A Constitutional Right to Health Care?
The assertion that we have a right to medical care is one of the pillars that supports the Affordable Care Act. Not the sole pillar, but one of them.
As with all of our rights, it has have a source, to be built up from the foundation for the national edifice. Being a democratic republic, as I understand it, we in the United States have two sources. One is the Constitution, and the other is the statutory authority given the various levels of government both federal and state by the Constitution.
Do we have the Constitutional right to medical care?
I would contend we do not. And the reason is simple and straightforward. The Framers of the document, in their historical context, had no concept of universal health care. They lived on the far side of the threshold of modern medicine. So to expect them to somehow divine what health care would look like two-hundred-plus years later is completely without justification. Therefore, there is no article or amendment in the Constitution that grants universal health care to us.
That being said, the Framers recognized there would be the need to occasionally amend the Constitution. That route has been taken by the nation some twenty-seven times (with one, the 18th, having been repealed). Ratification, however, is a protracted process, which is probably for the better, since amending the Constitution has for the most part been reserved for broad principles and the complexity of the ACA requires far too much statutory support for that to be practical.
That leaves one standardized process to grant (or in some cases restrict) rights: through the enactment of laws. It is the constitutionally-defined role of Congress to provide this governance. At the same time, the President of the United States has a different constitutionally-defined role to provide leadership and governance that ideally unifies these various processes and also provides a check and balance for the actions taken by the Congress. This is all the stuff of middle-school civics classes (if they haven’t been eliminated by budget cuts, but I digress).
The statutory process for legislating rights has both advantages and limitations. The advantages include the ability to pass laws in a much more expeditious manner (than a Constitutional amendment) and also to structure and focus them so as to facilitate writing the often complex rules required by legislation. The limitation of the statutory process, on the other hand, does not carry the weight of a Constitutional amendment, is more prone to be the result of political winds blowing at the moment, and can be challenged or repealed, as opposed to the significantly more difficult process that it takes to change an amendment. I believe the case can be made that 90% of the gale force winds of the current controversy over the ACA can be placed on the shoulders of the congress for not providing that governance, but that is a topic for another time.
The Right to Health Care is now a Matter of Law.
My perspective is that our right to receive medical treatment is based on the statutory side of the equation. And that is the problem. We lack a true Constitutional right for medical care. We are not going to get that, either. Instead, the President set out to provide that right to the American people, but ended up creating a buffet-menu-type-act cobbled together as a basket-full of provisions. It is not perfect. Even those of us who are advocates for universal health care knew that in advance and recognize it even now. The ACA’s redeeming factor, however, is that it can be modified and improved over time. And I maintain it is light-years better than the mishmash of laws, regulations and deregulations that characterized the pre-ACA situation masquerading as American health care.
And that is good, no question about it. But Congress, because of the current political polarization and vitriol between the political parties, and with the House of Representatives being under the control of the Republicans (at the moment), didn’t like the president’s list (that dislike being fueled by intense lobbyist pressures from the industries that would be most affected and from members of the “far right”). Subsequently, they have committed themselves to, as they say, “repeal and replace.”
In light of the pending Supreme Court decision, should they prevail, it is an open question whether the G.O.P. actually has any plan or even good faith intent to replace the ACA with an equivalent that will serve the American citizenry better. If that plan exists, why have they not been leaking copies of it to the media to prove their point? And what I have been reading about a Republican plan, I hold little hope that they have a coherent alternative to the ACA, but would foist off on the American people a set of badly conceived and unworkable “programs” that makes the ACA look like the best piece of legislation ever written.
It is very frustrating that even under the ACA, the laws that support the right and the laws that support the economics are completely out of synch with each other. The Republican-controlled House has done everthing possible to keep it that way so as to weaken the whole law and sow discontent out in the country by repeated pointing how bad it is. Of course, they leave out all the parts in which they have relentlessly worked to ensure that the ACA’s flaws are not corrected.
I have been an advocate for universal health care on the basis of my philosophy regarding creating a healthier America, one that is in line with the other “first nations” of the world, many of whom who have had universal health care for decades (and mysteriously not collapsed into despotic socialist states as many anti-ACA individuals and groups argue will happen, if you believe their inflammatory rhetoric).
Our Inalienable Rights Opened to Their Full Beneficence.
Only when the inalienability of our Rights to the Blessings of Liberty is opened to its full beneficence, can the common citizen be “blessed” to the utmost when his or her illness, injury or other medical condition can be treated–regardless of the individual’s circumstance in life.
I suggest that the right to medical treatment is found in the Constitutional foundation of inalienable rights. Although not enumerated in the Constitution (but also not forbidden if we apply the rights accorded to us in the 9th Amendment of the Constitution—I find it very curious that argument has not been put forth by the proponents of the ACA), a valid proposition for the constitutionality of the ACA can be made by referring to the Preamble, in which the Blessings of Liberty—as specified in the Declaration of Independence: life, liberty, and the pursuit of happiness—are essentially impossible if one is denied access to that very health care. Only when the inalienability of our Rights to the Blessings of Liberty is opened to its full beneficence, can the common citizen be “blessed” to the utmost when his or her illness, injury or other medical conditions can be treated–regardless of the individual’s circumstance in life. Unfettered access to health care, in context, is an inalienable right because none of the blessings can be attained, sustained, or in the case of chronic conditions, controlled to the best medical protocols available at that time, without it.
When universal access to medical care is placed in that frame of reference, it becomes part of the National Covenant in which we all share. Beneficence is the principle that all have the inalienable right to share in the blessings of liberty and that we, through the covenant of liberty, act with altruism for the one as well as for the whole. This is the same rationale used for Social Security and Medicare. Neither of them is enumerated in the Constitution, either. Therefore, the question of who pays for universal health care becomes moot: beneficence directs us toward universal altruism (also a principle of e pluribus Unum—one out of many), so, the only solution is that through our taxes we all pay to protect that right. To ensure that every individual has that right, the body has to contribute to the whole so that the Covenant is guaranteed to all. The denial of inalienable rights to one is the denial to all.
Am I suggesting we by default should be moving toward the so-called “single-payer” system? I have never been an advocate for that as the final solution. But two years after the ACA was signed into law, the current case before the Supreme Court of the United States is a suit based on the most trivial and marginally related arguments against it. It has been brought not by those who have an alternate plan they believe will be superior to the ACA in guaranteeing the Covenant is put into place, but for grossly political motives and just want it eliminated altogether. The ricochet of this legal bank shot just might result in single payer as the unintended consequence of their political hubris.
Ironic? More than a little.