03/23/2010 05:12 am ET Updated May 25, 2011

What the Healthcare Debacle Says About Our Country

One of the many things that have surprised me in the healthcare debate over the last year is the extent to which those who have health insurance (and who may have to pay a little more so that others can get it) seem much angrier than the millions of Americans whose only access to healthcare is through the emergency rooms of hospitals. In fact, the healthcare debate sadly shows how we are unable in this country to get beyond the "what is in it for me" mentality that so limits and diminishes us as a nation.

The tea party people have complained loudly about taxes and a supposed government takeover of healthcare. The unions have raised bloody murder over the proposed tax of expensive healthcare plans. The seniors have made it clear that they do not want their Medicare benefits touched. In short, while most Americans seem to want healthcare for all, few seem willing to make the sacrifices that it will take to make that happen.

All of this is, I think, the result of a prevailing ideology in this country that our main moral priority is to look after ourselves and that we have few obligations to act collectively, through our government, to help others. It is this ideology that explains why the healthcare debate over the last few months has been dominated by the angry voices of those who already have health insurance while we have heard almost nothing in the media from the millions who do not.

The late liberal political philosopher John Rawls argued that inequalities in society (such as those related to wealth and income) are acceptable only to the extent that they have some corresponding benefits for those who are less well off. If we use that understanding of justice, the inequality in healthcare access in this country is patently unjust because it hurts rather than helps the least advantaged. Unfortunately, however, that kind of compassionate view of what justice requires seems to have little resonance in our current political environment.

Like many supporters of healthcare reform, I am disturbed by what the result of the Massachusetts senate election is likely to mean for healthcare reform. But perhaps I just need to get with the program. I am lucky enough that I have health insurance and that I can provide it to my family. Under the prevailing ideology of the day, that seems to be what should matter most to us as individuals.

It seems that we will only get meaningful healthcare reform passed in this country when those who do not have health insurance get as angry as those who do. Until that happens, we are in this on our own.