Sociologist Robert Bellah calls individualism “the default mode” of American culture. It provides the rhetoric and political convictions to which people instinctively turn—whether or not it makes sense in the situation.
This deep desire to maximize individual freedom and choice has been abundantly evident in the narrow framing of the debate on health-care reform. Proponents of reform, knowing of the public’s instinctive aversion to government intervention, talk much of expanding individual choice. Meanwhile, opponents of reform, unwilling to confront the deformities of the system as a whole, act as if health itself is simply a matter of individual choice. “Trying to give [health care] off to the government,” said Tony Perkins of the Family Research Council—in a typically casual misrepresentation of the reform efforts—“is an abdication of personal responsibility.” In this view, if people can’t afford a doctor or need help paying their medical bills, it is finally their own fault.
It was important, then, that President Obama in his speech to Congress on September 9 challenged the tradition of individualism head on. Acknowledging that “rugged individualism” is part of the character of the country, he insisted that there is another important part of the national character, a part represented by a willingness “to stand in other people’s shoes” and to recognize “that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand.” He noted the enactment of Social Security in 1935 and Medicare in 1965 as occasions when Americans acted out of a sense of solidarity with one another and used government to provide for the common good. He recited cases of Americans being deprived of crucial medical care because of arbitrary decisions by insurance companies and then declared, “That is wrong, and no one should be treated that way in the United States of America.”
In short, Obama made a moral case for health-care reform, saying that access to health care is something that we owe one another simply because we are all human and because we “are all in this together.”
Such moral arguments for solidarity may not alter the politics of reform this time around, but they are important to make. In The Healing of America, a survey of health-care systems in other wealthy countries, T. R. Reid notes that there is one major difference between the U.S. and the countries that have provided universal coverage: those countries have concluded that health care is a human right. People in those countries have decided that health care is not like any other consumer item—something, like a new car, that you can have if and when you can afford it. They have decided that health care is something other people should have simply because they are—as we ourselves are—frail human beings, subject at any time to accident or disease, and thus deserving of care. In the culture of radical individualism, that moral argument needs to be made again and again.