousin marriage and “stigmatising certain communities and cultural traditions,” instead imposing “genetic counseling, awareness-raising initiatives and public health campaigns.”

The post has since been deleted, with the NHS responding to the global outrage over the blog with the concession that the guidance “should not have been published.” Labour Party Health Secretary Wes Streeting publicly lambasted the NHS, declaring that “clear” evidence proves that “first-cousin marriages are high risk and unsafe.”

More than three in four white and Indian Britons told YouGov that first-cousin marriage should be illegal, and over four in five black Britons said the same. But fewer than half of Pakistani Britons support the ban. Half of this sizable minority is indeed married to a first cousin.

And thus, there’s still no sign that the ruling Labour Party will back the ban on the practice once and for all.

Labour’s recalcitrance is a warning for liberals here at home, not just about the political perils of open borders and socialized healthcare systems, but of running away from Western civilization and the cultures it built. It is, in fact, evident, in the very justifications the NHS GEP used to claim cousin-marriage actually provides benefits, that importing lesser cultures would be our demise.

***

“UK laws allowing first-cousin marriage date back to the reign of Henry VIII in the 16th century: having broken with Rome in order to marry Anne Boleyn, Henry passed a new law that enabled him to marry her cousin, Catherine Howard, four years after Anne’s execution,” notes the GEP guidance, explaining why first-cousin marriage isn’t already banned in the country. Indeed, Henry VIII, who argued his first marriage to his brother’s widow was illegitimate under the Catholic Church’s prohibitions on consanguinity and affinity, responded by marrying Boleyn, whose sister he had already slept with. By the time a 49-year-old Henry VIII chose as his fourth wife the 17-year-old Catherine Howard, Boleyn’s first cousin, Henry effectively rid the entire country of Catholic marriage laws. After two marriages that the Catholic Church considered incestuous under canon law and a first marriage that Henry VIII bent over backward to convince the world was incestuous, old Bluebeard dispelled England of the pretense entirely, leaving only the incredibly narrow marriage prohibitions of the 3,000-year-old Book of Leviticus in place.

In practice, the legalization of cousin marriage didn’t actually change English behavior much. Few normal Englishmen adopted the practice, and only four subsequent monarchs married their first cousins. William III and Mary II famously sired no children. George IV had a single daughter who died without successfully producing a male heir, and although Queen Victoria was blessed with fecundity, her cousin marriage helped her transmit catastrophic hemophilia to the ruling royal houses of Prussia, Russia, Spain, Hesse, and Britain.

But beyond the obvious empirical evidence of incest’s genetic destruction — recall that incest doomed the Spanish Habsburgs and sparked the 13-year War of Spanish Succession — the main reason that cousin marriage didn’t have to be legally banned is because it had already transformed the psychology of Western Christendom. The Catholic Church‘s early and strict marriage prohibitions didn’t just change societal incentives in Western Europe, but the actual psychology of the generations that came afterwards.

In his landmark history of evolutionary psychology, The WEIRDest People in the World, Harvard professor Joseph Henrich spends nearly a hundred pages detailing how early Catholic marriage restrictions created the nuclear family, coercing young men and women out of their natal homes and into the workforce, leading to later and more consensual marriages in their own new and independent homes. This “Marriage and Family Program” dissolved intensive kin-based institutions, encouraging mobility of young people and new families in a way that was unprecedented in antiquity.

“The psychological chances induced by the shift in the organization of families and social networks help us understand why the newly forming institutions and organizations developed in certain ways. New monastic orders, guilds, towns, and universities increasingly built their laws, principles, norms, and rules in the ways that focused on the individual, often endowing each member with abstract rights, privileges, obligations and duties to the organization,” Heinrich writes. “With intensive kinship in a straitjacket, the one thing that medieval Europeans had in common was Christianity, with its universalizing morality, sense of individual responsibility, and strong notions of free will.”

From here, even the least careful reader can draw a straight line to the Renaissance’s celebration of individualism and agency, the Enlightenment’s reverence for rationality and the invention of the scientific method and capitalism, and the unprecedented founding of a nation that recognized that all men are created equal.

The problem that the U.K. has that the U.S. does not yet have is not simply that the U.K.’s migrants are disproportionately Muslims from the Middle East and South Asia, while ours are Catholics from the Americas. Rather, it’s this kinship question, and the fact that by and large, even illegal immigrants into America want to become functional Americans, whereas the U.K. is importing a foreign culture from people that don’t seem to want to become Britons. And unless the U.K. can muster a defense of the fact that it has a philosophical identity at all, it will lose.

***

Before racial essentialism transcended to the top of the hierarchy of oppression, cousin marriage was correctly loathed by feminists. The very “extended family support systems and economic advantages (resources, property and inheritance can be consolidated rather than diluted across households)” extolled by the GEP are better understood as patriarchal tools of oppression against not just women, but any lower status and younger men. Beyond the much-ballyhooed maternal instinct to not see one’s child have twice the risk of cystic fibrosis and sickle cell disease, women trapped in cousin marriages are uniquely susceptible to what Francis Fukuyama deems “the tyranny of cousins.”

Despite comprising just 9% of the nation’s population, U.K. women of Asian ethnicity — disproportionately South Asian and Pakistani in particular — made up a minimum of 17% of domestic abuse reports filed to the police from the spring of 2022 to 2024. This is likely a dramatic understatement of the problem. To illustrate the magnitude of the problem, the BBC reported that half of the women who use a specialist domestic violence unit at a Birmingham mosque did not report their abuse to the police “due to fear of losing their home, financial support and being isolated.”

This is indeed due to the prevailing intensity of kinship institutions over 1,000 years of Western norms.

“Many features of kin-based institutions promote a sense of trust that depends on interconnectedness through a web of personal relations and strong feelings of in-group loyalty toward one’s network,” Heinrich writes specifically of Pakistani culture. “Intensive kinship thus breeds a sharper distinction between in-groups and out-groups, along with a general distrust of strangers.”

Yes, cousin marriage does concentrate wealth and power, which is precisely why medieval monarchs bent over backwards to get the papal dispensations to allow it. But that’s precisely why it’s antithetical to the social mobility and autonomy that make the West great. Nepotism, dynastic concentrations of wealth, and tribal loyalty over patriotism and one’s efforts and merit are all bad things.

The problem is obviously not a matter of religion alone; in fact, consider Pakistani immigrants in America. Given our near-zero cousin marriage rate and the utter lack of reported mass genetic abnormalities among the Pakistani diaspora, it’s safe to say that Pakistanis in America, who earn an average of six figures and post higher education rates of the national average, are of a very different ilk than those in the U.K.

***

A part of this is because of the physical demands of moving to America. Yes, crossing the Atlantic is a tougher journey than the Mediterranean, but once in the U.S. itself, our great national tradition, more than any European nation we descended from, is to move.

Although the Census didn’t start tracking domestic migration until the immediate aftermath of World War II, Americans of the 1940s were still pioneers in spirit, with one in five moving in any given year. This number held constant for most of the 20th century, but by COVID-19, it has fallen below a dismal 10%.

It’s easy to write this off as statistical noise or an otherwise meaningless data point, but the willingness to seek out a new frontier doesn’t just shape psychology at a population level, but also at an individual one.

Writing on all the ways that MFP fostered relational mobility, or the way in which a person can create new interpersonal relationships, Henrich notes that this continues to influence us on a macro and micro scale.

“With the loss of kin-based social safety nets and the need to find unrelated marriage partners, individuals would have had more incentives to move and fewer to stay put, resulting in greater residential mobility,” Henrich writes. “Indeed, in the modern world people who value family ties less are more willing to move geographically. In fact, even the adult children of immigrants whose parents came from a country with stronger family ties are less likely to move geographically than are the children of immigrants who came from countries with weaker family ties.”

But Henrich notes the variance on an individual level, and how a parent who moves a family can bolster the relational mobility of their child. It would logically follow that the Pakistanis who move to America, knowing that our government does not gift you a council home or socialized medicine, will create children utterly different from the babies bred between cousins in Birmingham.

***

Over 15 years ago, Razib Khan, a Bangladeshi-American expert on genetics, warned us all about the coming storm for the NHS.

“On the one hand, there is individual freedom of choice,” Khan wrote of the persistence of cousin-marriage in much of the Muslim world. “This is a core Western value. On the other hand, there is the fact that health care costs are a long term structural issue for the fiscal health of any society. Ethnic Pakistanis are only a few percent of Britain’s population, so it is manageable right now, but their proportion will slowly rise because of higher fertility and continued immigration. If cousin marriage continues to remain popular in the community the later generations are going to have even greater health problems because of higher inbreeding coefficients (due to repeated cousin marriages across the generations within the family).”

Indeed, the NHS is at a breaking point, and unlike if, say, Aetna in the U.S. falls through, there is no competitor to take its place. The system posted a billion-pound deficit in the last fiscal year, with spending projected to increase by 3% annually after the country’s 3.8% inflation. Nearly 8 million Britons are on the nation’s elective treatment backlog despite the NHS collecting 20% of all taxes paid to the government.

An old-school socialist would have banned cousin marriage the moment the country nationalized the healthcare system. The Soviets famously used the state to standardize diets, promote “physical culture” as a patriotic imperative, and criminalize drunkenness and prostitution specifically due to the costs to the system.

Socialists today are such softies, beholden to the dogma of multiculturalism over the financial mandate of Marxism. The U.K. can go down with the ship, but it should come with a few lessons to the American Left.

First, a nationalized healthcare system requires a government to make moral decisions about individual health, ranging from obesity to incest. Do we trust AOC to have the stomach to stab chubby children with Ozempic before they develop six-figure healthcare bills in heart disease?

LIVE UPDATES: GOVERNMENT ENTERS SHUTDOWN WITH NO DEAL IN SIGHT

But more importantly, American immigration is one of our greatest assets so long as it brings in the folks who love the unknown of the frontier and self-reliance over slavery to the state. If we adopt the lethal combination of the U.K.’s socialized incentives with fealty to cultures of intensive kinship, immigration will be the greatest weapon against our own excellence.

Holding the line means the willingness to say ugly things, like the fact that the criminalization of incest and the intentional weakening of extended families and social safety networks created Western civilization. Europe may forget this, but America must not.