"No man is an island, entire of itself...any man's death diminishes me, because I am involved in mankind; and therefore never send to know for whom the bell tolls; it tolls for thee."
-- John Donne, Meditation XVII
Self-sufficiency, a.k.a. self-reliance or rugged individualism, is one of the great fetishes of American culture. To the self-sufficiency fetishists, being able to take care of oneself and pay one's own way is the opposite side of the coin of freedom. Sacrifice self-sufficiency and you have sacrificed freedom, they claim. Not to be able or willing to take care of yourself is to be an infant, whether your caretaker is a blood relative, a spouse, a paid caretaker or "Uncle Sam."
The debate over health insurance reform has brought out the self-sufficiency fetishists in full force. They post comments all over the Internet decrying the idea of "socialized medicine." They do not believe that health care is a human right but a "personal responsibility." They are against any government role in health care because people should take care of themselves. They see taxation to help other people to get health care as "confiscation" of their hard-earned money. (Strangely enough, they never see the ever-increasing premiums charged by private health insurance companies for ever-skimpier policies as "confiscation").
There is one problem with this point of view. Self-sufficiency does not exist. Unless you are grinding your own lenses, drilling your own teeth and making your own medicine, not to mention setting your own bones, stitching your own cuts and taking out your own appendix, you are not self-sufficient in health care. Doctors, nurses, dentists, pharmacists, optometrists, etc. have been helping you all your life. That's not self-sufficiency.
Oh, but you claim you are self-sufficient because you work for a living or own a business so you can pay for all this help. Well, let me not argue here the barbarism of paying to live on the planet on which you were born. I am content to ask you, Mr. and Ms. Self-Reliant, how did you get that job other than through the agency of someone else willing to employ you? Or how does your business thrive unless you have customers or clients willing to buy your goods or services? Is not the company you work for or the business you own dependent on other suppliers of goods and services? That's not self-sufficiency.
What about you, "trust fund baby"? Never had to work a day in your life? Then somebody worked for you so you could have that inheritance. Likewise, those of you ordinary folks lucky enough to marry rich depend on your spouse's (or ex's ) income. That's not self-sufficiency.
If, as a worker, you can purchase health insurance, which is a gateway to health care, not health care itself, it is because your employer provides a plan or you can afford the individual insurance market. Again, your ability to do this depends on others. The employer must provide the plan AND provide you with enough working hours to qualify, AND enough of a salary to afford your share of the premium--a 100% employer-paid plan being a rarity today--or enough of a salary for you to afford individual insurance.
And if you are like most workers, there was little or no negotiation of salary when you were hired. You took the wage and benefits (if any) package offered. The amount and frequency of raises, bonuses or additional benefits are at your employer's discretion. Even if you are represented by a union, you may have seen a wage or benefit freeze or cut in recent years. Unionists are dependent on the skill of their negotiators. Represented or not, working "for a living" means an awful lot of dependence for someone who claims self-sufficiency.