To paraphrase Chomsky: people vote against their best interests because they don't know what their best interests are, and because society's elites tell people what their interests are via propaganda.
Is this an accurate description?
It is not that people don't know what is best.
Everybody knows it is best that all people have health insurance.
What the elites do is pit people against each other.
So instead of people looking at taxes to fund a universal health system as a great thing, they look at it as a system where they are paying for freeloaders.
When in a country of hundreds of millions that probably amounts to a few dollars a year.
A delusion, huge costs on me to pay for freeloaders, has replaced the reality, health care costs go down because everybody is covered.