In the Declaration of Independence, Thomas Jefferson articulated the American ethos that life, liberty, and the pursuit of happiness are inalienable rights. The question of how best to protect these rights has shaped American politics as a struggle between advocates of small government with strictly enumerated powers and those articulating a more expansive role. A contemporary manifestation of this struggle is the debate over Obamacare; President Obama and many Democrats have championed bigger government to ensure universal health care, while most Republicans and some Democrats disagree vehemently, fearing a Leviathan state.
Twenty-six states sued on the grounds that the individual mandate and other portions of Affordable Care Act infringed on constitutionally guaranteed rights, and the Supreme Court heard their arguments. The Solicitor General responded primarily with the argument that the mandate fell into Congress’s power to regulate commerce as a practical matter, pointing out the substantial cost incurred by society (some $56 billion) of treating the uninsured in emergency rooms. The Court rejected this argument but upheld the mandate as a constitutionally legitimate tax.
In their narrow interpretations of the issue, both the Administration and the Court got it wrong.
Laws don’t exist in a vacuum. A sensible consideration of the health care law’s effect on freedom must appreciate how disease itself cripples a variety of rights. Any loss of rights arising from the requirement of the law must be balanced against the protection of rights resulting from universal care.
Take diabetes, for example. If caught at an early stage, patients treat their diabetes with medication and lifestyle adaptations which can manage the progression of a disease. Most sufferers can enjoy a relatively unencumbered life.
But if the disease is not treated, it will become increasingly disruptive and threaten one’s ability to live freely. Diabetes can cause neuropathy and eventually gangrene of the feet, resulting in amputation and restricted mobility. It can cause blindness. It can deteriorate one’s mental health. And the ultimate consequence of the untreated disease is death.
Indeed, 45,000 Americans die every year because they cannot afford health insurance. If the right to life is inalienable, then universal health insurance is a prerequisite for making the right to life mean anything at all.
Diseases are not necessarily products of lifestyle choices, either. The heritability of Type 1 Diabetes, for example, is about 90%. And we all know of perfectly healthy people stricken with cancer and other ailments for no fault of their own. One cannot simply dodge the issue by blaming these diseases on the choices of their victims.
Untreated disease often restricts liberty, certainly restrains the pursuit of happiness, and can prematurely rob one of life. One cannot live freely if one cannot move, think, or live at all; consequently, full protection of these American rights requires that the American government intervene to facilitate universal access to healthcare, as every other industrialized nation has done. The Affordable Care Act is a step in the right direction to this end.
Rational people can disagree on how best to provide health care to Americans. But fear that a subsidized requirement to buy health insurance will spell the end of the constitutional order is wholly unjustified.
Rugged individualism does not maximize freedom. In the case of healthcare, looking out for each other is the best way to protect our rights as individuals.
[Image Credit: http://obagiforcongress.com/wp-content/uploads/2012/05/America-has-a-heart.jpg]
