Yesterday I was listening to one of my favorite, local radio talk show host take calls on healthcare reform. A caller tried to make the case that it was “government’s responsibility” to provide health insurance for all. The host asked “Where in the Constitution does this unalienable right appear?” That got me thinking…….

Thinking of one Chico Rodriguez, aka Freddie Prinze from the 1974 imageT.V. hit Chico and the Man.summary.html Chico’s “money line” catchphrase was “It’s not my job” whenever he was asked to do just about anything outside his immediate interest, attention or responsibility. So, who’s responsibility is it to provide healthcare financing to the general public?

Remember, hospitals are not allowed to turn patients away based on their ability or inability to pay, or whether they have insurance. Remember also, that when many politicians say “all Americans are entitled to healthcare,” they really mean “healthcare financing.” This is healthcare without a bill or more accurately, where the bill gets mailed to your neighbor’s house!

Additionally, we’ve just heard announcements this week that Congress is proposing changes to enhance prescription drug coverage through Medicare Part D, by reducing the “donut hole” gap in coverage currently in place. The donut hole was originally designed to serve as a budget buffer, in effect, an additional deductible, so the humongous cost of providing prescription drugs to seasoned citizens, would fit into an acceptable budget deficit. No such concerns today!

After digging out my well-worn copy of the Constitution and Amendments (Bill of Rights, for those scoring at home), I began to search in order to establish some direction for taking a position on this vexing issue. Where oh where could that pesky clause be?

Let’s see, starting in the Preamble and followed up again in Article I Section 8 “provide for the common defense and general Welfare of the United States.”text.html That’s interesting: could “general Welfare” mean health insurance? Also in Article I Section 8 we read “The Congress shall have the power to promote the progress of science.” Odds botkins! Could “science” mean health insurance (or at least diagnostic screening with genetic testing for pre-disposition paid for through public taxation)? I believe the FDA and NIH should have this section quoted and hanging on their respective threshold as you enter their buildings!

Then, looking at the codified Bill of Rights billofr.htm, I remember the 10th Ammendment (who knew that paying attention in Mr. Robert’s 9th grade Civic’s class would pay off) that states “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” Whoa! Does that mean if the Federal government doesn’t have the specific authority to provide insurance services, then it’s reserved to the States or to the people (individuals)?

What did the Founding Fathers have in mind? As early as 1792, the Constitution’s language raised heated disagreements and provided a basis for creating alternative political parties with different visions for ceding authority to the Federal government. Alexander Hamilton was of the school where a broader interpretation of the Federal role in citizen welfare, and specifically, the taxing and spending powers clause (also in Article I, Section 8) was in order. Jefferson and Madison, on the other hand, argued that the phrasing was simply a summary or general description of the specific powers, and that it gave Congress no additional authority.

After thoughtful consideration, I tend to side with Tom and Jim, since they wrote the darn document (with minor editorial kudos to Johnny Adams and Ben Franklin). So back to my original question: when it comes to providing a reformed healthcare system, with universal health insurance, who’s job is it? What sayeth ye?

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