"We Take Care of Our Own" is the lead single from Bruce Springsteen's latest release. The expression also sums up how we treat people with health emergencies. For all the talk about the threat to the Constitution posed by the Patient Protection and Affordable Care Act, or "Obamacare," there has been little discussion of a vital law that guards against threats to bodily constitutions: the Emergency Medical Treatment and Active Labor Act.
Passed in 1986, the Emergency Medical Treatment Act provides that hospitals may not turn away people with "emergency medical conditions," regardless of whether they have health insurance. Hospitals must either offer treatment to stabilize a patient's condition or transfer the patient to a more appropriate facility. The law equally protects people born in the U.S.A., other Americans, and even non-citizens. It reflects basic humanity: "wherever this flag is flown" (as Springsteen puts it), we don't live and let die. Reagan cared too.
Of course, as noble as taking care of our own is, someone has to pay the bill. One arrangement is for those who have health insurance to subsidize those who do not. That is essentially how the system has worked until now. But with the Affordable Care Act, Congress decided instead to regulate health-care commerce by spreading the cost and requiring insurance for all, much as it decided three-quarters of a century ago to require Social Security contributions so that we could take care of our old. This "individual mandate" is what has triggered the current constitutional challenge, on the ground that Congress has overreached in its regulation of interstate commerce.
If the Supreme Court bars Congress from regulating the commerce of caring, Congress could respond in a number of ways. One option would be to continue putting the financial burden of the uninsured on the backs of the insured. As Justice Ruth Bader Ginsburg phrased it at last week's oral argument, what makes health insurance unique is "the cost that I am forcing on other people if I don't buy the product." In light of that rising cost, however, a more ominous reaction is also foreseeable: we might stop caring.
In other words, there could well be calls to repeal the Emergency Medical Treatment Act. That would satisfy the crowd at the Republican presidential debate in September at which people cheered their approval of the suggestion that, as to a hypothetical uninsured man in a coma, "society should just let him die."
Thankfully, American society has not embraced such hyperlibertarianism. We may be a group of individualists, but we take care of our own. In 1975, Springsteen famously sang of being born to run from a town that was a "death trap" and a "suicide rap." Who would want to live in a community like that? Twelve years earlier, the Supreme Court had reassured us that the Constitution of the country we live in is no "suicide pact."
In that case, the Court struck down a law stripping draft evaders' citizenship but at the same time stressed the inherent breadth of congressional authority to sustain the well-being of the nation: "The powers of Congress to require military service for the common defense are broad and far-reaching, for while the Constitution protects against invasions of individual rights, it is not a suicide pact."
Indeed, the health of the republic is at the pragmatic core of our national charter. Article I of the Constitution, at the head of its list of legislative powers, echoes identical language from the preamble to the whole document in proclaiming twin bases for taxing and spending: "the common Defence and general Welfare of the United States."
To be sure, that language was written in 1787, long before the advent of health insurance, and the Obama administration has been reluctant to characterize the penalty provisions of the individual mandate as a tax. But we should never forget that the overarching purpose of our national legislature is to protect us from dangerous threats while promoting the common good. Whatever flaws it may have, the Affordable Care Act is an effort to promote the physical health of the populace while protecting the financial health of the nation.
For our Constitution to stay healthy itself, the Supreme Court should recognize that it embraces the individual mandate as a valid regulation of interstate commerce in an attempt to heal some of the country's ills. Without the mandate, the costs of taking care of our own may become unsustainable. Striking it down thus would be a step toward the potential repeal of the Emergency Medical Treatment Act -- a repeal that would, for many, be a death trap. We the People take care of our own, and so should our Supreme Court take care of our Constitution.
quote: "For our Constitution to stay healthy itself, the Supreme Court should recognize that it embraces the individual mandate as a valid regulation of interstate commerce in an attempt to heal some of the country's ills."
the end justifies the means ..... this is not a valid argument at the Surpreme Court.
If they had done that, the SCOTUS would have had little recourse. But they are trying to play safe with the political rhetoric, and that might end up giving the conservatives on the SCOTUS enough reason to shoot it down.
Old people are still poor, but now they are lonely and distant from their families who are no longer obligated to take care of them. Good job government!
"the Supreme Court should recognize that it embraces the individual mandate as a valid regulation of interstate commerce in an attempt to heal some of the country's ills."
If you aren't smart enough to understand the law and economics - you shouldn't teach it and you shouldn't write about it in public.
Not delaying medical care to tend to bookkeeping isn't simply a way to show we are a moral nation ... that we have at least enough patriotism not to let our fellow citizens die for lack of medical care. It isn't just what Jesus, Buddha, Moroni, and Allah would do.
It is in each of our own personal best interest.
We don't want *our* emergency care delayed and the only way to ensure this is to not let anyone's emergency care be delayed.
Even if you are conscious the time wasted getting the accounting sorted can cost you. And unconsciousness will only make it take longer.
Which doesn't have a THING to do with whether or not Obamacare is CONSTITUTIONAL.
That's the only real issue. If you want to SAVE LIVES, let's go back to PROHIBITION.
Alcohol is directly linked to 75,000 deaths a year in the US:
http://www.msnbc.msn.com/id/6089353/ns/health-addictions/t/alcohol-linked-us-deaths-year/
But it isn't about saving lives, it's about the contract that each one of us are under which PERMITS the government to govern us, and that written contract is the constitution. And yes, THAT IS more important than life and death, because if you fail to honor the terms of that contract, then the government has no more moral legitimacy than the mafia.
It is not written in stone.
Perhaps that is the intent but it does NOTHING to correct the inefficiencies of our advertise the magical pill/ sue 'em for side effects ...let's pay for a doctor's computer while every freaking convenience store buys their own.
The goal is worthy, the implementation is a big government follow my waste extravagance.
Of course, as a conservative, you probably want to do away with Social Security, too.
The government is not requiring me to buy a retirement plan. The government is taking my money from my paycheck and investing it into something very similar to a Ponzzi scheme. By that, I mean that I will probably not see the money I am putting into the system. That money isn't going into my 'account.'; it's going to people who are already retired.
The problem with the mandate is that it is not defined (from what I can see) as a tax. The mandate forces me to purchase a product (that I may not want) so that the costs will go down for people who can't afford it right now. I don't honestly think that costs will go down. The CBO now says that the cost of Obamacare will be over $2 trillion instead of the original $1 trillion that we were told.
All that being said, the mandate is unconstitutional and violates the Tenth Amendment as well as the Commerce clause. If this does pass, it will set a precedence for the government to force us to do other things that we may or not want to do.