Most of the opposition to universal health care in America is based on our longstanding traditions of greed and double crossing.
The colonies that became the United States were founded as business ventures. Religious dissenters may have been used to staff some of them, but that was because they provided a substantial number of people willing to relocate far, far away. Along with their conscientious convictions, they had obligations to provide returns to their investors. As far as the investors were concerned, the obligations were all that mattered. This was the leading edge of capitalist expansion.
Business thrives on a certain amount of deceit. Profit is itself the amount that a business is able to overcharge for goods and services, in order to have funds to invest in things like other ventures, and the egotistical indulgences of people in charge. We put up with a little of it. The businesses push for a little more. Various forces push back if they can. But between nations, and against indigenous peoples, the deceit includes frequent signing -- and then violation -- of treaties. As the colonies became the nation and the nation developed, deals were struck in back rooms, palms were greased, and history written to show that the good guys always won.
Time and again the little guys have been reminded that the big guys look out for themselves first, and the rabble a distant second. We're conditioned to expect to be double crossed if we're not paying constant attention to how the cards are being dealt. It's almost a point of pride.
We do have our traditional belief in honesty and integrity, truth and justice, freedom and equality. But little of that was reflected in the period when robber barons amassed legendary fortunes to set the contemptible standard of wealth that still afflicts us.
All this conditions us to expect that any system will be gamed, and that cheaters will abound at the top and the bottom. What do you hear most often from people carping about social programs? They hate paying for freeloaders. And the second most common thing? They fear that the system will be inefficient and corrupt. It does not matter to them that the current system is already inefficient and corrupt. They assume, from historical precedent, that the government and corporate interests will collude to fix prices to the advantage of rich investors, and that the users of the programs will most likely be goldbricking slackers.
There is more support for the first contention than for the second. Most Americans work as hard a they can. Some strivers are fortunate enough to be able to find enough jobs to work way more than the 40-hour week we were once led to believe was a reasonable standard. Others fail to connect as well with virtuous toil, and end up living with their parents for a few decades, or falling onto public assistance. And yes, there are goldbricking slackers, but to assume that the person you see using food stamps or lining up for unemployment is just a loser with low morals looks through a pretty distorted lens. Most people have dreams and hopes. Unrealistic though many of them may be, they're generally innocent enough.
When it comes to health care, I often hear that objectors to a universal system don't want to pay for someone else's health care.
You pay for someone else's health care whenever you do business with a company that provides benefits for its employees. You pay for someone else's health care whenever you pay your own insurance premium. You pay for someone else's health care whenever you pay your taxes. By inserting the overhead costs and profit desires of insurance companies into a haphazard agglomeration of risk pools, we jack our own costs higher and higher. The idea that you are not paying for someone else's problems is a dangerous illusion. We all pay for other people's problems, and we always will. Even in libertarian anarchy we would pay dearly for other people's problems, as they acted them out without restraint for as far as they could extend their influence.
Accepting for the moment that we will believe in the innocence and integrity of most clients of a universal health care system, that still leaves the cheaters on the supply side. Only the unwavering resolve of a citizen government will restrain that. Raising children with better ethics will help keep such a government going. Abandon the unrealistic expectation that anyone can become filthy rich and that it's perfectly fine to try.
The social contract becomes complicated when it depends on the good faith and responsible behavior of large numbers of people, but the only alternatives are authoritarianism or anarchy. Put the unruly mob under an iron heel, or pull off all the controls and let the forces of nature bring tides of slaughter, interrupted by brief respites of exhaustion. Breed without restraint, planning on the deaths of many. Become less attached to specific people, places and things, because all will be in danger. Let most of civilization go. It's too expensive and complicated to maintain.
Reproduction is a controversial issue. The compulsion is basic and powerful. On the one hand, I can imagine a thoughtful society replenished by small families with carefully raised children. On the other hand, who knows where the next great mind might come from? The fruitfully multiplying crowd says to replicate early and often. On yet another hand, each generation uses the ideas that are born near it and within it to interpret and shape the world in which they find themselves. You never know to miss what you never had. So controlling the inflow to population seems much better than speeding up the outflow to maintain sustainable levels. Otherwise, any social system will be overwhelmed.
A democratic government, even on a republican model, requires educated, informed citizens asking good questions and focusing on the balance between the desires and needs of individuals and the best interests of the group. That seems to be falling apart, as the desires of individuals and sub-groups supersede the national interest. And that national interest has to acknowledge that the nation exists on a finite planet with other people on it. Conquest has not been possible, nor should it be. All we are left with is cooperation or annihilation. Didn't someone we revere once say "Join or Die?"