The Right Prescription
Facts Are Not Distortion
Government rationing of health care not only will happen — it’s already happening wherever government is involved.
When it comes to evaluating the claims of Democrat party leadership and others about rationing and how to deal with grandma, I am guided by that great philosopher, Marx. That’s Groucho, not Karl, who famously said: “Who do you believe, me or your eyes?”
The President and Democrats are promising, promising there are no “death panels” and that no one will “pull the plug on grandma.”
I am not worried about death panels or plugs being pulled. I am worried about expanding government power about what to pay doctors, how to allocate care and telling me (and my doctor) something is ineffective, wasteful or unnecessary treatment.
That’s government rationing. And it will happen.
Both House health and Senate bills require 20 million Americans to use Medicaid for health care coverage. That doubles the number of people on Medicaid while reducing Medicaid’s already low reimbursement rate. Cutting Medicaid payments to doctors and hospitals to subsidize the health premiums of Generation X-ers who can afford to pay for healthcare but don’t leads to rationing.
The White House and Democrats have the gall to respond there is rationing by private insurance companies. Yes, companies use what is known as comparative effectiveness research (CER) to decide what new technologies to pay for. By ignoring individual differences and information from the real world, CER studies wind up showing that there is no benefit to any new treatments most of the time.
There is also rationing by government agencies such as Medicaid and the VA system. Yes Medicare. All using CER.
Forget about grandma for a second. How about the kids?
Edith Andrews of Zanesville, Ohio, faced that problem last year when her twin girls, Sara and Samantha, were born prematurely nearly four years ago. Each weighed less than 3 pounds and needed a ventilator to breathe.
According to an article in the Cincinnati Enquirer: “To get care she had to take her infants to a Zanesville clinic or an emergency room, where they saw a different doctor every time, if they saw a doctor at all.”
When Sara’s lung collapsed, Edith couldn’t find a Medicaid pediatrician to care for her. “Sarah’s complications got worse and worse, and there was never a doctor around when I needed to talk to somebody.” She finally found a doctor to take her daughters on as patients after a year of searching.
No rationing?
According to a 2007 Wall Street Journal article, Nicole Garrett’s three teen-age children lost their private coverage and she enrolled them in Michigan’s managed-care Medicaid program.
When Nicole’s 16-year-old daughter, Jada, needed to see a rheumatologist, the one listed in her managed-care Medicaid plan’s network would not see her. Nicole notes, “When we had real insurance, we could call and come in at the drop of a hat.”
Last week Sen. Chris Dodd was rushed into surgery less than two weeks after his cancer diagnosis. Jada’s wait just for an appointment was a bit longer: The wait to get into a public clinic was more than three months.
About the Author
Robert M. Goldberg is vice president of the Center for Medicine in the Public Interest and founder of Hands Off My H ealth, a grass roots health care empowerment network. His is new book, Tabloid Medicine: How the Internet is Being Used To Hijack Medical Science For Fear and Profit, was published last month by Kaplan.
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De-population program| 8.14.09 @ 6:39AM
Breaking NewsCameron Defends NHS Amid US Healthcare Row
Patients 'denied rare cancer drugs'
3 hours 4 mins ago
Buzz Up! Print Story More than 1,000 patients suffering from rarer forms of cancer may have been denied potentially life-saving drugs, a report has revealed. Skip related content
The Rarer Cancers Forum found patients faced a "postcode lottery" when requesting drugs which had not been licensed for their condition, with many being refused treatment.
The charity described the variations as "unacceptable" and recommended a number of measures to improve access to treatment for patients with rare cancers.
The Off Limits report used Freedom of Information requests to collect data from health trusts and authorities across England about how they dealt with requests for "off-label" drugs.
These requests often come from patients with rare cancers for which there is no licensed treatment but which may benefit from the off-label drugs - those which are licensed for similar illnesses.
The survey found many trusts refused such requests due to funding issues and because the National Institute for Health and Clinical Excellence (Nice) cannot order NHS organisations to provide these treatments free of charge.
The charity used the figures obtained from 43 primary care trusts to calculate a national estimate of the number of requests for off-label treatments.
Of the 43 trusts which provided data, 902 requests were made over three years, with 583 of those being approved and 298 rejected.
The charity said this suggested a total of 3,188 requests would have been made to England's 152 primary care trusts during the same time period, with 2,061 approvals and 1,053 patients being denied the treatment.
Some requests were terminated or were still pending at the time the data was collated.
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Concord watches | 8.14.09 @ 7:24AM
Concord watches
Economic Time Bomb| 8.14.09 @ 7:27AM
An Economic Time-Bomb Being Mishandled by the Obama Administration?
Posted: 08/12/09Filed Under:Economy, Obama Administration, Deep Background 60 Comments + Join the discussion »TEXT SIZE:AAAPRINT SHARE Is there a ticking time-bomb for the US economy? And is the Obama administration, Congress, and the media not paying it sufficient attention? That seems to be the message of a government report released this week that drew not as much notice as it deserves.
This is all about those toxic assets--now euphemistically referred to by the US government as "legacy assets"--that were at the core of the economic meltdown. Though some economic news of late has been not so bad--economic contraction slowing, job losses leveling off, banks passing stress tests--these toxic assets still pollute the nation's financial system and endanger it.
On Tuesday, the Congressional Oversight Panel, which was set up to monitor the $700 billion Troubled Assets Relief Program (aka the Big Bank Bailout), put out another of its monthly reports, and this one notes that the Treasury Department has not used its TARP billions to purchase this junk--which includes both lousy commercial and residential mortgages and securities based on lousy mortgages--and that billions of
Robert Rosencrans| 8.14.09 @ 8:00AM
There are currently approximately 800,000 physicians in the United States with about 25,000 completing their training every year.
The United States needs 32,000 to 35,000 to finish training every year just to stay even with current needs.
Drop 42 million uninsured into that system and you guarantee rationing. Those 42 million are most likely sycophants who will overload the system with complaints of headaches and hang nails simply it's free. There's nothing like free.
Pingback| 8.14.09 @ 8:00AM
MIAMI ANTI-OBAMACARE PROTEST ECLIPSED OBAMA TROOPS – 08/13/09 at Senator Bill Nelson’ links to this page. Here’s an excerpt:
Indiana Alex| 8.14.09 @ 8:18AM
Robert,
I've said it before, and I will keep saying it. Look to the Cash for Clunkers program as an example. If you give people the opportunity to get something with someone else's money, the response will be much greater than anticipated by government.
This is why the projections for Medicare and Medicaid costs have been so far below reality.
Michael L. Hauschild| 8.14.09 @ 10:24AM
I as a boomer have little faith for “quality of life” in my future should I become ill. Any assets I have garnished in my lifetime would vanish in an “Obama Afterthought” at the first hint of a catastrophic health issue. I retired several years ago, not to fish or lay in the sun but to take care of my elderly parents. That act alone saved the government six or seven thousand dollars a month for several years as dad would have been eligible for “100%” and he was quite infirm. You had better believe that I am now on a diet, exercising regularly and rejoicing in the fact that I have not smoked or imbibed for decades. (Unless STD’s are air born I am safe on that level also.) I call this my “exercise bicycle health plan.” I recommend this for everyone and I recommend that you place no trust whatsoever in “all the usual suspects,” Medicare, Medicaid, and Insurance companies.
Solo| 8.14.09 @ 10:29AM
Those of you in your 40's and 50's ....
Ask your parents if they had Health Insurance back before you were a "twinkle" in their eye and, if so, how large a percentage of their income did it consume.
In most cases, the answer is going to be "No". Those who may have had health insurance through an employer would have paid a mere pittance, at best.
So what has changed in the last 50 years? One of the things that changed is that government became involved in health care funding. And...government distorts everything it touches.
Mandated reductions in payment schedules shifts costs to self-pay patients.
Doctors not willing to take on Medicaid patients as a result of reduced pay schedules shift patient loads to hospital emergency rooms for non-emergency treatment further driving up costs that are, also, shifted to self-pay patients.
Self-pay patients can no longer afford these higher costs (particularly for non-routine treatments) and are forced to pool resources in Health Insurance policies.
Health insurance companies try the same cost limiting tactics that the government uses thus requiring more creative management of tests and procedures by health care providers along with driving up their overhead for paperwork compliance.
Government then begins mandating what types of coverages health insurance companies may offer and/or MUST include and prohibits them from operating across state lines- again- further driving up costs and limiting personal choice options for patients.
Hefty jury awards for malpractice require HUGE investments and overhead for all health care providers along with the temptation to order tests and procedures for their patients as a precaution against a possible tort suit- again driving up costs to ridiculous levels.
All this precipitated by one thing.....government.
Government is what caused this health care nightmare in the first place and it is MADNESS to now suggest that government is the best way out.
The best way out is to get the government OUT to every extent possible.
Bill Pearce| 8.14.09 @ 12:10PM
Will Senator Ted Kennedy “take one” for team Obama?
Not a chance of that happening.
Rationing will be for thee and me not the Political Elite.
Pingback| 8.14.09 @ 12:18PM
Oh, those tricky Democrats: abortion is provided in Obamacare « Jim Blazsik links to this page. Here’s an excerpt:
gill.Oteen07041776@gmail.com| 8.14.09 @ 12:59PM
I had a weird thought last night. It popped into my head that we already have a single-payer system. The American taxpayer. Be sure to thank one today!
Gill O’Teen ✝✡
gill.Oteen07041776@gmail.com
Don’t Tread on Me!!
S.L. Toddard| 8.14.09 @ 1:48PM
I saw on Glenn Beck that under Obama's plan if you go to your doctor with a head cold they chop your head off. It's in the bill - fact.
Daniel| 8.14.09 @ 2:25PM
Health insurance premiums have been rising in recent years, above the rate that income is rising. People are being thrown off of their plan for any pre-existing illness, even though it is those people that need health care the most. Medicare must pay $177 billion dollars to private insurers for no reason other than because the lobbyists said so. Can you look at this system and tell me that we're not in trouble? I'm fine with dissenters, I'm fine with reasoned debate, but the Republican party is fighting for no health care reform, not better health care reform. Please, people, join me in making sure that health care is not a business, but a right to every citizen in the best country on Earth! Our current system is set up to make money for health insurers; how does that make you feel?
Brian B| 8.14.09 @ 2:31PM
--There are currently approximately 800,000 physicians in the United States with about 25,000 completing their training every year.--
To reinforce your point a little, according to the BLS there were 633,000 physicians and surgeons in the US in 2006, including osteopaths, and it is projected to rise to 723,000 in 2016.
Cheshire Cat| 8.14.09 @ 2:44PM
When Granny comes home with some pills in a plastic bag
Hurrah! Hurrah!
Obama will give her a hearty high five then
Hurrah! Hurrah!
The Emanuels will cheer, the Kevorkians will shout
The eugenicists they will all turn out
And the old folks will all be dead by Christmas time next year!
Get ready for the Ezekiel Emanuel Jubilee
Hurrah! Hurrah!
He’ll give Dr Obama three times three
Hurrah! Hurrah!
The Doctor of Life and Death degree is ready now
To place upon Obama’s Godly brow
And he will feel so happy and gay
When Pallbearers carry Grandma and Grandpa to the funeral home
Everly Waverly| 8.14.09 @ 2:46PM
The American public looks at the inside of the shirt collar of ObamaCare and declares, "Pure defecation".
Brian B| 8.14.09 @ 2:56PM
--Health insurance premiums have been rising in recent years, above the rate that income is rising.--
And will increasingly do so as Medicare and Medicaid continue to undercompensate doctors and hospitals and more cost shifting by necessity is directed to private insurance. Private insurance provides an indirect subsidy to Medicare/medicaid.
--People are being thrown off of their plan for any pre-existing illness, even though it is those people that need health care the most.--
It is in almost all cases illegal to cancel a contract because of an existing illness. The problem is losing a policy while ill which is best addressed by ensuring portability of insurance and HSAs.
--Medicare must pay $177 billion dollars to private insurers for no reason other than because the lobbyists said so.--
Medicare Advantage, which is the $177 billion of which you speak has become primarily the medicare program for the poorest elderly and includes dental, vision and physical rehab services standard medicare doesn't cover. They have the advantage to the poor of having the medicare premiums subsidized to the point some are free. So Obama and the left now want to squeeze the elderly who can least afford standard medicare premiums of $1500-3000?
Lullabys, Legends and Lies| 8.14.09 @ 3:02PM
Sleazy little Toddard: Hey Buddy?,.. you don’t look too good!!!,.. what’s the matter are you feeling alright?,.. oh!! Just a little head cold?,.. that's alright!!,.. just go to the Doctor,.. and they’ll take care of that little “head” cold for you,.. and don’t worry about the bill!!,.. we’ve got it covered!!
Sue| 8.14.09 @ 3:23PM
Thank you Mr. Goldberg; my grandson needs a pedicatric urologist. Think you can find one? 100 miles away and a wait list. The Democrats whine all the time about the taking care of the children. The problem is, they never back it up with resources. Only talk. This is the way it is with every government program from food stamps to housing. They talk a good game and get the votes, but some people are left out of the game all together.
Oh, and the paperwork you have to go through just to get "qualified." The bureaucrats act like you're stealing their money.
I've helped the elderly navigate social security, dept. of health and human services, etc. and it's the same level of service - stinks to high heaven.
Scott A Joseph, MD| 8.14.09 @ 4:52PM
The way it works is very simple. Go to the New Zealand Herald website and punch in DHBs. That will show you everything you need to know about government programs. NZ only has 4 million people, and 70,000 on waiting lists for simple operations.
The MDs make OK money there. The true sufferers are the patients.
Joseph| 8.14.09 @ 9:15PM
I was having a debate with someone who wasn't getting the simple fact that when gov't sticks its nose into the private sector...productivity and innovations...the 2 required driving forces behind the creation of wealth....decrease..and therefore the amount of wealth being created decreases....and when complete and total nationalization happens...productivity and wealth drop to zero.....and there is therefore no longer any wealth being created....once that happens only one thing will happen...the gov't will run out of money because no new wealth is being created.....forcing the gov't to borrow from other countries to support us....putting our country in negative equity
this is because all industries are now under the control of government....which is incapable of creating wealth...only laws and regulations.....common sense laws and regulations being necessary for sure to deal with crime.....but laws and regulations in and of themselves don't create wealth.....they help FACILITATE the creation of wealth through honest productivity and innovation by being there to deal with those who commit what are rightfully known as crimes
Solo| 8.14.09 @ 10:09PM
Daniel Wrote:
"Can you look at this system and tell me that we're not in trouble? I'm fine with dissenters, I'm fine with reasoned debate, but the Republican party is fighting for no health care reform, not better health care reform. Please, people, join me in making sure that health care is not a business, but a right to every citizen in the best country on Earth! "
No, Daniel. Health care is NOT a "right". I know that sounds cruel but...it's true. If you believe otherwise then I suggest that you do some research to determine the true meaning of the concept of "rights".
Health Care ( for those who cannot purchase it for themselves) is an entitlement. Is is granted by virtue of compassion of the individual at his (or her) own choice as dictated by his (or her) own conscience.
To use the force of government to mandate this highly subjective moral judgment is tyranny. The mitigation of tyranny is the very reason this republic was established in the first place. This is the very reason that the founders pledged their "...lives, fortunes and sacred honor".
The very thought of allowing the federal government to make these determinations for you is in direct contradiction to the very principles upon which the United States Of America is predicated.
That you have allowed yourself to buy-in to this narrative of these fictitious "rights" actually sickens and saddens me beyond my capacity to describe.
I believe that you mean well...I really do. But..you must carefully think through this train of thought before you surrender our freedom (and that of your children) for short term gain.
If the federal government (an entity which you cannot escape without surrendering your citizenship) can apply a subjective moral imperative upon you against your will- what is there to stop them? What boundary may they not cross?
You do not have the "right" to a car...or a plasma T.V....or a job...or health care.
You have the right to pursue these things for yourself unimpeded by others. But you do not have the "right" to compel another to surrender them to you.
This...is forced slavery. And it is the very definition of tyranny.
"The problem with socialism is that you eventually run out of other people's money"
Margaret Thatcher
"Capitalism is the un-equal distribution of wealth. Socialism is the equal distribution of poverty".
Winston Churchill
TQ| 8.14.09 @ 11:46PM
"Our current system is set up to make money for health insurers; how does that make you feel?"
It makes me feel just fine. They're providing a service to me, they're entitled to make a profit. Why on Earth would I care that a company is making a profit? Of course it is ridiculous that an insurance policy is paying for routine care and maintenance. And it is ridiculous that said policy is not portable. Those are problems, but they're easily addressed by small bits of legislation.
As for your other talking point from Organizing for America, how many people exactly are being denied coverage for pre-existing conditions? If the number is relatively small, we don't need to mess with everyone else's coverage. We simply need to find away to address THAT specific problem. I suspect the number is small.
And health care is a business, it is not a right. If we assume it's a right, then why isn't dental care covered? My root canal was paid out of pocket. Why isn't food a right too, since it is a major determinant of health? Why isn't my gym membership a right? I mean if I exercise it keeps me healthy, right? Why isn't my pet covered? Surely my cat deserves the right to free veterinary care. And why isn't it a right to be rich? Social status is one of the major determinants of health. It isn't fair that some people should be healthier simply because they have more money, and live in a nicer house than me, drive a safer car, get to take more vacations, eat better food, get personal trainers and all the rest. We all deserve that right.
And guess what? You're free to stop working for $15/hr or whatever they're paying Obama-bots these days (no benefits, I'm sure), getting a real job (well assuming the economy ever rebounds), and getting more money and getting better health care. At least until this monstrosity of a bill passes, in which case you won't really have any rights.
Fitz| 8.15.09 @ 9:49AM
Anyone who thinks the current health care system "shouldn't be tampered with," really needs to see this interview with Wendell Potter. Until very recently, he was VP of communications for CIGNA Health. He is a self-described capitalist and to hear his take on the current health care system is like a reading directly out of a Brave New World. Its only 20 minutes or so of your time and a far better conversation than anything we're seeing elsewhere.
http://www.pbs.org/moyers/journal/07102009/watch2.html
Akaky | 8.15.09 @ 5:04PM
Facts are indeed not distortion, Mr. Goldberg, but the source of your quote is incorrect. The distinguished philosopher Julius Henry Marx never mentioned the quote you use; the source, rather, is Mr. Marx's brother Leonard, himself an expert on the role of probability and a damn fine pianist in his own right.
Dr. Jason Campagna | 8.16.09 @ 3:53AM
Mr. Obama may mean well, but his policies as articulated and planned are a Trojan Horse of sorts for very concerning things. Light, as a supreme court justice once said, is the best disinfectant. Many doctors, a great many, do not agree with the AMA and do not support HCR as articulated. Our comments and discussion can be found at www.takebackmedicine.org
Fitz| 8.16.09 @ 10:35AM
I understand some of the cocnerns out there however, I feel compelled to share my own story with health insurance. I am a veteran of multiple deployments and am currently an officer in Army Reserves. During one of my deployments, my civilian job reorganized and my position went away. I took a job with a small company who had every intention of providing employer-based coverage. However, there are only about 8 employees and the rates proved too expensive for this small company. Once it became clear that I would not be getting coverage through my civilian position, I signed up for the discounted coverage offered through the Reserves. I received my card stating that my eligibility started on May 1, 2009. In August, I went to see a doctor to get some medication and found out that I'd been dropped from the roles of TRICARE on May 31, 2009. No explanation, no warning. Those medical expenses ended up being out of pocket. While I realize that TRICARE is a government provided plan, they are still a private health insurance company. If it was not for the VA, I'd have no coverage at all. The private insurance system has failed me.
I realize that many people feel that veterans are somehow more deserving of health care and therefore tolerate that public system. I don't feel that way. To me, its the same as saying that only some people deserve to have the fire department show up at their burning house while others must fend for themselves. Furthermore, the VA does not kick grandma or grandpa off the roles by virtue of their age alone whereas private insurance does do that by means of astronomical premiums, deductables, and outright refusals of coverage. Without a public option, like me, where will they go? We all bought into this private insurance based system, but its clear that we are not the customers in this equation. We are conduits only. I have seen a lot of talk in recent years about American exceptionalism and of patriotism and sacrifice. Barring the 1% of the population in uniform that is continually recycled through deployments, I don't really see where anyone has been asked to sacrifice anything for the common good of this nation until now.
Ken (Old Texican)| 8.16.09 @ 2:13PM
Hi Fitz
I certainly share your frustrations with Tri-care, but please do not confuse "Cause" and "effect".
Your government designed the parameters of Tri-care...believe me please. Once again, they screwed it up with rationing of various sorts.
You are exactly correct that health insurance needs to be overhauled...and the tax wierdness on medical insurance should be eliminated.
The "public option" puts you and yours right back in Tri-care...with no remorse, and worse rationing.
Thank you, Sir, for your service.
Ted Kelly| 8.16.09 @ 6:05PM
I see that you have used "horror stories" from examples of Medicare where younger people had a hard time finding doctors. Why do you think that is? Might it be because the average age of Medicare recipients is 65 and the people in your story are less than that age? It, obviously, is true that the majority of doctors in the Medicare system are doctors for older people. The data in your article is skewed and an inaccurate picture of the truth. Rationing is a fact of life in America because health care costs money here; Too much money here. Obama will fix that in time. You are intentionally deceiving your readers and that is deplorable.
Ken (Old Texican)| 8.16.09 @ 7:31PM
Ted
Welcome to the big leagues. Your comment was internally stupid, and your conclusion is stupid.
All doctors are "in" the medicare system, because patients are there as well.
If dummies like you overwhelm our country, the Obamas of the country will make sure you don't get old.
Fitz| 8.16.09 @ 7:33PM
Ken,
I don't disagree that the government sets the parameters for TRICARE. They represent the privatization of the military health care system. I never had that kind of an issue with Active Duty health care.
We do need to remember, though, that I would not have needed to go that route had my company been able to provide coverage in the first place. There are varying levels of rationing going on, including in the VA and military health systems. By far, though, the closer I get to private insurance, the more rationing I experience. First and foremost, healthcare is rationed through initial cost of premiums and deductibles, then through decisions to cover or not to cover. The VA dos make decisions based on cost and will tend to try the least expensive remedy first. Amidittedly, that can cause some problems if the right treatment is delayed for a worsening condition. The point I'm making though is that in spite those types of business decisions, they do treat the problem. It may not always be as expedient as I'd like, but by and large when something needed to be addressed right away, it has been.
Pingback| 8.17.09 @ 3:24AM
How Many Doctors Does It Take? Ask Canada | Tea Party of Northern Colorado links to this page. Here’s an excerpt:
Ken (Old Texican)| 8.17.09 @ 12:12PM
Fitz
Again...I am frustrated along WITH you.
Please keep in mind that I do want health care/insurance reform. BUT!
EVERY single time the govt. steps in with big flat feet, they screw it up, tilt the playing field, and the waste and corruption goes through the roof.
Please sir, let REAL reform take place as a result of this national debate. Please do not enslave your children with our medical bills.
crmang| 8.17.09 @ 3:39PM
Minor quibble with an otherwise very good article. I believe the quote you atribute to Groucho Marx was actually said by Chico Marx, dressed as Groucho, in Duck Soup. In fact, I used the same quote last week when commenting on Jeffrey Lord's 8/11 American Spectator column on Linda Douglass and her attempts to debunk the "myths" surrounding Obamacare.
Nonetheless, it does not take away the well stated points made in this article.
Len| 8.17.09 @ 6:45PM
Can the federal government involve itself in health care?
Currently under the GRANTED, LIMITED, powers granted to the federal government it has the power to do the following things;
1) Raise revenue. The Congress shall have power to lay and collect taxes, Duties, Imposts and Excises, to pay the Debts and provide for the Common Defense and General Welfare of the United States; but all duties, Imposts and Excises shall be uniform throughout the United States. Though this is limited as the revenue is for 3 purposes, to pay the debts, provide for the general welfare of the UNITED STATES, and the common defense. It should be noted that general welfare though misconstrued by many to be a broad grant is not even a grant, merely a purpose. How then do we know what is considered to be the general welfare? Well thankfully certain powers were delegated by which we may know what is considered general welfare.
2) To borrow money on the credit of the United States;
3) To regulate Commerce with foreign Nations, and among the several states, and with the Indian tribes;
This could be troubling as regulating commerce at first glance appears a bit vague, as does “among the states”. Fortunately good scholarly research has gone into this (Randy Barnett and Robert G. Natelson) that show the legal AND common understanding of commerce to be the exchange of goods. Certain sitting courts of the Supreme Court have considered this to grant congress the power to regulate industry or business that has affect on commerce. This is both disingenuous and untrue to the plain text and historical context.
First one must consider what is it that the framers and those who ratified were seeking to correct. Remember, “a more perfect union”, and “domestic tranquility”. What was not “perfect”? Well a state such as Maryland or Virginia might impose a tax upon ships not registered in their state for docking at their ports, others might levy tariffs upon the people of one state bringing their goods through their state. Thus REGULATE AMONG THE STATES was meant to both bring about harmony and keep the states united, and ensure a regular flow of commerce whereby all the states would benefit (general welfare).
Second, and although partially dealt with above, what does “among the states” mean? Well as I said, I partially showed among the states to be a governing, regulating influence to prevent one state from levying excise, taxes, or tariffs that were detrimental to others. This then we know is a power that extends to the states. Is it a power that extends to the private citizen? Under a limited grants constitution, if a power is not granted, then it cannot be exercised.
We know that it is a limited grants constitution as to gain more powers, amendments must be ratified for such. We also have clarification through the 9th and 10th amendments that show that the people have rights and are not granted them…retained by the people, and that the people and the states are the only ones that may exercise powers not granted. As no grant of power in the US constitution gives the federal government any specific authority either over the individual or to legislate on his behalf any attempt to regulate private business or promote good, particularly specific good that benefits the individual can only be seen as a usurpation of a right and power not granted.
To further ascertain the scope of power for the federal government we must look to the effect and manner of operation under the US constitution. For example..” The United States shall guarantee to every State in this Union a Republican Form of Government, and shall protect each of them against Invasion; and on Application of the Legislature, or of the Executive (when the Legislature cannot be convened), against domestic Violence”, from what is omitted we may see that individuals are not the concern, but the states comprising the Union.
4) To establish an uniform Rule of Naturalization, and uniform Laws on the subject of bankruptcies throughout the United States;
5) To coin money, regulate the value thereof, and of foreign coin and fix the Standard of weights and measures;
6) To provide for the punishment of counterfeiting, the Securities and current coin of the United States;
7) To establish Post roads and post offices;
8) To promote the progress of science and useful arts, by securing for limited times to authors and inventors the exclusive right to their respective writings and discoveries;
9) To constitute tribunals inferior to the supreme court;
10) To define and punish piracies and felonies committed on the high seas, and offences against the laws of nations;
11) To declare war, grant letters of Margue and Reprisal, and make rules concerning captures on land and water;
12) To raise and support armies, but no appropriations of Money to that use shall be for a longer term than two years;
13) To provide and maintain a navy;
14) To make rules for the government and regulation of land and naval forces;
15) To provide for calling forth the militia to execute the Laws of the Union, suppress insurrections and repel invasions;
16) To provide for organizing, arming and disciplining, the militia, and for governing such part of them as may be employed in the service of the United States respectively, the appointment of the officers, and the authority of training the militia according to the discipline prescribed by congress;
17) To exercise exclusive legislation in all cases whatsoever, over such district (not exceeding ten miles square), as may, by cession of particular states, and the acceptance of Congress, become the seat of the government of the United States, and to exercise like authority over all places purchased by the consent of the legislature of the state in which the same shall be, for the erection of forts, magazines, arsenals, dock-yards and other needful buildings; - And
18) To make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this constitution in the government of the United States, or in any department thereof.
I included all of the powers granted for three purposes, 1) To make sure we have before us all the powers available for governance to see if under any one of them Congress may involve itself in health care. 2) To illustrate the general effect and manner of operation of Congress’s power. 3) To see that the purposes of Congress are then defined by the powers granted. To pay the debts is self explanatory, so no exposition, but it needs to noted that as common defense is not a broad unlimited power, but a purpose defined and powers granted to do is seen by 11,12, and13 to name a few. In like manner so is general welfare a purpose defined and powers granted for, such as 4, 5 and 6.
In addition to the above, concerning the claim of “general welfare” being a power, rather than a purpose for which the power of revenue is granted, one needs only look at the structure used in wording the revenue power… The congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States…Here it is seen that a qualification on the revenue power is attached at the end, but if debts, defense and welfare were separate powers, why would they be packaged between a power and a qualifying phrase? This, in addition to the superfluity of enumerating powers which could easily be legislated on if Common Defense, or General Welfare were broad grants of power makes clear that the so called “General Welfare” clause that many use as an excuse for their usurpative acts is anything but.
Now a question may come up, “What about 18”. Easily answered in that it is placed there as an ancillary and subordinate power because of the difficulty in enumerating all the powers needed to carry out the above, but it certainly cannot properly be construed as a grant of power beyond those enumerated, only an assisting power, and if the main power does not speak to an issue, then certainly “necessary and proper” can only be understood in a limited sense, and in defining it’s usage as limiting, again NECESSARY and PROPER.
What about the Supreme Court’s rulings?
Section. 2. The Judicial power shall extend to all cases… arising under this Constitution…
The important phrase above is ….”arising under this constitution”. As private/individual citizens conduct of business, or the power to provide for their good, does not arise under this constitution one can only look at those decisions given by SCOTUS as misconduct and certainly a violation of the good behavior clause that allows a justice to maintain office.
In summary without the states and/or the people formally expressing their will through an amendment, and thus saying that we continue to be bound to the current grants of power, regardless of when adopted, the answer is “No, the federal government may not involve itself in health care.”
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