One thing President Barack Obama and some other politicians have figured out about Americans is that you can’t trust them to manage their own affairs, and if you want to fix health care in this country you are going to have to take away some more freedoms even if the Constitution doesn’t permit it.
Specifically, you may very well have to mandate that everyone buy health insurance because, otherwise, you are not going to have the premium money necessary to make this whole new scheme of things work and you could leave the door open to something akin to cheating.
That last possibility pops up because you will also be dictating to insurance companies that they cannot deny insurance to anyone with preconditions, which is a bit like saying to a home insurance company that it has to sell a policy to someone whose house has already burned down so that he can get himself a new one.
The danger is that if you do this thing, some people with no preconditions or other immediate health concerns will wait until something like lung cancer is discovered to purchase what they need, and meanwhile, you have not had that person’s financial contributions. So you will have to insist that everyone who does not now have it will have to buy the insurance right away and enforce this through some mechanism or the other that necessarily will be either punitive or confiscatory in some form.
I know, I know, some people won’t care because freedom is no big deal to them anyway, the idea of limited government makes them chuckle and they espy some sort of Utopia ultimately reached through a leviathan state that controls what it has to control. They may also dismiss the constitutional argument on the ground that states now require insurance for driving autos, and they would be wrong.
As some experts note, the Constitution specifically enumerates the powers of the federal government as a means of limiting its encroachment on the states and the people and certainly affords no power to require insurance purchases. Those limits do not apply to the states. It is true that the federal government has largely ignored these limits, often using the commerce clause as an illegitimate excuse to intervene where it has no right, and it will probably employ that device this time around, too.
The point of the commerce clause is to facilitate trade between states. Period. Mandating a purchase is not facilitating trade, although as others have pointed out, the clause could and should have been used to establish a national health insurance market instead of what we now have, where your options are limited to what you can get in the state you live in. The argument that the clause’s abuse justifies other abuses is like saying the robbery of banks justifies more bank robberies, and neither is it wise to say, well, this part of the Constitution is not so important to us anymore.
Almost everyone, no matter what his or her ideology, subscribes to some part of the Constitution or the other, whether it is free speech or due process or prohibitions against illegal search and seizure, and everyone ought to realize that the more you denigrate any one aspect of the document, the more you denigrate the document as a whole, slowly leaving it behind.
I am not against some needed restructuring of our health care system as long as it is done prudently and in accordance with principles that safeguard other things that matter to us, not the least of them being our liberties. Some of us think they still matter, that your very humanity is sucked out of you without them. Maybe we are in a minority, but part of what the Constitution is supposed to do is protect minorities.
(Jay Ambrose, formerly Washington director of editorial policy for Scripps Howard newspapers and the editor of dailies in El Paso, Texas, and Denver, is a columnist living in Colorado. He can be reached at SpeaktoJay(at)aol.com.)