Arthur Salm: Health care - It’s in the Constitution

By Arthur Salm, SDNN

Monday, August 24, 2009
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“I think health care is a privilege. I wouldn’t call it a right.” - Sen. Jim DeMint (R-S.C.)

San Diego: Arthur Salm is an SDNN columnist.

Arthur Salm is an SDNN columnist.

Slavery used to be cool, and that was even before cool was cool. In fact, slavery was beyond cool — it was something people didn’t think about one way or the other, because there was no “other.” San Diego: sdnn-opinion35

Just a few hundred years ago, just about everywhere, slavery was an accepted part of life, like families and work and the sun coming up in the morning and the Padres trading away franchise players. Not even slaves were anti-slavery: Any of them fortunate enough to be freed, and then to become prosperous, would just naturally get himself a slave or two or ten. That was the way people were. That was the way people thought.

Two hundred years ago, nearly half a century after this country’s founding, education was for the relatively few children whose families could afford to send them to private schools — which were the only schools. It certainly wasn’t the government’s business to educate its citizens. That was the way we were. That was the way Americans thought.

Today, the acceptance of slavery is all but unimaginable. Literally: unimaginable. So radically have our values shifted that it’s all but impossible to empathize with a slaveholder, to put one’s self into his mindframe and say, “All right, I see that. I may not agree with it, but I can kind of understand where he’s coming from.” It’s beyond our ken.

Likewise the notion that we bear no responsibility, as a society, to educate our children. Self interest plays a part, of course — a modern technological civilization requires an educated citizenry — but it goes further and deeper than that. We now agree that spending public treasure on sending kids to school is a moral imperative. Every child, we are convinced — we know — deserves an education.

So our values change, and change (from our point of view, at least) for the better. A lot of things people stood by and fought for, or, more telling, didn’t think about but simply accepted as given, are now alien concepts, consigned to the “Omigod-people-used-to-be-so-cruel” corner of history’s overflowing dustbin.

One of the values now undergoing transition involves health care. Sen. Jim DeMint (R - South Carolina), quoted above, maintains that it’s a privilege. That is to say, no one deserves it; it has to be earned, or, more likely, bestowed upon you because your family has the means to do so. Or, if you’re lucky enough to ping on the radar of a (privately run) charity, maybe an occasional checkup and some prescription-drug handouts will come your way.

See related from Arthur Salm: Health care in Canada — they’re not dying by the millions |  Insurance companies terrified by the public option |  Let’s make HMOs disappear

People in every other western industrial nation don’t see it like that. They have decided that all their citizens deserve health care; it has become, in their view, a right. It didn’t used to be, but it is now. Values, remember, change.

We Americans haven’t come that far yet, but we’re en route — and we even have the backing of the Founders on this one. The language is there, and has always been there, but it is coming to mean something different, something more, something better. Take this from the Preamble to the Constitution (my italics):

” … establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare …

And this, from the Declaration of Independence (again, my italics):

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

In this day and in this age, the government’s — that is to say, our — charge to promote the general welfare, coupled with every man’s (and woman’s; another value change) right simply to live, more than implies a right to health care - it demands a right to health care. Throw in the pursuit of happiness as a kicker — can’t be happy if you’re sick as a dog, or dead as one — and it’s something we shouldn’t even be talking or thinking about; it’s something we should know. I deserve good health care, you deserve it, your kids deserve it, people you don’t know and never will know deserve it. Everyone deserves it.

That means good care, real care, not a last-minute, desperate trip to the ER. Brian Johnston, chief of emergency services at White Memorial Medical Center in Los Angeles, wrote in the L.A. Times last Saturday about what he sees there:

” … a 47-year-old laborer, with untreated high blood pressure, dying from a cerebral hemorrhage. A woman in her 40s complaining of feeling ‘lousy,’ unaware that her blood pressure is extremely high and that her kidneys are destroyed. An elderly widow is brought in severely dehydrated and comatose, with a blood sugar level over 800. Medi-Cal had switched her over to a ’share of cost’ program, which forced her to choose between paying her rent or taking her medicine. She’d chosen to pay the rent.”

Senator DeMint and others opposing universal national health care may be okay with what happened to these people. Health care, they believe, is a privilege; it’s not available to everyone; that’s just the way it goes.

But the Declaration of Independence and the Preamble to the Constitution, as read and understood through modern sensibilities, say otherwise.  Those ER patients’ rights as Americans were violated. Our rights are being violated. May we soon hold these truths to be self-evident.

Arthur Salm is an SDNN columnist.

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62 comments

READER COMMENTS

Comment by: Sir Loin of Beef Posted: September 2, 2009, 1:36 pm

“Your interpretation completely ignores the constitutional ammendment process and holds the door open for all types of tyranny in the name of the public good.”

Well, I do ignore the ammendment process in this regard because the constitution is clear that laws can be drafted through the legislative process in the interests of the public good.

You brought up tyranny, please consider this: in a system where money has been declared free speech for corporations, where the idea that a “free market” is considered by many to mean an absence of any regulation, how is not tyranyn to do nothing to constrain the acquisitive actions of huge, wealthy corporations, particualrly in instances in which their increased profits depend upon the American citizenry experiencing misfortune, or paying the corporation’s external costs of doing business?

I would like to see predatory private corporations (which all are by nature)held in firm check by a government in which I, as a citizen, have a fundamental role. The American Revolution was sparked by the mercantilist relationship between government and industry, and I don’t want to lose that war now.

Comment by: wlc Posted: September 3, 2009, 5:50 am

Well, let us look at the welfare clause.

“WE, the PEOPLE of the UNITED
STATES, in order to form a more perfect union, establish justice, ensure domestic tranquility, provide for the common defence, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”

Clearly the preamble, the introductory passage, gives the reason WHY the constitution was “ordain(ed) and establish(ed)”, as evidenced by “in order to form a more perfect union… do”. “Promote the general welfare” is one of the reasons given, along with “secure the blessings of liberty”.

Clearly the welfare clause not a distinct power given to the govt, because there is no delegation of power in the preamble, the delegation occurs in the Articles that follow.

And we all know that the 10th ammendment states that powers not delegated in the constitution are reserved for the states, or the people.

My approach does not ignore the welfare clause as a reason why powers were delegated to the fed govt. But my approach does not give the fed govt sweeping powers that would unravel the ideals of limted govt, as yours would.

–
I have not said any discussions are unseemly or out of bounds. You have every right to question the cost of wars and to challenge their necessity.

But most of my far-left friends eventually make some statement like “better health care than bombers” as you seem to have, and the statements make no sense to me. Because inherent in limited govt ideals is the notion that the use of govt power must be judged and decided upon its own merits.

If we have become a nation that hands over a large portion of its income to the govt and then goes shopping for the govt we seek, we have lost our way surely.

You said that I misrepresented the health care system as a supermarket. It seems you misrepresent the fed govt as a supermarket.

Comment by: wlc Posted: September 3, 2009, 5:59 am

Beef, as to the “free market” I recommend the books of Ludwig Von Mises, an economist of the Austrian school. Mises accurately describes liberalism and the role of govt in society. You will be please to know that he wrote that a just power of the govt is establishing a regulatory framework, that the market requires it and cannot surive without it. You might not be pleased with his comments on socialism and collectivism.

But perhaps we should stick more to the topic at hand, no?

Comment by: wlc Posted: September 3, 2009, 6:15 am

Beef, I forgot. The constitution also mentions the “general welfare” in Article 1 section 8:

“Sect. 8. The Congress shall have power To lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defence and general welfare of the United States; but all duties; imposts and excises, shall be uniform throughout the United States;”

This provision deals with “lay and collecting taxes” and such “to”…

Which means Congress has the power to tax for the general welfare.

Of course, that does not mean Congress SHOULD tax for a nationalized health care system, only that it has the power to do so.

And it does not address the central issue here, whether health care is a right… with many supporting arguments that it is not.

I appreciate your respectfull replies. Good day.

Comment by: Sir Loin of Beef Posted: September 3, 2009, 1:13 pm

Even were I to accept your ascertion that Health Care is not a Right (which I admantly do not); you have provided no arguments in regard to why an efficient pooling of public resources in to a single payer system covering everyone would not be a wise policy beneficial to all of society.

The Republican/Free-Market Fundy objections to the idea boil down to simple stinginess. This world-view invariably views such things as public health and education as zero-sum proposals, in which one of these “commodities” received by one family or demographic reduces the stockpiles available to one’s own self or crowd. But this is not the nature of such things - they are self-perpetuating, self-multiplying values that benefit everyone, and multiply to a sum far greater than its consituent parts.

Comment by: wlc Posted: September 3, 2009, 2:13 pm

Beef, I guess you have forgotten about half of our discussion, which is disappointing. I was enjoying our discussion and felt we were both reasonably acting civil. But I refuse to debate in circles. This will be my final post to you.

You stated, “This entire issue regards PAYING for health care, not its provision by medical professionals.”, so I though you had given up the claim of health care being a right and moved on to more defendable terminology like “civility and decency”.

Health care is not a right for many reasons, the most blatent being that rights are endowed by our creator, so the only health care rights you have is the health care provided by your creator. Rights are not provided, health care is provided. Meaning that since health care can only be provided by the labor of others, and we do not have a right to the labor of others, so health care cannot be right. Another reason is that a procedure that was not in existance 10 years ago cannot be a right today. Health care must be bought, and rights, what you already have just cause to own, need not be bought.

And I did provide some very good and not “talking point” reasons why the forced pooling of funds would not be to our advantage. I will not repeat them here.

Lastly, you do not know my motivations unless I tell them to you. You do not know my financial situation either. It might surprise you to know just how much I have given to society. But I have refrained from such talk as not relevant. But I tell you now that reducing thought and researched ideas, ideas that have been the backbone of our country from its founding in classical liberalism as “stingy” is highly insulting.

When it comes to my motivations, you do not have the slightest idea what the heck you are talking about.

Comment by: Sir Loin of Beef Posted: September 3, 2009, 2:58 pm

I’ve been enjoying our discussion as well, but now that you’ve lapsed into metaphysics (”…so the only health care rights you have is the health care provided by your creator”)and tautology (”Health care must be bought, and rights, what you already have just cause to own, need not be bought”),I agree that its time to say adios.

Comment by: Vic Posted: September 5, 2009, 11:23 am

Um, this is so sweet, all you angels dancing on the head of the pin called the Preamble, but really now, the US decided long ago that rights are not only inhered but implied, too, and that fifty years of Cold War was never so much as questioned when it came to the government stimulating the economy for “defense” spending. If government has the power to spend on guns, it can do so on anything else Congress wishes, including building hospitals, providing medicines, establishing training standards for doctors, etc., just like it has since 1861. Read the histories, boys and girls and Loins of Beeves and wise up.

Comment by: wlc Posted: September 7, 2009, 6:12 am

“Increasingly, health care needs to be measured by the same metrics as other goods and services—cost, quality, benefits, and value. It can no longer claim to be treated differently from other social goods. ” Ezekial Emanuel (Now an advisor to Obama)

http://jama.ama-assn.org/cgi/content/full/297/19/2131?ijkey=4193d2c8d3535b4d6809675be6d682b17a60f869&keytype2=tf_ipsecsha

In this article he is certianly critical of our present system, as many are. And his words I posted are in context with the economics of health care, not a discussion of rights. But it seems he is saying that since health care is an ecomonic good, it must be provided by a system that best follows economic principles, not that health care is special and should be treated differently from other social goods.

Which re-enforces my belief that arguing HC is a right that must be provided by the govt is no different than arguing ford clothing and shelter are rights and must be provided by the govt, and such a mindset will lead to communism and tyranny.

Since Dr. Emanuel has gotten such negative press lately, I was reading his articles to find ammo against him with. Ironically, I found that I agree with a lot of what he says.

Comment by: JeffM Posted: September 17, 2009, 5:22 pm

Affordable access to quality healthcare for everyone is good for society as a whole. Just look at every other nation that has universal healthcare ask them if they would give it up for anything. The answer would be “no way”. They might want to improve it, but never take it away.

It doesn’t matter if the constitution makes it a right or not. Congress clearly has the power to enact laws to provide it and should do so for the good of the country.

Comment by: William Ladd Posted: September 18, 2009, 9:37 am

Might as well make health care, food, clothing, shelter, and whatever other things you like rights, and give them all away. The United States is rapidly losing its once-incredible-and-amazing uniqueness in the world anyway. We won’t have to deal with immigration issues, as nobody will be particularly interested in moving here anymore before long. Maybe we can get into the European Union and join up with the countries our ancestors couldn’t wait to leave!

Which brings up the question of why people that think our health care stinks don’t move to a country that has “better” health care. It seems like an issue worth moving for, if their strident voices reflect their true passion.

Comment by: sf Posted: October 4, 2009, 2:15 pm

It states “promote” for the general welfare,

NOT “provide” for the general welfare.

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