Building a New Wall: The Fundamental Right to Healthcare

Today's economic crisis, and the federal government's response, is like putting a finger in the dike to avert a major catastrophe -- possibly even a depression.

But as quickly as we plug one leak, another springs forth.

Congress is seeking to avoid deflation by pumping up public confidence and economic demand to encourage consumers who have lost faith and are operating on a psychology of fear. Most immediately and importantly, the credit crunch and consumer withdrawal is affecting the automotive industry. Millions of jobs and thousand of related suppliers are at stake if the auto industry fails, or if Congress fails to act. If this iconic sector collapses it's likely the American people will feel even greater economic pain over a more protracted period of time than is currently anticipated.

The truth is $25 billion may not be enough to save the auto industry. Worse, other troubled economic institutions may soon surface needing help. At some point Congress is going to run out of enough fingers, toes and elbows to plug the holes in our economic dike.

President Barack Obama will soon have to make a judgment to reform the nation's "wall" if he is, as he so often says, to build a more perfect union. The wall I refer to is the U. S. Constitution.

Candidate Obama said he can't bring the change we need on his own. He needs the American people to stay actively involved. At noon on January 20, he will say the following, "I do solemnly swear (or affirm) that I will faithfully execute the office of President of the United States, and will to the best of my ability, preserve, protect, and defend the Constitution of the United States." If Barack Obama is going to be a truly transformative President I suggest he also can't bring the change we need, and he wants, with the Constitution as it is.

The Constitution is the wall that surrounds everything within it. The current wall consists of material from two central sources: a supreme law and the free enterprise system. The Constitution gives direction and authority to Congress, the president, federal agencies and to the states (under the Tenth Amendment). It is this sacred document that also grants the free market, our laissez-faire capitalist system, the legal authority to operate.

The First Amendment illustrates the interaction between these two wall-building materials -- the public and the private sides. That familiar amendment states that Congress shall make no law prohibiting or abridging the freedom of speech, or of the press. That's it! The Constitution doesn't say USA Today, New York Times, Chicago Sun-Times, Chicago Tribune, Chicago Defender, AM, FM, Satellite Radio, Newsweek, Time, Channels 2, 5, 7, or 9, PBS or CNN. Nor does it state cell phones, i-phones, the internet, and on-and-on. So, while it's impossible to truly determine the economic impact of the First Amendment, the Constitution clearly has a major impact to our nation's economic vitality.

Because our current economic crisis is forcing us to think outside the box, one topic worthy of renewed discussion is health care. What if the Constitution said: "All citizens shall enjoy the right to health care of equal high quality and the Congress shall have the power to implement this article by appropriate legislation?"

Beyond the obvious benefits of greater and better health care itself, imagine the economic consequences: thousands of doctors and nurses being trained; new medical colleges established and older ones expanded; increased medical research; a massive preventive health care industry springing up; new hospitals in needy urban and rural areas with the private sector, federal, state, county and local governments all working cooperatively under the authority granted by the Constitution and Congress.

The absence of this human right as a health care constitutional amendment has major economic consequences as well. Preventive medicine is almost entirely missing from our current health care system, which costs taxpayers billions.

Of course, even without an amendment, Congress can pass legislation granting universal and comprehensive health care to all Americans. That's possible and candidate Barack Obama promised to do so in his first term in office. However, while high quality health care for all Americans can be established without a constitutional amendment, it can't be sustained without such an amendment. Future presidents and Congresses are under no legal obligation to continue past legislative programs. For the new wall of health care to be built and sustained for as long as the nation exists it must have a constitutional foundation!

How can we afford such a system? Without a constitutional right to health care we already spend nearly twice as much as any other developed nation in the world -- about $2.5 trillion or 16% of our GDP -- yet nearly fifty million Americans are without health insurance and often receive their care in the most expensive manner possible, in the local hospital emergency room.

With a health care constitutional amendment, instead of plugging a hole in the dike, we would be building a wall with a strong and solid foundation. Instead of spending money on more band-aids, a revised Constitution would give direction to a unique American purpose and, over time, solve an historic problem. And with American innovation we could put millions of Americans to work expanding a more balanced economic system on the solid foundation of health care for all. Health care would be a human right protected by the American people in our Constitution.

Congressman Jackson is a seven term Member of Congress serving on the Labor Health and Human Services Appropriations subcommittee. He is the co-author with Frank Watkins of A More Perfect Union, Advancing New American Rights.

Comments

[bannorhill]

Can someone show me where the "right" to health care is in the constitution. I have not been able to find it.

[QuestionableRights]

Health Care as a right? A discussion on what fundamental rights a person has would do everyone some good. What about the right to equal high quality food or equal high quality shelter? The right to a sufficient retirement fund and the right to high quality equal education sound good too. I really do hate slippery slope arguments but why not start with food and shelter over health care?

We have to realize that having positive rights in our federal constitution is extremely dangerous. What would courts be empowered to do? Could they force the government to raise taxes to pay for an "equal and high quality" health care system?

I think the best place to start this argument off is to say that a nation wide health care system is something that the government should do, rather is required to do. The federal government's job is not to provide anything for its citizens other than protect them from others encroaching on their rights. We should leave this to the states. Tie it to highway funds if you like.

Also, The Tenth amendment is not where states get their powers. Their powers were given by the people and all the tenth amendment does is state a principal that the federal government should refrain from using powers not enumerated. We've been long past that point since the 1930's.

[ruralwannabe]

What is overlooked (in addition to cjchicago's EXCELLENT observation) is that there are LEVELS of Health Care. A child's need for an asthma inhaler is quite different from an aging smoker's need for a lung transplant. We need health care to be accountable to someone (blanket coverage invites bill padding) and we need insurance companies to not be eating 25% of all our health care dollars. Somehow. It would also be nice if a doctor could actually treat a patient the way he knows is best instead of being limited by an insurance company's time limiations. Mental health care ought to include counseling and not just drugs. All that!!!!

[goldrush]

...continued

This is what is wrong with our health insurance; the government mandates it to cover almost everything under the sun, most of which you neither use nor need, so when a real emergency comes along the insurance company might not want to pay for it.

The answer is not universal healthcare but before-tax medical savings accounts coupled with a catastrophic care insurance package. This makes sure that we are responsible in our medical choices, adding price competition, now that people are shopping for price, which lowers costs.

Universal healthcare amounts to a health subsidy for 300 million people. This artificially infaltes the demand for healthcare (all those things under the sun that we were talking about before) which in turn shoots up prices. Now people know its "free" and get something when theydon't need it again inflating demand and shooting up prices. Doctors know the government will pay them and again raise prices. Healthcare costs skyrocket; now the government has to begin cutting costs (i.e. - rationing).

I don't want the government choosing whether I get to live or die. I don't want the insurance company deciding whether I live or die. That question should be answered by me and my family.

[doctoraaron]

Decisions in health care do need to be made by the individual, family, and physician without government or corporate interference. You are right about that. That is why corporate interests need to be removed from the system and the governments primary role should be simply to collect and pay the costs.
Advocates of single payer national health insurance, like myself, a family physician, are not interested in creating big brother socialized health care but in providing for public financing of a public good, a diversified network of privately delivered health care services.
Medical savings accounts do not work for those who have no money to save.
Requiring people to put up some of their own funds to pay for health care needs as they arise has been empirically tested multiple times. It does little to reduce unneeded care but sure results in a lot less preventive care and a lot of people avoiding therapy for asymptomatic conditions like diabetes and hypertension.
We need to put our ideologies aside and support what works.

[goldrush]

Imagine if the government started meddling with your your car insurance coverage. They began mandating coverage of oil changes, tire rotations, car washes, etc.. your monthly bill would skyrocket.

Then people would start abusing the system, getting oils changes every two weeks and a car wash every day. You being a good citizen only do these thing when you need to but you are now subsidizing others' waste. The insurance company doesn't put up a fight for these small things because they don't cost much so people get more than they need.

Then an 18 wheeler slams into your car and totals it. You need a new car so you go to your insurance company. The insurance company looks at all of these little costs they've been paying for and adds them up, then they look at the huge cost of your new car and decide that they can't afford both. Unfortunately for you they've already paid for all those little things that other people have been using irresponsibly.

You leave empty handed while other people drive around in the cars in which the upkeep you've been paying for.

continued...

[cylindar]

Interesting thought.

[DSPS]

HuffPost's Pick

Thank you, Rep. Jackson! As an American living in Norway, I can't tell you how grateful I am this Thanksgiving Day for the peace of mind that both I and my neighbors enjoy. None of us will go broke because of healthcare costs, as they are prepaid by our taxes, and I wouldn't give that up for anything. The same arguments for and against universal care come up time and again. There ought to be a central site where people can get and discuss information about the varied systems in use in various countries! My GP has chosen to be a part of the system. I have chosen my GP. He chooses which specialist and tests to send me to, and he keeps track of what all of them do. I pay up to $300 (dr. visits + essential medications) a year before care becomes free. Some people don't need that much care per year for years on end, but it is available to all of us and hospitalization is always free -- just like necessary service from police, fire fighters etc. Please keep working to put a just system into effect in the USA!

[flossophy]

population of Norway: 4,627,926

population of US: 301,139,947

Norway is always a poor analogy for comparing national health care systems.

[bikerguy76]

The United States, as Flossophy has pointed out, is a much larger country than Norway. Therefore, we will have a much larger national health insurance program than Norway.

When the United States builds our national health insurance program, we can look to countrys like Norway and learn from their mistakes.

[anninroosevelt]

The flaw in this proposal is the amount of time and effort it takes to amend the Constitution. To begin with, it requires two-thirds of both houses of Congress, voting in the same session, to pass an amendment. In the House that is 270 Members; in the Senate that is 67 Senators. Then the proposed amendment begins the ratification process, of being passed in both houses of 38 state legislatures. The support for a proposed universal health care constitutional amendment will be far from universal.­Regardless of whether we enact legislation or pass a constitutional amendment for universal healthcare, we will have a fight over what won't be included. You can bet your boots there will be a protracted battle over abortion and contraceptive coverage, over HIV inclusion, over in vitro fetilization and artificial insemination. We must prepare for these battles over inclusion and not gear up for a 7-10 year struggle to ratify a constitutional amendment. One session of Congress, 2 years, and we can push through legislation for universal health insurance. We can avoid a protracted and disheartening struggle for a constitutional amendment iin which we lose supporters long before it would be ratified by 38 states, and the opposition would have the opportunity to develop an effective propaganda campaign. The Clinton administration simply was not prepared for the effectiveness of the propaganda. We should be.

[flossophy]

Propaganda on which side?

[PeterNY]

We need a national value added tax (VAT) to finance universal medicare. Look at it this way. In Germany, there's a 19% VAT on all manufactured goods. If a German wants to buy either a Mercedes or a Toyota, he has to pay that 19% extra for either car. But here's the good part. The German government refunds that 19% to Mercedes (and all German manufacturers) by providing health care costs and mass transit and day care subsidies to all the employees. Mercedes in turn knocks that 19% off the sticker price, and the Germans find that Mercedes is a better value.

Because the VAT is placed on all manufactured products, it is considered a form of sales tax and does not violate any GATT treaties. As a result, domestic manufacturing is protected; everybody gets health care, and local taxes go DOWN, because local governments don't have to pay health and legacy health costs for their civil servants.

[Emlyn]

Gee, am I going to have to buy a Mercedes to get health care?

[cjchicago]

Mr. Jackson,
You misinterpret the term "right" as expressed in the Constitution. That document guarantees rights to be "free of" government infringement on the citizen's liberty. For instance, the right to speak freely without government suppression, the right to freely practice your religion, the right to be free of unlawful searches and arrests. What you describe, however, is a right a "to" something, in other words a mandated entitlement. A case in point is the second amendment. The right to bear arms stipulates that the government shall not interfere with the citizen's right to own a firearm if he or she chooses to do so. It does not say that that citizen is entitled to a firearm, to be provided at the government's expense. Thus, even a Constitutional amendment guaranteeing a "fundamental right to health care" would merely state that which has never been contested: that the government shall not interfere with a citizen's right to pursue medical treatment as he or she sees fit.
Your misunderstanding of the philosophy upon which the Constitution is based is worrisome. Its original purpose was to safeguard the individual's liberty, not to mandate who gets what and how.
And why arbitrarily stop at health care? What about a fundamental right to food? A right to shelter? Clothing? What you suggest represents an obvious slippery slope down a path that neither the founding fathers envisioned nor most Americans want: a society divested of self-responsibility ruled by an all-pervasive and paternalistic government.

[flossophy]

HuffPo, it would be great to have a response from Rep. Jesse Jackson Jr to cjchicago's post.

[LiberalForever]

Universal FREE health care will NEVER happen in the USA. Forget it. A constitutional amendment? Absurd. Never happen.

[doctoraaron]

Medicare For All, single payer national health care, not only can but must happen. Only by eliminating the waste embodied in the private health insurance system (marketing, profits, underwriting, obscene corporate executive salaries, etc) will we have enough resources to properly pay for care for all. But if we make these changes we can get what we need. We need to hope and let our hope lead to action and change. Yes we can!

[floib]

Totally agree. We have been brainwashed into thinking that we just can't get along without insurance companies deciding what treatments we should and should not have. Insurance companies need to make money, and the only way to do that is to deny care.

HR 676 will insure that EVERYONE will get the care they deserve. Yes, health care is a RIGHT not a PRIVILEGE only for the ones lucky enough to have money in the bank. I don't think that CEOs for AIG, Fannie Mae, Freddie Mac, or Lehman will have trouble paying for their health care thanks to our hard earned tax dollars.

Having single-payer will not cost the government anything because the people will be paying for their health care. When we pool all our money, the cost of health care goes down, and we are able to cover everyone from cradle to the grave. I don't understand how some people posting here would rather have their premiums rise significantly each year and get less medical care rather than have their premiums lowered and know everyone is covered. If you feel that everyone is on their own, then, you are probably fortunate enough to not have had cancer, heart disease, brain tumors, kidney failure, diabetes, etc. Once you get sick, insurance companies don't want to know you because you are draining their profits. Ridiculous.

[floib]

Never say never. That's what they said about giving women the vote.

[felix335]

The two biggest problems in this country are:

1. Too many people inventing new rights and too few people living up to their part as a citizen under our "social contract" with oneanother. Too many people get their rights but refuse to live up to their responsibilities. Chief among these responsibilities is for every, non-profou­ndly-disab­led individual 18 and over, to provide for themselves and their families. The "safety net" of our "Social Contract" should help people and families in need of temporary assistance.

2. There is a quotation (can't remember who, John Locke? Edmund Burke"?) that goes something like this: "A democratic-republic (us) will begin to die when a majority of the electorate realizes that it can vote money for themselves taken from other citizens." There are far too many deadbeats in this country who believe that the rest of us owe them a living.

As to "healthcare as a right", how about housing?, how about personal transportation?, how about clothing allowances?, how about guaranteed food?

My opinion is this: Profoundly disabled adults and children up to 18 should receive either Medicare or Medicaid. All other adults (less those "temporary" situations mentioned above) are on their own or
private charity. A couple of hints to the poor in this country: don't marry if you can't afford to support yourself and do not have children if you expect others to pay for them. Take charge of your own life.

[Chbronze]

Alexander Tytler " A democracy can not exist as a permanent form of government, it will exist only until the populace learns it can vote itself the largess of others."

[flossophy]

Robert Heinlein had a similar quote: " For when the plebs discover they can vote themselves bread & circuses without limit, and that the productive members of the body politic can't stop them, they'll do so. They'll vote themselves bread & circuses every time. Until the state bleeds to death or in its weakened condition, the state succumbs to an invader. Such as the barbarians entering Rome."

otherwise known as the late 70's

[Emlyn]

i CAN TELL THAT YOU HAVE NEVER BEEN DISABLED. You feel that a person who is disabled won't live up to their rights and responsibilities. That that person should provide for themselves and their families. Good Lord, what if that person can't!? What if that person can no longer make a living? Can no longer work? Can they get health insurance? There's that little thing that says a "pre-existing" illness. If you could work, employers aren't going to hire you because their insurance rates will go up. You might be more sick than you should be? An insurance company here in California advertised that their deductible would be no higher than $67 a month - except for a disabled person - the cost went up to $267 a month. that person, who was disabled, could not afford to buy that insurance and went without for two years. I know - that person was me. Thank God, I got Social Security Disability and Medicare kicked in early. I would have never made it without Medicare. And oh, yes, I pay my rent and my food and other things but it has been a lot harder under the Republicans. HEALTHCARE SHOULD BE A RIGHT IN THIS COUNTRY. All these fat cats on Wall Street, etc. have been getting it for years. Why not the rest of us? Are we not as good? I feel sorry for you. the Bible says not to judge people; what are you doing?????

[Rick0101]

Say there are five doctors in your town. One is top-notch. Three are average and one is awful. Once the government mandates this new "fundamental" right, everyone in town will want to go to the single best MD. Why not? It's "free."

Therefore, the government will have to assign each citizen a doctor - and the attempt to mandate "high quality" health care for all will fail. And this is but one source of that failure. Reason: The government will not know which doctors actually offer the best care. Is it the local GP? The chiropractor? The acupuncturist? Who gets to decide?
]
The "fundamental" rights are those explicitly set forth in the Constitution (the right to vote or to a jury trial for example).

The free market already picks the best doctors and the best modalities. The government does not know nor ever will know more than tens of millions of people making individual decisions as to what is best for themselves and for their families. That's the free market will always allocate scarce resources more efficiently that any governmental committee.

A couple years ago, my mother needed knee-replacement surgery. She went to the doctor, made an appointment and, shortly thereafter, had the surgery performed. Later, a friend from Canada told me that her brother had been waiting in Canada for the same procedure for a year and a half and had not yet been scheduled for surgery. That's why Canadians come here for medical care.

[doctoraaron]

The problem is there is no free market, or the closest we come to it is Medicare. Generally we are forced by insurance companies to see the doctors on their little list of covered providers. Recently a patient of mine (I am a family physician) needed psychiatric help. She went on line and got a listing of the covered providers. She called every name on the two pages list. No one would or could see her. She's still waiting, weeks later! Meanwhile my mother, a Canadian, had no trouble scheduling two cataract surgeries in Montreal and was able to schedule a consultation about another problem with a leading endocrinologist at the University much more easily than I could have gotten her an appointment here. We need to face it, we've got rationing here. And if you are one of the 40 million uninsured, step back to the end of the line, or really, behind the wall!!

[juanjo]

Sorry but I do not buy it. Medical care is already restricted in this country and has been for a long time. I pay over 500.00 a month for health care through an HMO. I can only see the approved doctors on their list. I only have access to the approved medicines on their list. If I need the services of a specialist, I can only see the ones they have approved and must jump through hoops to see that specialist. If I am lucky, I see my doctor for 15 minutes when I do get an appointment and often I have to schedule appointments six to eight weeks in advance. If I go to the emergency room for treatment of something i feel may be life threatening, I run the risk of them refusing to pay for it. Think about how that makes one feel when they come from a family with significant history of heart attacks on both sides.

I have friends who are Canadians living here in the same city I live in, they return home for medical care. Two years ago I was in Argentina when I ran short of some prescription meds I was taking. I went to the local clinic where the prescriptions were filled quickly and easily and it cost me the equivalent of one US dollar.

The USA ranks below Cuba when it comes to medical care for its citizens. We can do better.

[flossophy]

juanjo... you probably shouldn't rely on information provided by Michael Moore.

[billw8017]

The constitution as it stands is already a radical document. The first amendment rights of the free press, religious tolerance, and the right to peacefully assemble are tempered by court precedents. Radical additions will be similarly tempered as when the anti slavery amendments were interpreted as forbidding unions as a constraint on the free expression of employers. There are only one kind of rights: Those the people will fight for and defend. Constant vigilance, as the founding fathers wrote, is the price of liberty. Add a constitutional right to medical care and you may as well call the multi volume list of US statutes a Constitution. It is better to keep the Constitution simple and the laws relevant and stand up for what you believe. Nothing else works anyway.

[billw8017]

It is generally accepted fact that before 1915, a sick person was better off avoiding American doctors. When he was shot in Milwaukee, Theodore Roosevelt refused any local health care, saying he wasn't going to let himself be killed by the kind of quacks who had killed Garfield and McKinley and waited until he could go to Chicago where he trusted particular doctors. So, a universal health plan then would have been somewhat pointless. Times have changed.

Since doctors, paramedics and nurses are capable of genuinely bettering a person's life, their attention has become worth something. The current problem is that truly effective care is too expensive for the most people. It would involve nutrition, observation and counseling. We wait until more desperate measures are necessary and are plunged into bankruptcy when we try to cover the now necessary treatment. This is no joke: an operation can easily cost a million dollars but relatively few people are millionaires. Even while the US government pays more per capita than countries with universal care, this amounts to half the called for costs. This is the product of poor design.

A universal coverage is the first step to good design.

[JenniferInMO]

There is a very good post which lays out an indisputable argument for universal health care. In fact, it is compelling. I would love to hear the comments of those of you who are afraid of universal health care after reading this article. I would like to know whether it changes your mind and if not, please tell me why not: http://www.dailykos.com/story/2008/11/25/7564/6432

[flossophy]

Here's why not: NPR - Intelligence Squared "Is the government responsible for health care?"

http://www.npr.org/templates/story/story.php?storyId=6263392

Both sides explain this issue better than anyone I've heard / read thus far.

[ostsau]

What about food, without food I can't be healthy. I need shelter, can I ask for a right to have shelter? Do I have a right to ask my friends and neighbors (taxpayers) to provide for my clothe?

[Chbronze]

And a car or transportation, I live in the country and without a car I can't get to the doctor. What about my right to get to the doctor.

[floib]

If you lived in England, you transportation fees would be reimbursed. Watch Michael Moore's "SICKO". Our country would be so much better off if we had single-payer. Let's do what works in other countries and avoid what doesn't. We won't know if it truly will work until we try.