value in self-reliance and a certain amount of selfishness in expecting others to shoulder your responsibilities.
The problem with that argument is that you assume that all people who who wind up with health care needs aren't self-reliant and they actually expect others to shoulder their responsibilities.

You're in pharma, Alan, as I am. I interview patients, and these past two weeks I have been interviewing people with rare auto-immune disorders. Here's a snapshot:

Patient A: 39 year old former funeral home director who loved her job but who now can't even get in a car to drive. No job. No insurance. No way to get the treatments that will actually help her. She recently downsized into a small apartment-it's all she can afford.

Patient B: 41 year-old former high-powered founder of an international branding company with a million dollar home he has to sell because he was suddenly struck with this weird disease. He can't work. He can't even get off the couch. He desperately misses his old life. At least he has insurance.

Patient C: A 55 year old woman who has had this disease since college. She can't afford the best treatment. She hates the burden she is to her family. She hates feeling like an imposition, that she's not the person she should be. So in spite of her disease, she gets herself to a part-time job with a compassionate employer and works until 1, at which point, she's totally spent for the day.

I interview these patients and I spend my whole ride home praying, "There but for the grace of God go I." As a citizen and extended neighbor of these people, I will offer my taxes so that Patient A might be able to get back to her funeral home, and Patient B will be able to potentiate his abilities in leadership and marketing, and Patient C can have her family to dinner without feeling like she's a failure as mother and wife.