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Symptoms Of Bad Constitutional Medicine

Posted: 03/26/2012 4:30 pm

As ObamaCare heads towards its day in the Supreme Court, how can we make sense of competing claims about whether Congress has exceeded its authority under the Commerce Clause?

A bit of history might be helpful. The principle reason the Constitution bestowed on Congress the power to "regulate" interstate commerce was the need to dismantle the economic barricades of duties, tariffs, and taxes erected by the individual States under the precursor to our Constitution, the Articles of Confederation.

As the Framers met in Philadelphia, the states were hunkered down against one another, piling more taxes on top of ever more retaliatory tariffs. The fledgling American economy was floundering and foreign commerce had all but collapsed.

Something had to give. The remedy was the Commerce Clause, which was widely popular at the Constitutional Convention and also afterwards during the ratification debates: James Madison wrote that while the commerce power was admittedly "an addition" to federal authority, and such additions were usually met with suspicion, this was one "which few oppose and from which no apprehensions are entertained."

Besides, Madison continued, the Constitution -- Commerce Clause and all -- reserved to the states power over "all the objects which, in the ordinary course of affairs, concern the lives, liberties, and properties of the people, and the internal order, improvement, and prosperity of the State."

Not to worry, in other words. The trade barriers would come down, while the federal government would be granted only limited powers -- in order to secure the people's freedom from the larger potential problem of undue federal centralization.

And the great debates over the big questions of life would continue, as before, in the states. That's where they would still be decided, close to the people. What could go wrong? Well, stay tuned.

A couple centuries later, this same Commerce Clause is being used to justify a federal takeover of essentially the entire health care sector. ObamaCare may or may not be the best model of health care. It's certainly not the only imaginable one.

But, if it is upheld by the Supreme Court, it will very shortly be the only legal one. This will crush competition and preempt a great deal of state experimentation.

For example, the States of Utah and Oregon have adopted very different models to further access to health care. These models diverge significantly, in theory and practice.

Utah has adopted a strict, market-based approach, emphasizing access to information and consumer choice.

Oregon directly finances health care services for qualifying low-income adults and seeks to control costs by rigorously prioritizing and selectively funding particular medical services.

Such experimentation is good and healthy. Yet ObamaCare largely preempts both and every other alternative -- and so closes the laboratory of state innovation.

It's not just a fiscal takeover either. Structurally, there is no "live and let live" here, but serious preclusion of the personal choices that define us and go to the heart of liberty; ObamaCare has a foundational presumption that decisions don't really belong with patients and their doctors, but with remote bureaucrats' one-size-fits-all template.

For along with the dollars-and-cents issues, ObamaCare nationalizes a number of big moral and philosophical questions, some of the same ones Madison was sure would stay at the states' level. The most obvious of these concern our concepts of justice, charity, liberty, and even more profoundly, questions of when life begins and how it should end.

ObamaCare goes out of its way to nationalize and impose a single federal answer to a number of highly charged questions: Are abortion-inducing pills, sterilization, and contraception so uniquely essential that they should be available to all, free of charge?

Should abortion and the recent HHS mandate items be subsidized even by those who, in conscience, find them abhorrent? Even those for whom these are not moral concerns recognize the importance to our rights of conscience exemptions.

Should patients be denied care because doctors will be penalized for trying innovative treatments for those who don't respond to standard protocols, or for assisting those who need more than the average number of tests?

To what extent should patients and their doctors have dictated to them the treatment options at the end of their lives? These are big questions that should be open for debate. They should not be summarily silenced by a centralized federal bureaucracy.

Whatever else may be said about ObamaCare, one thing is clear: somewhere James Madison is tearing his hair out.

To be sure, much has happened since the founding generation. Interstate commerce has expanded light years beyond what the Framers could ever have imagined. And so "regulating" it isn't always as simple as they would have assumed.

Nevertheless, the Commerce Clause's origins still have plenty to teach us: Competition is a good thing, and centralization a bad thing, for the economy and for individual freedom, because the free exchange of ideas and goods is how we increase our cultural intelligence and personal well-being.

And life's great questions are best answered at the lowest level possible -- the level closest to where people actually live their lives.

For the federal government to centralize a vast area of our economy and shut down competition, at the same time it nationalizes the answers to huge moral and social questions, is symptomatic of a constitutional pathology. ObamaCare points clearly to a Congress that has breached the limits of its power under the Commerce Clause.

Independent Women's Forum filed an Amicus brief in HHS v. Florida regarding the Commerce Clause; Kevin Hasson was counsel on the brief, Heather Higgins and Gayle Trotter are Chairman and General Counsel for IWF respectively.

 
 
 
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06:35 PM on 03/28/2012
I believe Obamacare has little to with actual healthcare. It has to do with control. If the government has control of your healthcare, the government can control every aspect of our lives. Besides, the government has done such a great job managing things like the budget, social security, and medicare. Why not let the government take on more power over us. I agree that healthcare is expensive but it is the best care in the world. I am a breast cancer survivor, the herceptin I needed each month for a year to save my life was 6000.00 per treatment. Women in England are dying because they will not pay for this treatment. WAKE UP AMERICA!!!!!
06:14 PM on 03/27/2012
The biggest lie in all of this is the statement by Ginsburg/Kagan is that the market already exists and everyone is already in it, (sounds like the Borg Collective) and if you do not have health insurance someone else pays for your medical bills, this is BS. I do not have health insurance and no one has ever magically appeared and paid any of my medical bills. I either pay for it on spot or I get a bill sent to me, as my medical bills have never been sent to these imaginary people that only exist in the minds of these progressive control-freak tyrants.
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Lisa DAlia
06:09 PM on 03/27/2012
BRAVO! Huff Post for proving that the mainstream media sources can really provide their audience with factual, unbiased serious information and news, not bending to one side or another. Please keep it up. This is the perfect example of how America deserves to receive their news. Excellent reporting. I'm really impressed and thank you.
05:49 PM on 03/27/2012
In the 1980s I was married to a medical doctor and living in Portland, OR. Half of my husband's patients were from Canada. Canada has socialized medicine which Canadians despise. They travel to the U.S. to get decent medical care. You discuss the subject with any doctor and they will tell you socialized medicine is for the birds. Canadian patients who need urgent surgery have to come to the U.S. to get it. Otherwise, they will be on a waiting list in their country for no telling how long, and by then it may be too late for the patient. Under socialized medicine the individual has no control over what kind of medical treatment he/she will be allowed by the government. Who in their right mind would want to give up such a precious freedom?
01:18 PM on 03/27/2012
The Commerce Clause has been being misused by Congress since 1942, when the Supreme Court decided that Roscoe Filburn could not grow wheat on his own property for his own consumption because the potential "aggregate effect" of his actions would impact the national price of wheat. This is the decision that needs to be overturned, as the growth in federal regulation of our lives literally skyrocketed after this decision. http://libertylegalfoundation.org/1563/what-wickard-has-wrought/
12:58 PM on 03/27/2012
Competition is good! Why should I pay Dr. Smith $4,500.00 for an appendectomy when Sam the Butcher will remove it for $395.00?
12:36 PM on 03/27/2012
I have been in the Healthcare industry for 34 years now. I have seen everything but this takes the cake. He could not get his government plan pushed through because the American People did not want it so hes back dooring us so to speak. With this plan he will drive Health Insurers out of the market, bust prices so high nobody will be able to afford the cost and there in turn, he will get this wish, he will have a government run system that does not work just like the rest of them.........Obamacare must go. We can not implement a plan of such magnitude without first taking baby steps and each step of the way monitor the progress and see if it works. We need to start over from scratch and do this. This is the MOST IMPORTANT year of our lives. We need to get Obama out of the White House before he totally destroys our Constitution and all of our rights as citizens.
12:50 PM on 03/27/2012
This is the truth. Wherever government begins to operate, it drives out the market. Canada has only the government now paying for health care. If you want to see what happens to innovation in medicine, there is no venture capital or private equity growth. It all happens in America. Also, mid sized medical companies get shut out of the buying chain as the health care only deals with large corporations like GE. The medical supplies businesses sell into South America and China and to GE who resells to Canada.
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Vintage59
Seeking tickets to First Class
01:08 PM on 03/27/2012
In other words: "I'm making money off the current system so go die in the corner quietly. "
12:31 PM on 03/28/2012
I know you're willing to work for nothing. Why bother having profits or competition at all? That would only encourage businesses to improve products and services... who really needs that? And anyways, when businesses make more money, they can hire more people to make even more money. That would mean someone is getting rich... wow. And all those poor people who can actually work for a living instead of collecting welfare and popping babies to increase their entitlements. God forbid. And maybe those who get jobs from those rich business owners will get health care as a nice bennie. There are some warped people who think that getting an education, building a business, making good money is a bad thing. They cry income disparity. Give ME what you make. But they don't want to jump through the same hoops to EARN what they want just given to them. Common free-loaders like this are just undeveloped children who were never given any responsibilities or accountability growing up. Grown up.
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Vintage59
Seeking tickets to First Class
12:33 PM on 03/27/2012
The founders are dead. They don't have to worry about healthcare.

Let's put it to a direct vote. What is more important? Carrying on an old experiment or having access to doctors when your child is sick? If another state can use a state's rights argument to block my right to decent healthcare then let's end the experiment and all go our separate ways. My state can join up with any other that is willing if we think it will be a better country for us than this one is.

Break up the Union. It's far overdue. This is an unwieldy Empire.
12:18 PM on 03/27/2012
I have nothing to add to this very concise and reasonable assessment. Anyone who recognizes the Constitution as the legal foundation for a LIMITED government must acknowledge that Obamacare is, therefore, illegal and philosophically at odds with the very nature of individual liberty.
12:16 PM on 03/27/2012
I'm amazed to see this article on the huffingtonpost and applaud them for posting it.
12:12 PM on 03/27/2012
Do you realize if they could "fix" TORT REFORM (frivilous lawsuits), doctors could get out of the insurance "game" and decrease their fees 75% which people could afford to pay without insurance like they used to do before insurance found a way to make money off of doctors backs!! Insurance has become like a "FEDERAL GOVERNMENT",so to speak. Insurance keeps increasing premiums,deductibles, and copayments ;insurances pay less to providers and doctors; keep most of the money to pay themselves and build new insurance buildings! The Feds government do the same thing; they keep increasing taxes on its citizens, do less services for Americans, and keep hiring more government workers and building more government buildings!!!!!
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homer winslow
Truth in Beauty, Beauty in Truth
12:02 PM on 03/27/2012
Should abortion and the recent HHS mandate items be subsidized even by those who, in conscience, find them abhorrent? Even those for whom these are not moral concerns recognize the importance to our rights of conscience exemptions.

I have always hated this argument. I am opposed to war, yet I do not have the right to withhold my taxes which go to pay for the murder of innocents, so why should anyone opposed to the above be exempt from paying for them with their taxes? The most I can do is refuse to go to war. Those opposed to abortion need not have one.
12:54 PM on 03/27/2012
Agreed and good point. The problem is that now you have who deciding in health care as well as military industry. That is a heck of a lot of government. Military sounds good on paper but when you hear all the wastage, why must business owners who create the bulk of jobs be subsidizing government? I stayed at a luxury hotel in Washington recently, packed with military generals. I asked why they stayed there and they said the military had a special package with the hotel. As a business owner paying lots of tax, that disgusts me. We are going to kill entrepreneurism
11:25 AM on 03/27/2012
I don't understand why I don't hear more doctors weighing in on this.
11:29 PM on 03/27/2012
If you talk to your local Dr's they are likely meeting. I have 2 good friends who are Dr's they goto meeting at the hospital every so often. Alot of doctors, that are nearing retirement are going to just drop out because they dont want to deal with it. So not only will we gain 30 million new patients in a very short period of time, but there wont be enough doctors, and presumably alot less if what Im hearing holds up across the board. If you do some research there is already a major shortage of doctors over the next 10 years (Wikipedia has some good info on the trend). I believe the doctors union/association officially supports the law, but the internal polling of doctors who liked it within that group was 13%, and 50% of doctors are considering leaving the AMA over the backing. Read : forbes.com 9/26/2011 Doctors and AMA split over Obamacare (13% approval)
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dreux62
The GOP - Now 100% Fact Free!
11:12 AM on 03/27/2012
Had this beena discussino of the Commerce Clause isntead of a diatribe on the AFA it might have presented some value. As yet another politically motivated discussion, it adds nothing.
11:09 AM on 03/27/2012
Federal overreach at its pinnacle! If this thing is ruled constitutional you can kiss our country goodbye. The government will then be telling us we have to buy a Chevy Volt because it is covered by the commerce clause. For you people that are for this thing, where does government intervention stop?