Health Insurance Is Not a Federal Issue or Constitutional Right

President Barak Obama proposes to federalize health insurance and to make it a “right.” However, health insurance is neither a right, nor is it even generally a federal issue under the United States Constitution in the first place.

As I note in an earlier post (Misleading Media Phrases), in which I observe that the issue is not about “health care,” but health insurance, many people who lack health insurance chose not to obtain health insurance because they are wealthy enough to afford to pay for their own health care, do not need it or believe in it for cultural or religious purposes, or are too young and healthy to justify the expense that seems unnecessary. In the case of the last group, catastrophic health insurance should suffice. A last major group of people who lack health insurance lack it only temporarily, as they are people between jobs, which is why there have been some reforms like Health Savings Accounts that President George W. Bush signed into law that allow people to maintain coverage even if they lose their jobs. Obama’s proposal moves in the wrong direction by forcing a return to the system whereby health insurance is only obtainable through one’s employer.

Health insurance premiums began to be provided by employers because of federal government interference in the free market in the first place. General Motors Corporation first began providing health benefits to its employees because of federal wage controls during World War II. Thus, over time most people’s health insurance has been provided by their employers, with often generous “Cadillac” health insurance plans. Employer-provided plans have allowed people to feel as if their health care is free, even though it costs them compensation they would otherwise have made, which provides no incentive to them to reduce costs. Now, in response to such employer generosity, Obama and Congressional Democrats led by Senator Edward Kennedy (D-Massachusetts) propose to mandate all but the smallest employers to provide health insurance to their employees or face a federal penalty. They also propose the provision of health insurance, which will compete with private plans and eventually drive them out of business.

An argument can reasonably be made that federal mandates or provision of health insurance benefits would violate the Commerce Clause of the Constitution, which allows the federal government to regulate interstate (between states) commerce, which means that the federal government lacks any constitutional authority to regulate intrastate (within states) commerce. Alas, the Commerce Clause has routinely been ignored by the federal government unconstitutionally for decades without any serious debate about whether to repeal it with a constitutional amendment. Regardless of the constitutional question, it is not appropriate for the federal government, nor any government at all, to be involved in the matter of health insurance, as it is a private matter. Even if it were a government issue, it is not a federal one, as there is nothing particularly federal about it. The federal government’s only interest in health is generally limited to communicable diseases because non-communicable diseases do no pose a threat to the health of others like contagious ones do, while state governments’ interests are similar. Once the federal government subsidizes all health care, then it will have the total power to regulate all health issues totally. For example, it could decide which foods people could eat, let alone ration health care.

The argument that Obama and other liberals claim is that health insurance improves health because it provides people the opportunity to avail themselves of preventative care, which, in turn, saves the federal government money, is irrelevant, even if it were only interested in communicable diseases. The main reason that liberals claim government interest in health care besides for veterans is because of federal government subsidization of health insurance in the first place (e.g. Medicare and Medicaid). The circular argument is that government has an interest in health insurance once it takes an interest by subsidizing health care. But government should not have begun to subsidize health care because it has no constitutional authority to take money from one person and give it to another, which is a form of welfare. It is never too late to privatize health insurance, which would eliminate federal interest in health insurance.

A right is a legal claim, which necessarily imposes a duty on others. The analogy between the federal government providing health care and providing an accused person with a lawyer fails because the provision of the lawyer is arguably a facet of the Due Process Clause of the Constitution; a bundle of rights, including the Sixth Amendment right to counsel, attaches once a person is accused of a crime. However, a person cannot claim health insurance as a right, just as he cannot claim food as a right, for he cannot generally impose upon someone else the duty to pay for his needs. Note: I say “health insurance,” because emergency health care is a right; no one can be denied emergency health care, but one can be denied health insurance, just as one cannot be denied food if one were dying of starvation but could not pay for it, but can be denied food absent starvation otherwise. But although one cannot be denied food or healthcare in emergencies, their provision to one person does not impose a duty upon another to pay for it. Obama’s proposal to create a right to non-emergency health care at other people’s expense would be like creating a right to be fed at others’ expense, which would establish a precedent to be housed or clothed at other people’s expense, even on a non-emergency basis. Thus, welfare would be expanded to a federal right of unlimited degree.

As with Obama’s massive so-called stimulus plan, the danger to liberty goes beyond the massive spending and borrowing and taxing his proposed federalization of health insurance would necessitate, but to the increase in federal control over our lives. If Obama and other liberals get their way, the federal government will decide who gets what health care or not, what foods we may eat and what behaviors in which we may engage. For the sake of liberty, the federalization of health insurance must be stopped.