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Posted at 2:35 PM ET, 01/20/2011

Newsflash: Founders favored "government run health care"

By Greg Sargent

Forbes writer Rick Ungar is getting some attention for a piece arguing that history shows that John Adams supported a strong Federal role in health care. Ungar argues that Adams even championed an early measure utilizing the concept behind the individual mandate, which Tea Partyers say is unconsittutional.

I just ran this theory past a professor of history who specializes in the early republic, and he said there's actually something to it. Short version: There's no proof from the historical record that Adams would have backed the idea behind the individual mandate in particular. But it is fair to conclude, the professor says, that the founding generation supported the basic idea of government run health care, and the use of mandatory taxation to pay for it.

Here's the background. Ungar points out that in July of 1798, Congress passed "An Act for the Relief of Sick and Disabled Seaman," which was signed by President Adams. That law authorized the creation of a government operated system of marine hospitals and mandated that laboring merchant marine sailors pay a tax to support it.

Ungar argues that this blows away the argument made by many opponents of the individual mandate: That it's unconstitutional to mandate that all citizens purchase health coverage, or that this violates the founding fathers' view of the proper role of government.

Is this true? In some ways it is, according to Adam Rothman, an associated professor of history at Georgetown University. He argues that it's a "bit of a leap" to compare the 1798 act directly to the individual mandate, because the act taxed sailors to pay for their health care, rather than "requiring that sailors purchase it."

But Rothman says that it's perfectly legit to see shades of today's debate in that early initiative.

"It's a good example that the post-revolutionary generation clearly thought that the national government had a role in subsidizing health care," Rothman says. "That in itself is pretty remarkable and a strong refutation of the basic principles that some Tea Party types offer."

"You could argue that it's precedent for government run health care," Rothman continues. "This defies a lot of stereotypes about limited government in the early republic."

Also: Some have argued that the individual mandate is, in effect a tax, but one that cuts out the Federal government as middleman. In this reading, everyone will eventually participate in the health system anyway, and the mandate means the Federal government is merely directing people to buy insurance, rather than collecting a tax and using that money to purchase that same insurance for them.

We will never know whether the founding generation would have agreed with this concept or not. They didn't agree on much even among themselves. But in Rothman's view, they are already on record supporting government run health care, financed by mandatory taxation. So there!

UPDATE, 3:29 p.m.: To be clear, the system of government-run hospitals was established for laboring merchant marine sailors, whose very dangerous work in trade was crucial to the young republic. The history is right here. I've edited the above to clarify.

By Greg Sargent  | January 20, 2011; 2:35 PM ET
Categories:  Health reform  
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Comments

@Greg

Wow. What a great find. Now if this get's linked to the righty blogs as you have been sometime in the past...get ready for the deluge of traffic!!!!!!

Of course we already know that the R/TPers have their own Constitution...they've read it for us...it says nothing about 3/5 of a person or a woman's lack of sufferedge. If there was a specific black and white statement..The Federal Gov't is responsible for healthcare of the nation...the right would figure a way to read around it....because remember...no matter how much you lie..about anything...no matter much you distort the Constitution or the intentions of the Founding Fathers.....IOKIYAR!!!!!!!!!!!!!!

Posted by: rukidding7 | January 20, 2011 2:44 PM | Report abuse

Sorry for the typo women's suffrage!

Posted by: rukidding7 | January 20, 2011 2:45 PM | Report abuse

The big difference, of course, is that maritime law falls under exclusive FEDERAL jdx. No one disputes that the VA should provide healthcare either.

Posted by: clawrence12 | January 20, 2011 2:47 PM | Report abuse

UMMMMMM Morons

If the founding fathers WANTED health care to be a power of Congress, it would have been listed in ARTICLE ONE.

Meanwhile, for the last 200 years, health care has been a STATE power - and ALL doctor's licenses come from the STATES, nowhere else.


Health care is a STATE power. And please read the 10th Amendment. Just because the liberals ignore the 10th Amendment, that doesn't mean it doesn't exist.


What is wrong with you people?

Are you that desperate, or just stupid?

.

Posted by: RainForestRising | January 20, 2011 2:47 PM | Report abuse

"the yearly interest of which is to be applied to the accommodating of the sick poor in the said hospital, free of charge for diet, attendance, advice and medicines), and shall make the same appear to the satisfaction of the speaker of the Assembly, for the time being, that then it shall and maybe lawful for the said speaker, and he is hereby required, to sign an order on the provincial treasurer for the payment of two thousand pounds, in two yearly payments, to the treasurer of the said hospital, to be applied to the founding, building, and finishing of the same."

From Ben Franklin's Autobiography.

OT but Obama at 51% approval in Gallup. Not since February of last year.

http://www.gallup.com/poll/113980/Gallup-Daily-Obama-Job-Approval.aspx

All these figures are worth quoting in this poll.

http://www.gallup.com/poll/145694/Americans-Optimistic-Not-Obama-Economy.aspx

Posted by: mikefromArlington | January 20, 2011 2:50 PM | Report abuse

Ben Franklin, among his other great achievements, was most proud of his free hospital for the poor.

What a SOSHULISTS!!!

Posted by: mikefromArlington | January 20, 2011 2:53 PM | Report abuse

RainForestRising, don't make a liar out of me! You aren't saying that States have to provide healthcare for wounded vets, are you? That's clearly witting Art. I, Sec. 8 "provide for Army".

Posted by: clawrence12 | January 20, 2011 2:53 PM | Report abuse

mikefromArlington, Franklin never used FEDERAL monies for said hospital.

Posted by: clawrence12 | January 20, 2011 2:57 PM | Report abuse

clawrence, what's the comparison between sailors working on trade ships and people who have been wounded fighting in the military?

Posted by: Greg Sargent | January 20, 2011 2:58 PM | Report abuse

Greg-

Interesting article. I would make the distinction, though, between the seaman health care tax and the individual mandate. In the case of the health care tax paid by sailors, if I am reading your article correctly, sailors were required to pay the tax as a condition on participating in a particular industry. It sounds much more like regulation of the industry and of those voluntarily entering into that line of work than it does like a universal mandate to engage in particular economic behavior. So, I think the analogy to the individual mandate is a little thin.

Applying your logic, I might consider that the founders would certainly have permitted an inquiry into the loyalties of a person seeking to participate in the national security/defense industry and conclude that they would therefore permit all Americans to be subjected to compulsory "loyalty inquiries." The logic just doesn't hold up.

On the other hand, the existence at that time of a federal role in health care does contradict the contention that the founders were fundamentally opposed to a federal role in the provision of health care services.

Posted by: mobrien83 | January 20, 2011 3:04 PM | Report abuse

Kind of interesting that there's no question our constitution will permit more socialist solution to health care (taxes paying directly for care a la Medicare), but tea partiers insist that rules which make a capitalist free market work are unconstitutional.

But hey, Democrats passed it, so it MUST be socialist and illegitimate and unconstitutional, right? Because we're a "center-right" nation which should always be ruled by Republicans...

Posted by: theorajones1 | January 20, 2011 3:06 PM | Report abuse

"We will never know whether the founding generation would have agreed with this concept or not. They didn't agree on much even among themselves. But in Rothman's view, they are already on record supporting government run health care, financed by mandatory taxation. So there!"

This is an excellent argument for why the Obama administration should present a legal defense of the individual mandate in the ACA as a tax rather than as something else. It's a tax on being uninsured.

Posted by: jnc4p | January 20, 2011 3:12 PM | Report abuse

theora here's a question. You said:
"tea partiers insist that rules which make a capitalist free market work are unconstitutional. "

Can you cite some specific examples?

Posted by: skipsailing28 | January 20, 2011 3:14 PM | Report abuse

Great post, Greg! Nice job!

Posted by: suekzoo1 | January 20, 2011 3:15 PM | Report abuse

Greg, I don't think there's a distinction legally (ask one of the WaPo lawyers about admiralty law someday: in rem jurisdiction, attaching to the ship, is exclusively within the purview of the federal government). Ben Franklin's hospital OTOH was a joint State and private charity venture. I also have nothing against Massachusetts providing universal healthcare.

Posted by: clawrence12 | January 20, 2011 3:16 PM | Report abuse

mobrien, fair points. note, though, that I did address the imperfection in the analogy in the post...also, the response to that is that some argue that in some sense the individual mandate is a tax (last few grafs)

Posted by: Greg Sargent | January 20, 2011 3:18 PM | Report abuse

"Be it enacted, Sfc. That from and after the first day of September next, the master or owner of every ship or vessel of the United States, arriving from a foreign port into any port of the United States, shall, before such ship or vessel shall be admitted to an entry, render to the collector a true account of the number of seamen that shall have been employed on board such vessel since she was last entered at any port in the United States, and shall pay, to the said collector, at the rate of twenty cents per month for every seaman so employed ; which sum he is hereby authorized to retain out of the wages of such seamen."

You can also make an excellent argument that sailors on ocean going vessels entering into ports in the United States from foreign ports are clearly engaged in "Commerce with foreign Nations" per Article 1, Section 8 whereas people who are just residing within the United States aren't.

It doesn't appear from the language that this act would apply to a ship going from say Charleston, SC to New York, NY either.

Note also:

"§ 3...Provided, that the moneys collected in any one district, shall be expended within the same. "

No redistribution allowed here.

Posted by: jnc4p | January 20, 2011 3:20 PM | Report abuse

This refried meme was fisked last year.
http://volokh.com/2010/04/02/an-act-for-the-relief-of-sick-and-disabled-seamen/

This 1798 statute (5 Cong. Ch. 77, July 16, 1798, 1 Stat. 605) is currently making the blogospheric rounds as purported proof that the 2010 congressional mandate to purchase health insurance from a private company is based on long-established practice. INCORRECT.

Sections 1 and 2 of the act impose a 20 cent per month tax on seamen’s wages, to be withheld by the employer.

Section 3 requires that all the withheld taxes be turned over to the U.S. Treasury on a quarterly basis, and that the revenue shall be expended in the district where it was collected. The revenue shall be spent to support sick and injured seamen.

So the Act is totally dissimilar to the Obamacare mandate. In the 1798 Act, the government imposes a tax, collects all the tax revenue, and spends the revenue as it chooses. This is a good precedent for programs in which the government imposes a tax and then spends the money on medical programs (e.g., Medicare), but it has nothing to do with mandating that individuals purchase a private product.

Under section 4, if there is a surplus in a district, the surplus shall be spent in the construction of marine hospitals; the executive may combine the tax revenue with voluntary private donations of land or money for hospital construction. The President may also receive voluntary private donations for relief of the seamen, or for operation of the hospitals.

Section 5 instructs the President to select the directors of the marine hospitals. The directors shall make quarterly reports to the Secretary of the Treasury. The directors will be reimbursed for expenses, but will not receive other compensation.

Today, the 1798 Act is viewed as the beginning of the creation of the U.S. Public Health Service.

The Act is very strong precedent for the federal government imposing taxes and dedicating the tax revenue to medical care for the taxed class. Further, the government may provide the medical care directly, or may cooperate with private individuals for the providing of that care. The 1798 Act thus shows that Medicare, while vastly broader in scope than anything from the Early Republic, is generally consistent with constitutional practice of that period.

The Act certainly did not order seamen to purchase any form of private insurance, nor did it order them to purchase any other type of private good. The Act is a solid precedent for federal involvement in health care, and no precedent at all for a federal mandate to purchase private products.

Grade: F (miserable failure)

/dismissed

Posted by: KaddafiDelendaEst | January 20, 2011 3:21 PM | Report abuse

So Why don't we give 'tax breaks' to the people who don't get sick! People who actually take care of their health and try to prevent illness and accidents

Posted by: JennyLuke | January 20, 2011 3:23 PM | Report abuse

Greg-

Thanks for the response, and I appreciate your honesty about the imperfections of the analogy. I would draw a similar distinction even if we consider both provisions taxes:

The sailor healthcare tax is a tax on an individual's choice to engage in some behavior, whereas a tax on "not purchasing health insurance" would be a tax on inactivity.

I am interested if there are other examples of taxes on inactivity. I would suggest that a way to make this a tax on activity would be to impose the tax on anyone who uses health care services without purchasing insurance ahead of time. It could even be imposed on the basis of the number of preceding years during which the person was uninsured.

At least that leaves the option open for a person to choose not to participate in the health insurance market at their own peril.

Posted by: mobrien83 | January 20, 2011 3:24 PM | Report abuse

@clawrence

"No one disputes that the VA should provide healthcare either."

Why not? I'm all for our veterans...I am one...why not give them some form of Medicare. Why an entire system of Hospitals and Providers...which btw are performing far better than the rest of our system.

OMG say it isn't so...socialized medicine is working is this country better than the R model we were currently stuck with..of course the R's HAVE NEVER DONE A SINGLE THING FOR OUR CITIZENS HEALTH. Oops let's give them some credit for the prescription drug plan...ANYTHING else anybody can think the R's have done to solve our health care problems or control cost?

http://www.businessweek.com/magazine/content/06_29/b3993061.htm

LOWER COSTS, HIGHER QUALITY
Roemer seems to have stepped through the looking glass into an alternative universe, one where a nationwide health system that is run and financed by the federal government provides the best medical care in America. But it's true -- if you want to be sure of top-notch care, join the military. The 154 hospitals and 875 clinics run by the Veterans Affairs Dept. have been ranked best-in-class by a number of independent groups on a broad range of measures, from chronic care to heart disease treatment to percentage of members who receive flu shots. It offers all the same services, and sometimes more, than private sector providers.

According to a Rand Corp. study, the VA system provides two-thirds of the care recommended by such standards bodies as the Agency for Healthcare Research & Quality. Far from perfect, granted -- but the nation's private-sector hospitals provide only 50%. And while studies show that 3% to 8% of the nation's prescriptions are filled erroneously, the VA's prescription accuracy rate is greater than 99.997%, a level most hospitals only dream about. That's largely because the VA has by far the most advanced computerized medical-records system in the U.S. And for the past six years the VA has outranked private-sector hospitals on patient satisfaction in an annual consumer survey conducted by the National Quality Research Center at the University of Michigan. This keeps happening despite the fact that the VA spends an average of $5,000 per patient, vs. the national average of $6,300.

Posted by: rukidding7 | January 20, 2011 3:25 PM | Report abuse

Another point to take from this Greg is that a full government run health care program, paid for by taxation may actually be easier to pass Constitutional muster than a mandate that citizens are required to purchase a product from a private, for profit entity or pay a fine.

I.e. It would probably be easier to defend the Constitutionality of the Federal Government making "free" health care available for whomever wanted it and just jacking up the income tax to pay for it. Basically Medicaid for all.

Posted by: jnc4p | January 20, 2011 3:27 PM | Report abuse

Not that the private sector does much better, but on the topic of quality of care in our VA hospitals, they do a woefully inadequate job of addressing behavioral health issues of returning soldiers.

Posted by: mobrien83 | January 20, 2011 3:29 PM | Report abuse

Grade: F (miserable failure)

/dismissed

Posted by: KaddafiDelendaEst
_______________________________________

Grade: A (for plagiarism)

/expelled

Posted by: ashotinthedark | January 20, 2011 3:34 PM | Report abuse

I would also point out the serious flaws in comparing satisfaction with healthcare of veterans versus non-veterans. Veterans are receiving care free of charge and may be deriving some satisfaction from not directly paying for care. There is also a selection bias, I suspect, since military personnel, given their toughness and training, may be substantially less likely to become "dissatisfied" by trivial inconveniences.

Posted by: mobrien83 | January 20, 2011 3:34 PM | Report abuse

[ass_hat_inthedark snarked: "plagiarism"]

It's not "plagiarism" when the source is properly cited, ass_hat.

But thanks for demonstrating your intellectual bankruptcy with respect to the substance of the cited evidence.

/dismissed

Posted by: KaddafiDelendaEst | January 20, 2011 3:40 PM | Report abuse

Here you go again, Greg -- seeking out professors and scholars who can shed some educated, enlightened thought and actual historical perspective on the issues of the day....thereby providing a factual context for reasonable debate.

I like your style. ;)

Posted by: elscott | January 20, 2011 3:43 PM | Report abuse

Just a couple of points here.

first, the author of the Forbes piece makes this statement:
"So much for the claim that “The Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty….”"

Yet his article NEVER mentions whether or not the act faced a challenge to its constitutionality. the author's contention is that since the folks who wrote the constitution made this law they it must therefore pass muster. Yet when did Marbury VS Madison occur? why 1803. So what we see is that within a view short years of its adoption the founders were already arguing about what was and was not constitituional. Relying on Adams as a paradigmn of constitutional probity is also foolish. Would anyone today believe that the alien and sedition acts would pass muster?

So, the fact that this law was passed doesn't prove that it was constitutional. Nor does it prove that Obamacare is likewise constitutional. It just proves that the government sees a problem and feels compelled to act. Hence the need for a constitution to begin with.

Also, the author doesn't discuss article I section 8, which grants the congress the right to issue letters of marque. This is no big deal to us now, yet these privateers represented a significant naval force for the fledgling country at its founding. Without such venture capitalists the government's ability to harry the shipping and thus disrupt the logistics of its enemies would be severly limited.

so the government had a stake in keeping the sailors healthy. Not only was commerce crucial so was war fighting capability. I will grant that the act itself is silent to the letters of marque issue but there is no way that the authors were ignorant of this aspect of the maritime trade.

Posted by: skipsailing28 | January 20, 2011 3:45 PM | Report abuse

Mobrien:

"I am interested if there are other examples of taxes on inactivity."

In Wickard v Filburn, the SCOTUS authorized Congress to compel wheat farmers to stop growing wheat for their own consumption, forcing them to get it on the interstate market:

http://en.wikipedia.org/wiki/Wickard_v._Filburn

Posted by: Greg Sargent | January 20, 2011 3:45 PM | Report abuse

"There's no proof from the historical record that Adams..."

But don't let that stop you Leftist nuts from going ahead and pulling something out of your rumps and foisting it upon your stupid readers.

You have spent the last 2 years lying in every conceivable way to to get your marxist wet dream foisted on an America which does not want it.

Even the complete annilation of 85 Democrat Representatives and hundreds of other Democrats in state races by the American voters hasn't stopped you nuts, so what is just one more LIE and fable.

Another purge of Democrats in 2012 is going to be necessary to end this nonsense.

Posted by: LogicalSC | January 20, 2011 3:46 PM | Report abuse

The Merchant Marine falls under Trade with other nations - and Interstate Commerce.

Article One, Section 8

To regulate commerce with foreign nations, and among the several states, and with the Indian tribes;


__________________________


So the Merchant Marine, running the ships engaged in international trade, falls under Section 8.

It was NEVER meant to provide general powers over health care throughout the United States.

AND Congress has taken NO ACTION in this area for over 200 years. You mean to say that Congress has been wrong for 200 years, and only the liberals today are correct? NO, sorry.

Posted by: RainForestRising | January 20, 2011 3:48 PM | Report abuse

A key problem with this logic is that it undermines the justification the current Health Care Reform act. Using a 'tax' to provide a benefit, untold amounts of historical and actual justification for this.
.
Forcing the purchase of health care coverage from a private provider? not so much.
.
I want universal single payer gov't health insurance; the current bill is a hodgepodge of both that really shouldn't pass constitutional muster.

Posted by: rpixley220 | January 20, 2011 3:51 PM | Report abuse

This is rich! The Huffington Post is creating an all, African-American section.

This seems to be segregation, all over again. Hmmmmmmm!

I guess "separate but equal" is back in vogue out there in liberal land.

Who woulda thought??

Does the Washington Post do this??

Posted by: battleground51 | January 20, 2011 3:51 PM | Report abuse

mobrien83 writes
"The sailor healthcare tax is a tax on an individual's choice to engage in some behavior, whereas a tax on "not purchasing health insurance" would be a tax on inactivity."


Call it a tax on enjoying the benefits of living in a free society, with a rebate for those who purchase their own health care. Voila!

Posted by: bsimon1 | January 20, 2011 3:52 PM | Report abuse

It's not "plagiarism" when the source is properly cited, ass_hat.

------------------------------------

oops...sorry missed the link at the top.

As for intellectual bankruptcy, I'm sorry I didn't have a left wing blog to instantly cut and paste from. It's a complex issue that, frankly, I need much more time to think about.

I'll leave others to draw their own conclusion as to your intellect. You do seem to be a great cut and paster!

Greg seems to concede that this doesn't much support the position that the mandate is Constitutional. And to some extent your link agrees with Greg's point that the founding father's envisioned a government role in health care and considered essential, at least to sailors.

Posted by: ashotinthedark | January 20, 2011 3:52 PM | Report abuse

The VA is a closed shop. it's really tough to compare it to other hospitals/systems. Maybe you can compare it to Kaiser's closed model. The VA controls and sets prices for everything.

You can argue that it's a better model, but it isn't competing with other facilities and it doesn't have to ERs that are subject to EMTALA. One of the big advantages is that it's much easier to implement an EHR system in a closed shop. You have to get buy-in from all sorts of players -- hospitals, docs, pharmacies, device suppliers, post-acute care -- for an EHR to really take off in the private sector.

Posted by: NoVAHockey | January 20, 2011 3:52 PM | Report abuse

@mobrien "At least that leaves the option open for a person to choose not to participate in the health insurance market at their own peril."

May I respectfully disagree with your conclusion. Perhaps in theory but not in reality...and this is where the R arguments always come up short...

Unless you are willing to let the slackers who choose not to participate to literally lie in the street and die...unless you are willing to let all those uninsured who contract cancers etc..DIE...your theory does not work.

That is the bottom line to all of this.
TominCo has candidly confessed when he was younger he went naked feeling that his auto insurance would cover any accidents...perhaps..but what would Tom have done if he contracted a life threatening illness and couldn't possibly afford to pay for the treatment since he was uninsured..one night in the Hospital can now cost an uninsured person thousands and thousands of dollars. Remember the uninsured get really whacked while the Ins Co's and Govt(Medicare) pay a small fraction of what John Q. Uninsured Public must pay. Anyway there is Tom dying of this uninsured illness. Are we simply going to let him die and say tough darts.
Are we really prepared to let people die in the streets.

This is the same canard about illegal aliens at the ER...we shouldn't spend money on illegals...OK are you really ready to let them die on the streets and them simply clean up the blood and their corpses? These are not whiny liberal questions...it's reality versus theory.

R's and Liberterians are great in theory...their reality pretty much sucks.

Posted by: rukidding7 | January 20, 2011 3:54 PM | Report abuse

bsimon

I like your creative approach to this issue. We Americans are great at making distinctions without differences. So much of our politics are based on these semantics. Bravo for pointing out the ridiculousness.

Posted by: mobrien83 | January 20, 2011 3:55 PM | Report abuse

mikeinArlington, what you left out about Franklin's hospital is that PRIVATE donations raised the other two thousand pounds. The Pennsylvania Assembly had agreed to his plan, thinking such a task impossible, but they were ready to receive the "credit of being charitable without the expense."

http://www.uphs.upenn.edu/paharc/features/creation.html

ruk, feel free to rally against the VA then. That is a bridge too far for even me and RainForestRising.

Posted by: clawrence12 | January 20, 2011 3:57 PM | Report abuse

Greg-

Thanks for the info re: Wickard. I remember that case, and I would have to largely agree with you that it provides some answers to the concerns I raised.

Were the farmers permitted to go without wheat?

Posted by: mobrien83 | January 20, 2011 3:57 PM | Report abuse

@jnc4p: "It would probably be easier to defend the Constitutionality of... Medicaid for all."

That's correct. The 1798 precedent is a foundation to argue that the mandate and fines be linked to implementing a federal single payer healthcare insurance plan. (NOT what the ACA does.)

Or, as Kopel wrote at Volokh: "The Act is a solid precedent for federal involvement in health care, and no precedent at all for a federal mandate to purchase private products."

Posted by: sbj3 | January 20, 2011 3:58 PM | Report abuse

rpixley220 writes
"Forcing the purchase of health care coverage from a private provider? not so much [justification]."

So the flaw is that the market does not include a public option. Which I actually agree with - there should be bare-bones coverage for those who choose not to buy insurance, that is paid for via a tax. Offer a partial rebate to those who choose a non-government option.

Posted by: bsimon1 | January 20, 2011 3:58 PM | Report abuse

rukidding- definitely would have to admit that my conclusion is not sophisticated and subject to many complicating factors that make it perhaps untenable. Many of those same problems exist in trying to enforce the individual mandate.

Posted by: mobrien83 | January 20, 2011 3:59 PM | Report abuse

Clawrence

You and I agree on this one. I really don't believe that the military provisions apply here, however the VA is a good example of how the military powers extend to health care to those in that area.


International Commerce

The Merchant Marine falls under Trade with other nations - and Interstate Commerce.

Article One, Section 8

To regulate commerce with foreign nations, and among the several states, and with the Indian tribes;


_________________________


Clawrence, the liberals have the problem that for 200 years, health care has been the domain of the States.

All 50 States have enacted laws in health care. Are all those laws now unconstitutional???

We all know that once Congress occupies a sphere of powers, the States are not permitted to enact laws in that area. The Federal government takes precedence.

So, once health care is handed over to the States, the States are out. The States should not attempt to regulate health care after that.

Is that the system we have had for 200 years? Doctors' licenses are one example - the States have handled that power. NOW, logically if the Federal government has power in health care, the Federal government should be licensing doctors.

That principle would apply to ALL health care laws which the States have ever had.

It makes zero sense. The States are sovereign. There has to be a line between Federal and State power.

A side issue is the industrial revolution. Given the vast changes in the economy, it made sense for the Courts to allow Congress to occupy more space in the field of interstate commerce. A line had to be drawn, and the advent of industrialization required a line to be drawn.

However, at this point in history, such a case has no basis.


If the democrats want Congress to have powers over health care, write a Constitutional Amendment that is their remedy.

__________________


I have to mention one thing: Hillary's health care plan in 94 required the STATES to pass implementing legislation - does Obama do that?

There is NO implementing legislation - the States have no choice.


.

Posted by: RainForestRising | January 20, 2011 3:59 PM | Report abuse

[ass_hat drooled: "I'm sorry I didn't have a left wing blog to instantly cut and paste from."]

So Greg can cite his evidence from Forbes, but any rebuttals must sprout spontaneously from Zeus' head fully formed.

Do get back to us when Zeus contacts you.

/pffl

Posted by: KaddafiDelendaEst | January 20, 2011 4:02 PM | Report abuse

mobrien83 writes
"I like your creative approach to this issue. We Americans are great at making distinctions without differences. So much of our politics are based on these semantics. Bravo for pointing out the ridiculousness."

Well, thank you very much. The comment was merely a variant of my argument for a means-based fee structure for supporting the gov't. Those who have most enjoyed the benefits of living in a free society ought to contribute the most to the kitty.

Posted by: bsimon1 | January 20, 2011 4:02 PM | Report abuse

@mobrien Satisfaction? Obviously the factg that it's free influences them. However the differences are dramatic..VA in high 90% Private system high 50%.

You still haven't addressed the most IMPORTANT issue COST. The VA blows away the private system. Socialized medicine in this country at this time is the most successful form we have by any metric. If you wish to quibble with the satisfaction metric I'll give you your point...but outcomes..and cost..those are real. When something as critical as making sure the patient gets the correct drug administered and the VA is 3% more accurate than the private hospitals..well if you're brainwashed that socialized medicine is evil..the Private Insurance cabal will be happy...do NOT by any means OPEN your mind to the POSSIBILITY that there may be a better way...perhaps Medicare for all...perhaps VA for all...perhaps the ACA will work out best. I'm OPENMINDED and don't feel a threat to my love of America if my nation becomes compassionate and decides health care is important for EVERYBODY..not just those who can afford it.

WTF has happened to our nation. Ben Franklin and John Adams would be appalled at how greed and avarice have overwhelmed compassion.

Posted by: rukidding7 | January 20, 2011 4:05 PM | Report abuse

Newsflash: WaPo refries stale memes

*moldy*

Posted by: KaddafiDelendaEst | January 20, 2011 4:07 PM | Report abuse

RainForestRising, that is the FEDERAL government takeover that we conservatives are worried about (and that Cohen think is the Big Lie). Hillary's plan would have been found unconstitutional under New York v. U.S. (which overturned the Feds compelling State legislatures to regulate according to a FEDERAL scheme).

Posted by: clawrence12 | January 20, 2011 4:09 PM | Report abuse

Greg and mobrien

The competing (and correct) argument to the interstate commerce issue is this case

United States v. Alfonso Lopez, Jr., 514 U.S. 549 (1995)


In this case, the Supreme Court recongized that there were limits to the Federal powers in "interstate commerce."

The Court did not exactly define where the line is, however, the Court stated clearly THERE IS A LINE.

Most liberals believe there is no line at all, that Congress has powers over whatever it wants.

However, most Americans believe that there is a line between Federal powers and State powers, that the sovereignty of the States must be respected.

In the Lopez case, the Supreme Court affirmed there is a line. Later cases will refine where that line is.

I would imagine that the Supreme Court will be looking at these issues closely, along with the individual mandate.

There are many Americans beleive that there is much more unConstitutional to Obama's plan than just the individual mandate - there is a fundamental issue as to on which side of the line health care is.

For 200 years, health care has been on the States' side of the line. So, all of a sudden we are going to say that EVERYONE has been wrong for 200 years, and it really should have been done differently for the last 200 years ???

That makes absolutely zero sense.


.

Posted by: RainForestRising | January 20, 2011 4:11 PM | Report abuse

So Greg can cite his evidence from Forbes, but any rebuttals must sprout spontaneously from Zeus' head fully formed.

-------------------------------------

No, doing nothing but cutting and pasting is perfectly fine and something you clearly approve of. I just was questioning your conclusion that I had no rebuttal to your link simply because I didn't instantly have a similar link from a liberal webpage.

Whether a more than 200 year old law supports the Constitutionality of the ACA's mandate requires thought unless you have a group of blogs that express your exact opinion on virtually all topics as appears to be the case with you.

Posted by: ashotinthedark | January 20, 2011 4:19 PM | Report abuse

clawrence

I agree with you.

I brought up Hillary's plan because in it, (which is mute) the plan gave the States some control over health care.

Hillary's plan practically recognized that the States had powers over health care - and attempted to address that situation by creating a system of dual-legislation, one federal and the other a set of State laws which implemented the plan.

Supposedly, under Hillary's plan, the States could have had some discretion and could have said no - however Hillary's plan hoped that the Federal money involved would give the States enough incentives.

__________________

I really didn't want to make a big deal of this issue last year - because I really didn't want the Obama people to actually listen to me, and alter their plan to make it "more Constitutional" if that is possible.


I honestly believe that Obama's arrogance sunk this plan more than anything else. If Obama had settled for half of what he has in this plan, he would have gotten enough Republicans and we would have been stuck with it.


.

Posted by: RainForestRising | January 20, 2011 4:21 PM | Report abuse

It seems confused to me to criticize those who call the ACA "Government Run Healthcare" by arguing that the "Founders favored "government run health care."

Posted by: sbj3 | January 20, 2011 4:21 PM | Report abuse

So providing health care benefits for merchant marines that are serving the government equates to forcing Americans (outside of unions and large corporations that contribute to the Democratic party, and those who voted in Obamacare)to buy insurance?

Just think, some parents are paying a small fortune to have their child study under this professor.

Posted by: Hening | January 20, 2011 4:22 PM | Report abuse

"Are we really prepared to let people die in the streets."

I'll say that if you have the ability to pay for insurance and opted not to, you can either pay cash, agree to take on the debt, or go home. Like that guy a few months ago whining about his house burning down after he didn't sign up for the insurance. He gambled and lost.

Also -- "America if my nation becomes compassionate and decides health care is important for EVERYBODY..not just those who can afford it." This is the ACA's flaw. It addressed the wrong problem by focusing on health insurance and not access to health care. Everybody will have insurance soon. While I disagree with the way it goes about it, that's great. But we won't have the capacity to treat. So the problem remains -- people will have to go without or will have to wait for care. And it's not going to be the rich who are waiting for care.

HSA + catastrophic coverage is a better model. If the government wants to spend money on health care, put the money into increased capacity. This focus on getting everyone the excellent insurance and prevention is exactly the wrong approach. We're spending a ton on people who may have never gotten sick or will get sick anyway. The idea that prevention is a savings is iffy at best. My doc knows what I'm at risk for better than any team of physicians and experts in HHS. Those folks mean well, but what gets covered and why has become insanely political because there is big money to be made if you can get your test/treatment included on the prevention list.

Posted by: NoVAHockey | January 20, 2011 4:24 PM | Report abuse

@mobrien I apologize if I come off sounding too strident...it's just a really passionate issue for me. I appreciate your thoughtful input.

@nova Excellent points about the VA's built in advantages over the private system.
I completely accept your points and will add that I toss this out there simply to let people know that simplistic thinking...socialized medicine=evil single payer=evil (until they get on Medicare) and worse than simplistic thinking is sheer ignorance...socialized medicine=single payer=ACA NO NO NO. They are three different animals each with a set of advantages and disadvantages.

BTW NoVa another advantage the VA has...nobody is looking over their shoulders with threats of "death panels" They actually let medical professionals triage and ration in a sane fashion.
I doubt an 80 year old Vet could get a vasectomy from the V.A.

Posted by: rukidding7 | January 20, 2011 4:25 PM | Report abuse

Oh my. Always good to see lefties get so excited. Of course, the purpose behind the law is clear, as it applies only to sailors on ships originating from foreign ports. Can you lefties figure it out? Can you? And if so, do I really need to explain how it has NOTHING to do with "government run healthcare"?

Posted by: SouthernNHer | January 20, 2011 4:25 PM | Report abuse

All,

If the Founding Fathers wanted government-run Health Care, Article One, Section 8 would have said EXACTLY THAT.

In addition, our Founding Fathers would have SET UP GOVERNMENT-RUN HEALTH CARE in Philadelphia, Annapolis or New York or wherever they were before they built Washington DC.


Seriously folks, the Founding Fathers DID NOT DO THAT.


How much more OBVIOUS do you want it to be?


.

Posted by: RainForestRising | January 20, 2011 4:26 PM | Report abuse

All, my take on why Americans think Obama is too liberal:

http://voices.washingtonpost.com/plum-line/2011/01/why_americans_think_obama_is_t.html

Posted by: Greg Sargent | January 20, 2011 4:27 PM | Report abuse

@NoVA "but what gets covered and why has become insanely political because there is big money to be made if you can get your test/treatment included on the prevention list."

Agreed 100%. IMO this happens more often in the private sector than the VA however.
Again I'm happy for my fellow veterans and I'm not ranting AGAINST..or FOR the VA model.

I think where the U.S. got into trouble is when our health insurance became a benefit provided by employers. When costs were low in the 50's..fine..but now that has become a real burden that confuses everything.

Posted by: rukidding7 | January 20, 2011 4:30 PM | Report abuse

Maybe Americans think Obama is too liberal because he is too liberal.

Posted by: clawrence12 | January 20, 2011 4:35 PM | Report abuse

@NoVA Here is where we disagree.
HSA's are a complete joke. We tried them at our office for about three months. The paperwork was onerous and the benefits would have been minimal. If a person earning the average income in our nation..slightly more than $50,000 let me round to 48,000 to get to $4,000 monthly. If said person saved 10% of their gross income every month that would be $4,800 or roughly the out of pocket cost I had for a simple kidney stone that had to be taken by a surgical procedure since it was too large to pass. $4,800 on top of the $10,000 I pay in premiums.

The point is what person making $30,000 is going to use HSA's? 10% of their salary wouldn't treat a bad kidney stone..and so does you catastrophic coverage cover every illness..because virtually every illness now comes with a catastrophic price tag.

Posted by: rukidding7 | January 20, 2011 4:36 PM | Report abuse

bsimon:

""Those who have most enjoyed the benefits of living in a free society ought to contribute the most to the kitty.""

What makes you think that "means" is a reasonable measure of how much one has enjoyed the benefits of a free society? A person who chooses a profession of modest means because he enjoys the job is benefitting just as much from the existence of a free society as someone who chooses a profession that pays a great deal.

Besides which, government expenditures go towards a great deal more than simply its role in providing for a free society, so it doesn't strike me that the benefit one gains simply from a free society (even if it was knowable/measureable) is a sensible metric of what one "ought" to pay.

Posted by: ScottC3 | January 20, 2011 4:36 PM | Report abuse

There are some other significant differences between the VA and the rest of the provider community.

The first is the homogeneous patient population. They are all self selected military volunteers. They have lived in the military environment and therefore have a different attitude toward the VA's relative ability than the heterogeneous group of people that a community hospital might serve.

Next, the type of illnesses that the VA confronts is limited. Instead of having compentencies over a truly broad range of healthcare specialties, the VA can focus on those issues specific to their population. they don't have to be good at trauma AND obstetrics, for example.

Posted by: skipsailing28 | January 20, 2011 4:37 PM | Report abuse

ruk:

""I think where the U.S. got into trouble is when our health insurance became a benefit provided by employers.""

Which happened because of income tax laws. Last year, prior to passage, I argued repeatedly with you that the income tax law should be changed for precisely this reason. I didn't get much traction with you (or anyone else) at the time.

Posted by: ScottC3 | January 20, 2011 4:43 PM | Report abuse

The Department of Veterans Affairs provides elective sterilization and reversal (tubal ligation and vasectomy).

Posted by: clawrence12 | January 20, 2011 4:43 PM | Report abuse

@Ruk -- sure, but once you hit your cap you're covered 100%. so IF you get a stone in year 1, it costs you. but if you don't? that's $4800 in the bank for you to use next year. and your premiums are way lower that a traditional plan -- I've never seen a plan with $10,000 in annual premiums for an HSA -- that's more than $800 a month. Are you sure that's what you meant?

Posted by: NoVAHockey | January 20, 2011 4:47 PM | Report abuse

[ass_hat_inthedark: "requires thought"]

Thank you Stuart Smalley*... we all anxiously await your deep thoughts.

Q: Are you in a *shame spiral?

Posted by: KaddafiDelendaEst | January 21, 2011 9:55 AM | Report abuse

To the person who said "why not give tax breaks to those don't get sick...those who do healthy things."

If you think that you will never get sick, did you make some deal with Satan. We will ALL get sick eventually, even those who don't smoke, drink, parachute from planes. GAH. Tell that to my friend who never drank, smoke, party, who worked out every day, who criticized those who drank, who took no risks whatsoever and...who died last year at the age of 43 of a rare cancer and who was self-employed, insured, but who has a mother who a year later is still fighting the insurance company because her daughter had a pre-existing condition of wearing hearing aids since she was 4. Please. Contrary to what you read, no one is immortal.

Posted by: mizlandry | January 21, 2011 1:07 PM | Report abuse

the founding fathers went along with slavery for economic reasons as well. Do we want to try that again?

Posted by: endor5 | January 21, 2011 5:23 PM | Report abuse

The Section 8 Commerce clause allows Congress to make laws to regulate commerce with Foreign Nations. Section 1 of the Act for the Relief of Sick and Disabled Seamen specifies that a tax be rendered on ships or vessels "arriving from a foreign port". Domestic vessels were excluded from the tax. This is a proper power exercised under the Commerce Clause. Today's proposal for a DOMESTIC health insurance tax CANNOT be justified in the same way. Period. Let's be clear about what Congress is and is not authorized to do...

Posted by: sonomasun | January 21, 2011 5:27 PM | Report abuse

Protest the companies that give money to conservatives in both parties.

Sign this petition at WWW.DEMOCRATZ.ORG if you want to get congress to enact a $10 an hour minimum wage, The Employee Free Choice act, a real prescription drug benefit for Medicare in part B, an End to 2 expensive wars, a single payer government health insurance plan, Tier 5 unemployment benefits extension and the women's freedom of choice act into law. Post this message on facebook groups, pages and profiles. Thank you.

After you sign this petition Join the the facebook page at

www.facebook.com/pages/Sign-this-petition-for-progressive-legislation-at-wwwdemocratzorg/181036078591739

Then you can click on a link called suggest to friends. Select every friend you have and yes it will send it to every one of your friends you select to invite to the group which will tell them to go to this petition and sign it.


Posted by: WWWoDEMOCRATZoORG | January 21, 2011 5:42 PM | Report abuse

http://www.nytimes.com/2010/07/18/health/policy/18health.html?_r=2&ref=politics

I keep seeing people say that it is not a tax. Please someone call President Obama and let him know, because his administration is defending it as an exercise of the government’s “power to lay and collect taxes.”

The link is the NYT article reporting the defense.

Posted by: martel732 | January 21, 2011 6:59 PM | Report abuse

Newsflash: Founders favored "government run health care"
---------------------
Doesn't make it Constitutional. Plenty of bills signed into law were struck down by the Supreme Court.

Posted by: martel732 | January 21, 2011 7:08 PM | Report abuse

Maritime law has ALWAYS been the exclusive jurisdiction of the Federal Government. However, regular health care of regular citizens has always been a matter for the States, and as the 10th AMD makes clear: any power not expressly given to the Federal Government is explicitly reserved for the States or people individually. Thus it is unconstitutional for the Federal government to takeover a matter left to the states. Besides, Congress from the start passed laws that were unconstitutional -- like the Seditions act, which clearly violated the First AMD. So the Framers knew they could pass laws to satisfy constituents, and punt responsibility to the Supreme Court to delete the law that they all knew was unconstitutional before it was even passed.

Posted by: SFreason | January 22, 2011 10:04 PM | Report abuse

I know there is value to the effort to understand the health care issue in the context of history, and the law, and the constitution. It is certainly important to understand it in the context of legitimate powers of the Federal government.

There are two other perspectives that I think are simply ignored.

(1) Health outcomes, based on different health care systems - for which the U.S. system ranks comparatively poorly.

(2) Moral decency. This is the point I think is simply lacking in the breakdown of civility and community in the U.S. (me, a lifelong U.S. citizen). The point is that, given our technological and physical capacity today, there is simply no moral reason that millions should go without health care, without housing, without food, without work.

The truth is that these are moral issues being addressed in crass political attacks, gingoism, and nativism. I get regular email blasts from right-wing racists (the real ones) trying to drub up fear of a black and brown take over of government and live like kings (literally) on the backs of hard working white people.

I get some messed up emails. But the point is that this is the context of the debate. It is this slight of hand, and confounding of the issue that puts truth through mazes and hoops and back-bend to accommodate the most cruel in our culture, instead of honest debate: should we have a health care system that denies primary care to tens of millions of our people?

Yes? Tough love, it's their damn fault, blah, blah, blah.

Or No. We should not. It is a moral outrage. A moral imperative to change.

If 1/50 of 1% of the heat and thunder on the right was agreed that the current health care system was immoral, we could talk. Instead, the Republicans in Congress created hurdle after hurdle, and the Democrats watered and watered down the bill, until at the last, not one Republican would support it. They want the status quo.

That is the moral issue. If you want to talk, but you aren't willing to admit that tens of millions of Americans without health coverage is a moral outrage, then the talk will be of little merit.

Posted by: alardin08 | January 23, 2011 12:44 AM | Report abuse

This really isn't a very well researched article. First of all the law in question is not stated, which I would understand with today's 2000 page monstrosities but this law is a few sentences. Second, the law does not mandate employees (even as your so called expert claims) but employers and only in regards to seamen returning from a foreign port which makes it a maritime issue and one of congress' few areas of juristiction. To say that it is a leap is the understatement of the year but the year is young.

My biggest problem with this new bill, believe me I can make you a list, is that yet again the federal government created the problem by getting involved where it didn't belong and tied our health care to our jobs. Nobody has the same job their whole life so between every new job, insurance companies have a chance to see if you are still worth insuring. This is exactly where most pre-existing conditions insurance refusals come from.

Now, just like everything else they try to control, it's out of control. Then they get to claim "EMERGENCY, I don't know how this happened but we have to act now!...No there is no time to read this bill or debate it. It must be passed now!" What a bunch of BS. The government is not the answer they are the problem and the sooner we get to that realization, the better off we will be.

Posted by: AustinDave1 | January 23, 2011 3:02 AM | Report abuse

You can already hear the steam going out of the push in Congress to repeal the health care bill.

Posted by: Rightist | January 23, 2011 6:49 AM | Report abuse

correct me if I am wrong- I am not American so may be I am wrong- does the govt not mandate that everyone who is driving have insurance. what is wrong in everyone also buying some sort of health insurance whether bought from private or govt source? Some institutes ( I work for a University) mandate that everyone is immunized against a variety of diseases if they want to work there.

Posted by: molgen6 | January 23, 2011 12:57 PM | Report abuse

There are two reasons why this law is of little relevance to the debate over the constitutionality of Obamacare:

1. This act does not contain an individual mandate. Congress imposes a tax, and then it uses the money collected to pay for services. Those claiming the individual mandate to be unconstitutional have widely agreed that had Congress used this same approach (tax and then spend the money acquired on healthcare services) it would have passed constitutional muster. [It also would have failed since there was insufficient political support for a tax of this magnitude].

2. More importantly, this act falls squarely within the ability of congress to regulate maritime trade.

A serious reporter would have taken the time to send an email to one of the hundreds of constitutional scholars who have asserted that the individual mandate is unconstitutional, and gotten their take on it.

This argument seems crafted to persuade the uneducated.

Posted by: jsolinsky | January 23, 2011 1:08 PM | Report abuse

Nice try, but the act specified seaman a profession and not employees in general. This Journalist is hallucinating as they are reading into the text something that it not there. Here's what their hallucinating, "An Act for the Relief of Sick and Disabled United States Employees" whereas the act isolated the mandate for seaman only.They were specifying a profession rather than the entire workforce of the country. But let's say that they were in favor of government health care for the entire country which this article implies. Even if that was so, then they would be contradicting their own constitution which they created. So one can argue that they were deviating from their own writings as well and therefore invalidate any of their health care mandates. The framers of the constitution were themselves bounded to it and not above it. Remember these folks were also the ones that agreed that all men were created equal, yet some of them owned slaves. So, using liberal logic, one could argue the slavery is okay because some of our founders had slaves. However, slavery clearly contradicted the aforementioned statement which our founders previously wrote so they themselves were not being faithful to their own ideology of being equal by the very act of owning slaves. Bottom line, unless the Constitutions explicitly states so or is amended, then neither congress today or in 1798 had the right to mandate health care. Yes, and this would apply to the founders themselves.

Posted by: NadaNada | January 23, 2011 3:22 PM | Report abuse

Our founding fathers also owned slaves and did not allow women to vote.

Should we tack amendments legalizing slavery and forbidding women to vote onto Obamacare?

Heck, someone better look, these provisions may already be in the 2700-page travesty of a law.

Posted by: RobertV1 | January 23, 2011 10:51 PM | Report abuse

I love the way those who are against the Health Care law feel it's an open and shut case.

1) Congress has the power to tax.

2) The interstate commerce clause allows congress to regulate what is bought and sold if it is a product which greatly affects the economy as a whole. The argument over whether it is 'interstate' or within a state is loose considering the purchase of something so crucial to our economy as health care clearly affects all forms of commerce - interstate included.

3) Any holes in 1 or 2 on the exact manner that this mandate is fulfilled for the purpose of the country as a whole are filled by the necessary and proper clause - which essentially says congress can write any law necessary to fulfill the other powers.

4) Wrap it all in the words "promote the general welfare" with a nice little bow - and we're all done.

Now - can a supreme court decide it isn't constitutional? Sure. Are they right? That's a matter of opinion... just like everything else.

But there's plenty there to write a nice SCOTUS opinion on why it is constitutional... there's also plenty to say it isn't. -

And for all these people that say "If the government wanted congress to control health care they would have said that"... The constitution was ingeniously written - it's one page in length and uses words like "necessary and proper" and other generalities because they knew everything that would come about in future years would not be covered in a one page document.

Why do you think they use terms like "cruel and unusual punishment" (yes, I know this is an amendment..) They used terms like this because they had no intention of defining all forms of punishment current or in the future - but what they could define easily.. is the punishment shouldn't be cruel or unusual.

And also.. as to the argument that this is "completely different than govt. health care because it's maritime" -- they also later expanded the law to apply to those on the Mississippi river and the Ohio river.. so sorry - not the case.

The real point of the article is simply that anyone arguing that the founding fathers were against any government involvement in health care - even health care by taxation.. from people which work in a private sector... is wrong.

No matter how you bicker - it looks an awful lot like a mandate. If you don't want to pay the tax for the bill.. you didn't become a seaman - if you don't want to pay the tax for the health care bill - then don't get a job I guess.

Anyway.. think that covers all I had on my mind.

Posted by: Dkennedy2 | January 24, 2011 4:09 AM | Report abuse

oh Robertv1..

I've read the health care bill - every version.

You're right - it's too lengthy.

"Medicare for all" could have been done in a couple pages.

Posted by: Dkennedy2 | January 24, 2011 4:13 AM | Report abuse

OK, so the government of 1798 was in favor of government-run healthcare for a tiny fraction of the people of the country, mandating a payroll tax on those same people in order to pay for it. But it still isn't government-mandated purchasing of anything... it's technically an income tax on a small portion of people (which is probably UnConstitutional prior to that amendment, but different argument). So, the individual mandate is unanswered by this argument. Also, Obamacare taxes everyone EXCEPT the people who will be covered by the universal healthcare, so it fails in the utilization of the taxes trial. And, if we go through the bill, there are literally thousands of pages which have nothing to do with healthcare... most of which are questionable Constitutionally (from a Checks and Balance perspective if nothing else). The private army under the Public Health Service, the takeover of student loans coupled with the indentured servitude of those students to pay it off are just a couple of the easier examples. The healthcare portion is only about 15-20% of that behemoth. In 1798 they set up a better program and did it in just a page or two. Strike 1.
@rukidding7: I'm not sure about the studies you cite, but I think they were at the same time that the 3 top hospitals in the military/VA circuit (Bethesda, Walter Reed, and I forget the other) were ALL being investigated for unlivable conditions, horrendous administrative errors, and a back-log of heaven only knows how long. The VA medical system is good only if you compare it relative to the amount of dollars actually paid for the care by the patient. If you take into account the other payments (which, as a veteran, I think you might understand), then the care is awful for the price. The VA is very definitely proof that the government should not be running health care. The only reason those other hospitals do well is because they take care of government members, so they get tons of money. Oh, and active duty folks have precedence (as they should) so good luck getting into any of the top ones as an out-of-uniform veteran. Strike 2.
One last reminder: This is the same Congress (same year, in fact) that passed the Alien and Sedition Acts... all of which have been proven to be UnConstitutional after the fact... and which John Adams was pressured into signing by his POLITICAL PARTY . I think I found our problem. But anyway, Strike 3 for guilt by association. Y'all can go back to getting your political advice from Rosie O'Donnell.

Posted by: JLG91 | January 24, 2011 3:49 PM | Report abuse

After all of the talking points, and historical references, and precedents/non-precedents, and naming-and-blaming on health care, consider this: We as a society have agreed that mandated auto insurance passes legal muster. As a result, we have increased the risk pool, which together with competition somewhat controls prices of policies and repairs. It's imperfect, of course, but it kind of works, with all parties basically keeping a checks-and-balances eye on each other. I haven't heard anyone of late shrieking about socialism or fascism or the downfall of the Republic because we've agreed to this system; we've developed some pointed legal sanctions for those who abuse this Commons to which most of us contribute. Even with large awards for liability and pain-and-suffering stemming from auto accidents, we are jostling toward a more workable system for managing risk on the road. If we can do that, we can fix the health care crises (plural intended).

Granted, medical costs are rocketing up with no ceiling in sight, making it more difficult to apprehend the scope of the problem and to implement possible solutions. Still, the best and brightest among us ought to be able to design a system in which people don't lose their homes to cancer as their loved ones battle the disease, and in which kids with earaches or diarrhea don't have to get indigent care in emergency rooms. The system is broken, and it's hurting us big-time, financially, physically, and emotionally.
Spending our political and emotional capital on "gotcha!" and "gotcha back!" in these various media gets us no closer to solving these problems for the most vulnerable among us, or for our kids and grandkids.
Let's please look harder for solutions; blame solves nothing. History shows how the founders wrestled their debates back from vitriol toward principle and solution at no small personal cost, in an effort to design our system to allow us to do the same with the problems of our day, and with a similar eye toward our future.
Thanks for listening.
jtrask3

Posted by: jtrask3 | January 24, 2011 11:11 PM | Report abuse

Greg, it seems to me you found evidence that the founding fathers saw an impediment to the country's ability to grow and thrive, and took steps to solve it. While it could easily argued that this is a precedent for Medicare and Medicaid, it does not provide compelling support for the current attempt to mandate the purchase of health care insurance with a penalty for deciding not to buy it. Thoughts?

Posted by: curlbud-washpost | January 25, 2011 8:46 AM | Report abuse

I think the flaw in your argument, Mr. Sargent, is that you seem to think Federal Law and the US Constitution are one and the same. They are not. The Constitution does not provide the Federal Government any power to create a National Health Care System, or a National Health Insurance System, etc. Period.

But, Congress, from time to time, will pass laws, as they did in 1798 for sailors, and also in 2010, but that does not make them valid, Constitutional laws.

As we all know from civics class, the Federal Government is restricted from doing anything not provided for in the Constitution. This does not mean that they don't exercise powers unlawfully anyway; they do it all the time.

Just like the 2010 Health Insurance Bill that passed, I would argue that the one in 1798 is just as Unconstitutional. The method by which we grant more power to the Federal Government is the Ammendment. Nothing else is valid. Simple majority bills passed by Congress don't cut the mustard. And the reason for this is so that a quirk in the mood of the electorate does not install crazy legislation. Two-thirds majority in the House, Senate and of the States is what this requires.

I'm not arguing against having Universal Health Care in the US, I'm simply arguing that if wish to grant ourselves these entitlements, we do it under the method set forth by the Cosntitution - The Consitutional Amendment. Not behind closed doors with the minority party excluded from the decision making process...

Posted by: druvas | January 25, 2011 1:03 PM | Report abuse

I think the flaw in your argument, Mr. Sargent, is that you seem to think Federal Law and the US Constitution are one and the same. They are not. The Constitution does not provide the Federal Government any power to create a National Health Care System, or a National Health Insurance System, etc. Period.

But, Congress, from time to time, will pass laws, as they did in 1798 for sailors, and also in 2010, but that does not make them valid, Constitutional laws.

As we all know from civics class, the Federal Government is restricted from doing anything not provided for in the Constitution. This does not mean that they don't exercise powers unlawfully anyway; they do it all the time.

Just like the 2010 Health Insurance Bill that passed, I would argue that the one in 1798 is just as Unconstitutional. The method by which we grant more power to the Federal Government is the Ammendment. Nothing else is valid. Simple majority bills passed by Congress don't cut the mustard. And the reason for this is so that a quirk in the mood of the electorate does not install crazy legislation. Two-thirds majority in the House, Senate and of the States is what this requires.

I'm not arguing against having Universal Health Care in the US, I'm simply arguing that if wish to grant ourselves these entitlements, we do it under the method set forth by the Cosntitution - The Consitutional Amendment. Not behind closed doors with the minority party excluded from the decision making process...

Posted by: druvas | January 25, 2011 1:07 PM | Report abuse

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