Resistance to the A.C.A. may be rooted in something that goes deeper than greed, or the spectre of yet another liberal plot to give the government more power, in order to take money from the hardworking and dole it out to the undeserving. To the person who believes in rugged individualism and independence, who accepts society’s emphasis on youth, and who has profound discomfort with the idea of aging, what worse insult could there be than mandatory health care? It threatens an American’s self-image of toughness, so much so that the concept seems un-American. Perhaps the resistance to the A.C.A. is not so much about money as it is about a myth of invincibility that many Americans are reluctant to part with.
— G. Randy Kasten, letter in the 10/21/2013 New Yorker