America’s rugged individualism makes it hard for us to accept this prospect: that the many may have to provide for the needs of the few. Those less fortunate get thrown into poverty over an unavoidable and unplanned-for medical bill. In the twenty-first century the unfathomable maze of healthcare and finance make it impossible for the American individual to be an informed actor in any life-or-death economic transaction.

While the ACA may impose responsibilities upon citiZens which are unprecedented, it is important to remember that this was originally a conservative proposition, conceived by The Heritage Foundation and implemented in Mass by Republican governor, Mitt Romney. I remember listening to him on a Q&A one afternoon telling a woman why it was her responsibility to buy insurance lest she saddle her fellow citiZens with the bill for medical care she incurred. I remember thinking he sounded so harsh.

But that is the essence if the ACA: you are required to pay your way for your medical care. There are subsidies and requirements placed upon insurers that sweeten the deal, but the bottom line is that you gotta buy insurance. And this works out so well for insurers. They essentially get to play the role that governments play in most other developed countries. They are the payer. But since there are several of them, they will be unable to negotiate the best price from providers. That can really only be done by a single
Payer because the provider’s product is so precious that they will always be the dominant negotiator against multiple entities.

Businesses are on the losing end in this proposition because they are still expected to provide insurance as a benefit. It always puzzled me that American business didn’t get behind single payer. One would think that would get them out from under this onerous responsibility which befell them after WWII when they implemented it as a means to compete for scarce employees. It became an American institution which is increasingly taking up a larger piece of the pie.

I would think they would jump at the chance to abdicate this responsibility. I suspect they are more concerned with the higher personal taxes that are inevitable in any single payer model. So we get back to the primacy if the individual in this culture holding us back from true progress. Rugged individualism is at the core of every Titan of industry’s psyche. That personal greed trumps the company’s best interests every time.