Health Care’s “I’ve Got Mine” Problem


All throughout the health care process progressives have found ourselves frustrated by the extent to which senior citizens—the beneficiaries of a liberal-style single-payer system—seem to have the most reactionary views on health reform. And now the voters of Massachusetts have thrown a major wrench into the works by electing a Senator who says not that health care should be left up to the tender mercies of the free market, but rather that since Massachusetts already has a universal health care system he doesn’t care about anyone else.

There’s a certain logic to this kind of behavior, of course, though it’s at odds with the fact that voters rarely explicitly conceive of themselves as acting on self-interest.* But it’s pretty depressing for the larger progressive project. One would hope for expanding circles of solidarity whereby people who come to benefit from a solidaristic scheme also come to appreciate the logic of extending the scheme. If that kind of logic doesn’t work, then it becomes very hard to do anything. Change tends to be incremental, but the hope is that the increments add up over time. The pattern we’re seeing is the reverse of that.

* This makes sense when you think about it. One person’s vote is very unlikely to make a difference. The very act of voting makes it a kind of expressive or altruistic behavior so you’re bound to do it for reasons that you understand as righteous.