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The United States is culturally oriented more toward individual rights and values than to communitarian values. That proclivity has made it hard to develop a common good, or solidarity-based, perspective on health care. Too many people believe they have no obligation to support the health care of others and resist a strong role for government, higher taxation, or reduced health benefits. I argue that we need to build a communitarian perspective on the concept of solidarity, which has been the concept underlying European health care systems, by focusing not on individual needs, but rather, on those of different age groups--that is, what people need at different stages of life.

Though the health care systems of the United States and the European countries are very different, they are being buffeted by similar problems: rising health care costs caused by aging populations, technology, and rising public demand and expectations. The primary difference is that the US system is heavily privatized, whereas the European systems are heavily government run or operated. But the latter systems are increasingly open to market ideas and practices while the US is steadily being pushed toward a stronger government role. This article offers some speculation about their gradual convergence in the years ahead.