Tuesday, September 11, 2007

Health care issues are better addressed at the state rather than the federal level

"America should adopt a single-payer health system like Canada's."

"Sweden has social benefits x, y, and z, while the U.S. is still in the dark ages."

"Even Cuba, CUBA, is better at providing x for their people than America is."

These opinions are very common. For the sake of argument, I'll concede that Canada, Sweden, and Cuba may be better at providing some social services than is the United States. But this leaves out some interesting information. Canada has fewer people than California, and a smaller gross domestic product. Sweden has the same number of people as Georgia. Cuba's population is about the same size as Ohio's.

Indeed, the state with the lowest GDP, Vermont, is wealthier than some 60 countries, most of whom have far greater populations. Indeed, the poorest state, Mississippi has the same per capita GDP as Greece and New Zealand, and is well ahead of dozens of countries with a more comprehensive health care system than the United States.

Surely, if poorer countries can afford universal health care, the United States should, right?

But that's asking the wrong question. Consider that while all nations of Europe have some form of government-run health care, the systems vary in the different countries; there is no one-size-fits, European Union program.

We shouldn't be asking, "Why doesn't the federal government provide universal health care?" but rather, "Why doesn't California? Or Georgia? Or Ohio, Mississippi, Vermont, Nebraska, or Wisconsin? If the people in those states, or any state, really wanted such a system, they could certainly afford it, because other countries of similar size and less wealth provide it.

And isn't 50 different solutions to our heath care problems better than a one-size-fits-all, nationwide plan that may not work? I'm not advocating socialized medicine, but I believe the debate over free markets vs. government intervention should take place at the state, not the federal level. One state may increase income taxes to pay for "universal" health care coverage. Another may greatly increases sales taxes, and another property taxes. Some states will only cover the poor but require others to purchase insurance. Some would provide basic care, while others might offer more advanced care. And some may take a laissez-faire approach and not do anything at all. In any case, the people would be better represented at the state level than in Congress, because of the much smaller state legislative districts. It would be far more difficult for lobbyists of the insurance industry or Big Pharma to bribe 50 state legislatures than just one Congress. The states would serve as "laboratories of democracy," and would learn from each other what works best and what doesn't work at all.

Such is how government under the United States Constitution is supposed to operate. Under the Constitution, Congress isn't authorized to run, regulate, or subsidize our health care. Because the Tenth Amendment prohibits the federal government from doing anything the Constitution doesn't expressly authorize it to do, federal intervention in health care is unconstitutional.

This is not an anachronistic interpretation of the Constitution, unless undertanding basic English is also anachronistic. Yes, the Supreme Court hasn't struck down unconstitutional programs such as Medicaid and the prescription drug benefit , but that's neither here nor there. For decades, the Supreme Court held that segregation was constitutional, and then, one day, poof! it wasn't. The Supreme Court does as the Supreme Court wants, not what the Constitution says.

The truth is, once we ignore or "reinterpret" one provision of the Constitution, the others - even the ones we like - will also fall. The President and Congress started attacking the Tenth Amendment in earnest during the 1930's New Deal era. Next to go was the clause authorizing only Congress to declare war. That went out with Korea and the U.S. has been at war somewhere most of the time since then - with disastrous results. The War on Drugs has led to federal violations of just about every provision of the Bill of Rights, and there are thousands of gun laws on the books that flout the Second Amendment. Should we then be shocked that a President would now "reinterpret" the clauses about habeas corpus and warrantless searches?

Any federal solution to our health care problems would be unconstitutional. This would only encourage even more unconstitutional legislation and is thus a grave threat to our liberty. Instead of increasing the federal role in health, the federal government should end its health programs, laws, and regulations, and return the money back to states or the people, leaving it up to them to solve their health care problems.

Many countries that have government-run health care are smaller and far less wealthy than many of our states. This shows that the states could have the same thing if the people wanted it, and if the federal government didn't interfere. I don't think socialized medicine is a good idea. But if you want to agitate for socialized medicine, do it at the state level. It's the Constitutional and democratic thing to do.


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