While repealing Obamacare continues to be debated and voted on in Congress, it should be noted that health care policy is not a federal responsibility.
Control over the nation’s health care industry is not in the list of enumerated powers in Article I, Section 8, of the U.S. Constitution. There is no provision in the Constitution that gives the federal government authority to legislate in this area. While judicial activists have twisted the Commerce Clause to assert a federal role in health care, there is no constitutional support for such a role.
Of course, when considering the intrusion of the federal government into health care policy, observers understand that horse left the barn back in the 1960s with the federal government’s entry into the health care marketplace, first through Medicare and then Medicaid. But neither of these programs is constitutional. If we really want them, they should be run by the states. The states, under the Constitution, have wide latitude to legislate, so if they want to be involved in health care policy, there is no federal constitutional barrier to them doing so.
Having said that, one can logically question why this is even a governmental responsibility. Health care decisions should occur between a patient and his or her physician. Why should government have a role at all?
The best thing the federal government could do would be to totally pull out of the health care business; but that would take some real education of the masses and leadership to make that case—and that’s in short supply right now in Washington, D.C. Besides, our politicians have constructed and incentivized a variety of client classes over the years. People who really didn’t have a dependency mindset to begin with have now become dependent on these programs just because federal policies have enabled them to do so.
In June, U.S. Rep. Tom Price (R-Roswell) introduced his “Empowering Patients First Act” (HR 2300). It repeals Obamacare and replaces it with patient-centered reforms, many which are friendlier to free markets than Obamacare. His proposals would be an improvement over Obamacare and perhaps would make a good transition policy to what we really want.
To get to what we really want will take massive societal change built on the personal ethic of individual responsibility. Without a broad-based embracing of this ethic, it will be difficult to bring about political change. Folks won’t clamor for political change if they are comfortable with the benefits being provided by their fellow taxpayers. Those who are able to provide for themselves should do so and forsake the nanny state. The private sector, charities and local and state authorities should deal with the rest.
The damage done by our modern “monster” welfare state is deep. It will take perhaps a generation to root out this cancer. For the most part, the “great unwashed” are clueless about this. These low-information citizens provide the fertile ground for intrusive government and the cradle-to-grave mentality. While constitutional conservatives must continue their efforts to educate and inform the folks who are already paying attention, the more difficult battle is for the hearts and minds of those who aren’t paying attention. This is going to take some time.
Obamacare should be repealed and replaced with something that will help us transition the federal government out of health care altogether. Strong support from constitutional conservatives and ordinary citizens will be a big key to this effort, as well as efforts to educate the public about the genuine meaning of our Constitution.