How Being Selfish Sometimes Benefits Everyone

The Paradox of Self‑Interest

In theory, selfishness is what breaks societies. In practice, well‑designed systems channel selfishness into cooperation. Health insurance is one such system. You pay in so that when you’re unlucky, others cover you—and when they’re unlucky, you do the same. But when leaders dismantle those stabilizers in the name of ideology, they forget the real math: fewer people covered means higher costs for everyone. And when enough people stop believing the system will ever protect them, they stop playing by its rules.

The Economics of Stability

Health insurance pricing isn’t guesswork. Insurers are required to spend about 80–85% of premium dollars on actual medical care—the medical loss ratio. The remaining 15–20% covers administration, marketing, taxes, and profit. Remove subsidies, and healthier people drop out of the pool first because they can’t justify paying full price. That’s adverse selection. As the pool gets sicker, insurers raise premiums to rebalance the ratio, which pushes even more people out. It’s a feedback loop—and not the good kind.

Even if you never take a subsidy, it’s in your best interest that others can afford to stay insured. Every person who remains in the pool helps keep your premium stable. That’s not charity; it’s self‑preservation.

The Role of Leadership

Leaders who promise lower costs by cutting subsidies or benefits aren’t protecting taxpayers; they’re destabilizing the system. They’re either misunderstanding the risk pool or counting on voters not to notice until premiums spike. The truth is simple: when policy drives people out of the insurance pool, everyone’s costs rise. Our leaders should act in the public’s rational self‑interest, not in pursuit of ideological purity tests.

The Civic Parallel

Once enough people lose faith that the system protects them, they stop cooperating. They look for their own escape hatches—private doctors, concierge care, or worse, political violence justified as “self‑defense.” Those with wealth can insulate themselves, but everyone else is left in a spiral of distrust. A society that can’t insure its citizens eventually can’t ensure its peace.

The Game Behind the System (An Aside)

Health insurance also follows the same logic as a public‑goods game in economics. Everyone contributes a little, and the group benefits from collective stability. If too many people choose not to contribute—by dropping coverage or opposing subsidies—the whole system collapses.

It’s the same math behind recycling, vaccinations, or even voting. The short‑term, self‑focused decision can feel rational (“Why should I pay for others?”). But when too many act that way, the equilibrium breaks. The system only works if enough of us recognize that cooperation isn’t weakness—it’s the most efficient form of self‑interest.

The Closing Thought

Selfishness isn’t always the enemy. In the right systems, it’s the engine of stability. But it only works when the system channels that self‑interest toward collective benefit. Health insurance was designed to do precisely that. Undo it, and we don’t just break the math—we break the trust that holds us together.