THE BLOG
05/20/2010 05:12 am ET Updated Dec 06, 2017

Health Care: In Order to Form a More Perfect Union...

It's a beautiful spring day in Washington. I'm walking west on East Capitol Street. Before me the Capitol is glowing white in the bright morning sun. My thoughts are on the health care debate, and the one hour opportunity that I will have to argue the issue on the floor of the House today. As I enter the East plaza I pause and look at the Capitol dome and realize how special this moment is.

It's special for the 32 million Americans about to receive health care. It's special for our economy about to see the largest deficit reduction in 20 years. And it's special for me to be able to represent the people of Alameda, Contra Costa, Solano and Sacramento Counties.

My thoughts are crystallized at this moment by an elderly couple who walk past me towards the Supreme Court building. They were holding a hand painted sign, "WE THE PEOPLE," one of the ever present signs around the Capitol.

"We the People", the first three words of the Preamble of the United States Constitution is used every day by the talking heads on TV and radio. But those three words are just the beginning of the preamble. Here is the entire message:

"We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, 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."

"A more perfect union" implies that the progress of the American experience is never complete. The adjectives "more" coupled with "perfect" lead me to conclude that my task as a Congressman is to seek to improve the state of our union while knowing that my efforts, indeed our collective efforts at any time, will still be imperfect. It will be left to those who follow to continue the fight to improve the union.

"Establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare and secure the blessings of liberty to ourselves and to our posterity...." In these words is found the genesis of the great debates of the American age. What is "justice"?

From the very beginning of our nation's history, competing sides have fought to define the scope and reach of justice. Extending voting rights to people without property was once fiercely debated. The women's suffrage movement bitterly divided our nation. The end of slavery and the long path to civil rights for all races was a multi-generational fight that on some levels continues to this day. The rights of sharecroppers and immigrants and the LGBT community and political dissidents and faith based communities of all stripes have been the source of much consternation in the history of our Republic. Many of the basic protections afforded to citizens in our democracy -- Social Security, Medicare, Medicaid, pensions for veterans and their families, Section 8 housing, universal public education, environmental protections, national parks -- to varying degrees these have all pitted father against son, neighbor against neighbor.

With the passage of time a more perfect union has emerged and a broader consensus has been reached. Yet for many Americans justice is not yet secured. When personal and national economic conditions deny individuals access to the health care necessary for survival, where is the justice? The Declaration of Independence calls for every American to have access to "life, liberty, and the pursuit of happiness." Yet 45,000 Americans die each year because they do not have health insurance and millions more uninsured remain one accident away from economic devastation. For the victims and their families, lives are robbed, liberty is not pursued, happiness is not attained.

"Promote the general welfare." Why would the framers of the Constitution include this clause if not for a strong concern about the well being of individuals and the American community? I believe this is why it was included, and as we vote tomorrow on the health care legislation, these words will be on my mind. I know countless individuals who have lost their health and their wealth because they did not have health insurance.

I know the economy is losing its ability to compete internationally as we spend 17% of our wealth on our health care while our competitors in Europe and Asia spend no more than 11%. Yet with all our extra expenses, Americans die earlier and our babies die more often. Our health statistics place the United States at the bottom of industrialized nations in health outcomes and preventable deaths. We spend more; we get less; and neither our general welfare nor our individual welfare are as good as they could be or should be.

Tomorrow's vote on the health reform bill will be an historic moment in the process of forming a more perfect union. Under the legislation, 9,000 people in my district with preexisting conditions will finally be able to have access to insurance. 96,000 seniors will see their Medicare improved with significant prescription drug discounts and free preventative screenings. 106,000 families will receive tax credits to make their coverage more affordable. 52,000 young adults will be able to attain coverage through their parents' insurance. 1,400 families will avoid bankruptcy. 10 new community health centers will be founded in our communities.

On the long road forward toward real social justice, this is a major landmark that our great grandchildren will read about in the history books. It's not a perfect bill, but few bills are.

In the fight to extend health coverage to every man, woman, and child, this bill is an incredibly important beginning. But it's still just a beginning. On the day health care reform is signed into law, I will continue my work in Congress fighting to strengthen our health care laws. Our founders called upon every member of Congress to work toward a more perfect union. I won't live to see a perfect union, but it is a tremendous honor to see a more perfect union formed before my eyes.

NOTE: Congressman Garamendi, California's first elected Insurance Commissioner, will be leading an hour long discussion on the merits of health care reform sometime this evening on the House floor. It will be broadcast on C-SPAN. Staff will live-Tweet it on the Congressman's Twitter page.

Congressman John Garamendi represents California's 10th Congressional District. He served eight years as California's first elected Insurance Commissioner and also served as the chair of the California State Senate Health Committee. In the early 1990s, he authored a health care reform bill in California that inspired President Bill Clinton's health care reform proposal. More information on health care reform is available at Congressman Garamendi's website and on Twitter, Facebook, and YouTube.

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