Archive of blog originally posted 3/26/2014 in The Huffington Post
A friend left me a note last night: “My life has been crazy—But with
God’s help it will get better.” I’ll come back to my friend. Let me
first turn to another quote that drives many Americans crazy and as a
result is endangering the life of my friend:
“Every American
regardless of his means must have access to reasonable health care. In
the absence of a single-payer system, every American regardless of his
means must purchase health insurance in the marketplace to guarantee
such access.”
What in these
words (and their equivalents) raises such ire in decent folk?
Americans on the whole are decent folk and selfishness or other immoral
motives therefore do not likely underly their anger. Instead, I believe
much of their anger turns on the myth of the self-made man. Let me
explain.
Americans are proud of their country as a land of opportunity where
all can succeed if they just work hard enough. We all know stories of
those who rose from rags to riches. We also of course know our own
“hardship” stories of pinching pennies to make it through law school or
medical school so that we could be the lawyers or doctors that we are
today. We pat ourselves on our backs for our hard work and our
sacrifices.
By running such
gauntlets, we believe that we’ve proved our self-sufficiency. We are
self-made men. It’s of course nonsensical to tell self-made men (and
those who are on their way to such status) that they must buy insurance.
Such persons have already proved that they need no such patronizing.
Furthermore, by our example we believe that we’ve proved that others can
be self-made men, too, if they will just work as hard as we did. We
shouldn’t therefore just “hand” out insurance to those who could have
worked for a better status in life. Such “handouts” would encourage
laziness. Like self-made men, all other Americans should strive to be
self-made men (or the lucky children of self-made men).
Self-made men.
What, though, does that phrase really mean? At first blush, it seems a
straightforward reference to those of us who relied on ourselves alone,
who didn’t whine when we were down, who worked as hard as we needed to
work to achieve our goals, as a result achieved them, and thus became
self-made men.
However, this
“straightforward” definition doesn’t withstand even a sliver of real
scrutiny. We are all subject to natural and social forces beyond our
control. Despite our best efforts, we get sick and we suffer setbacks.
If we made it through law school or medical school by pinching pennies
and by hard work, those of course aren’t the only reasons that we made
it through law school or medical school (or whatever other school or
task you might wish to substitute). The pinched pennies and hard work
numerically pale in comparison to the endless number of other factors
involved. In addition to all the things beyond our control that could
have gone wrong before we even stepped through the doors of law or
medical school, we were lucky enough to keep our health throughout the
process. We were lucky enough to have the teachers, parents, and other
supporters that we had. We were lucky enough to have the fellow
students from whom we also learned. We were lucky enough to have the
police, military forces, and fire departments that kept us safe as we
studied and whose expenses we therefore did not generally mind paying in
the form of taxes. (Isn’t it interesting that we generally don’t
question taxes to protect the health of our structures but go into a
tizzy over taxes to protect the health of the persons inside?) We were
lucky enough to have the roads that let us get to school and to have the
safe food to eat (however cheap) that allowed us to survive. I could
go on but the reader should get the drift by now: no one can be a
self-made man in this contingent and interrelated world.
In fact, the more we try to speak of ourselves as self-made men, the
more we contradict ourselves. Virtuous “self-made men” are
understandably proud of their property which they hopefully charitably
share with others. Yet property cannot exist without society — if there
are no other people around it makes no sense to speak of property. If
there is no one you can ask to get off your land, what could it possibly
mean to say that the land is yours? To be a self-made landowner, you
therefore require others. But then how can you be a self-made man? As
John Dewey puts it, “...[T]he more we emphasize the free right of an
individual to his property, the more we emphasize what society has done
for him: the avenues it has opened to him for acquiring; the safeguards
it has put about him for keeping...” To claim to be a self-made man is
thus to renounce the claim.
Once we finally
take the myth of the self-made man for what it is, we can begin to be
sensible about health care not only for others but for the sake of
“self-made men” as well. That’s right, I did say for the sake of
“self-made men” as well. The “self-made man” also benefits from
universal health care. He, too, could lose all his wealth and actually
need his health insurance for necessary care. He, too, should not then
simply go to the emergency room and stick the rest of us with his bill.
He, too, could catch diseases universal health care could have
prevented. His stock portfolio, too, is harmed by the lowered
productivity of ill workers and by the lowered productivity of those
with pre-existing conditions stuck in jobs that do not maximize their
potential. Things that hurt our GDP hurt all of us including the
“self-made man.”
Though the
“self-made man” should also embrace universal health care, more humble
persons concern me as well. This brings me back to my friend I quoted
above. She is a woman who has worked hard all her life and who is under
no illusion that she is a “self-made woman.” The Republicans who
recently took control of North Carolina’s state government have refused
to join the Medicaid expansion under Obamacare. This hard-working
woman is now ineligible for state Medicaid assistance and she does not
make enough to qualify for subsidies under Obamacare. The March 31
Obamacare enrollment deadline is looming and in the meantime she has no
health care coverage. Though not a “self-made woman” of means, she has
done nothing wrong. She goes to church, works hard, takes care of her
elderly father, is helping put her daughter through college, and is a
blessing to this earth. As the minutes tick down to the end of the
month, legal aid workers and kind law students at Wake Forest Law School
are trying to provide this hard-working American with access to medical
care. They understand that we (including “self-made men”) are all in
this together. The rest of us should be as clear-headed.
