Should Government Pay?

EmmaG, RN · Nov 1, 2007

No way.
Section 7 does not authorize anything. It merely lays out procedure.

The question was if it is Constitutional for the Federal Government to use taxes to fund a universal health plan. Article I, Sections 7, 8, and 9 give it that Constitutional authority:

Section 7. All Bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.

There also is no pertinent clause in Section 9.

Ah, but there is :)

Section 9. No money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law; and a regular Statement and Account of the Receipts and Expenditures of all public Money shall be published from time to time.

(i.e. the Government can spend money if approved by Congress by law)

An argument can be made that Section 8 does support it implicitly, but it is tenuous.

Section 8. The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

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 or Officer thereof.

Not "tenuous" at all.

If it took an amendment for prohibition, it definitely would take one to legally implement a universal health care system.

No, it wouldn't. See above.

Long Term Care Columnist / Guide · Nov 1, 2007

I can't give this a Yes or No answer, because it's not really a Yes or No question. To my understanding, government is supposed to provide for the general welfare of the citizenry; but what does that consist of? And who decides?

Some people seem to think 'general welfare' would include waging war on a country that has not attacked us. Others would say that 'general welfare' means the government (and by extension, we taxpayers) should provide food, clothing, housing and medical care for each and every person living in the U.S., whether they were born here or are in the country illegally.

Personally, I think the 'general welfare' lies somewhere between the two extremes. I have no problem with paying taxes for protection from criminals both within and outside the country, safe drinking water and food supplies, fire and police services; and yes, I believe basic medical care for every citizen should be a RIGHT, not a commodity to be bought and sold like a car or a house, and certainly not a privilege for the few who can afford it.

HOWEVER---I also believe that health care paid for by the public should include only the basics needed to prevent disease and maintain health and dignity (Viagra and rhinoplasty don't count), and that it should be administered at the state, rather than the federal level. I think those who want and can afford more services should be allowed to purchase them, either on a fee-for-service basis or a cafeteria-type plan offered by physicians---NOT the insurance industry. I want to see that beast starved until it dies.........it is of no practical use, unless one doesn't mind the inflation of care costs due to top-heavy administration, the reams of paperwork, and the mass confusion caused by hundreds of different companies with thousands of different rules.

So you see why I cannot answer this in a black-and-white manner. I have little faith in federal control of health care, yet my social conscience argues that every citizen of a civilized country should be able to go to the doctor when he or she is sick, regardless of income or social status.

rita359 · Nov 1, 2007

a quick poll for allnurses.com members. reply with a "yes" or "no" please.
does the federal constitution give the american federal government the authority or power to collect money in the form of taxes to pay for the health care for anyone who wants or needs it?

quick answer: no can't imagine how the founding fathers would have ever imagined the federal government paying for health care considering what health care was like at that time.

rita359 · Nov 1, 2007

See:
We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.
http://www.law.cornell.edu/constitution/constitution.preamble.html accessed today.
See also:
Section 8. 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....
...
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 or officer thereof.
http://www.law.cornell.edu/constitution/constitution.articlei.html#section7
The short answer is yes the Congress is acting within the scope of delegated Constitutional responsibilities to establish a single payer system. Frankly, I think that this is a settled matter of law with the establishment of the Medicare and Medicaid programs.

I do not think the framers of the constitution would have defined "general wellfare" as each persons medical needs. That is not general but specific. "General" would be safety, security, other things like that. The way some people want to interpret things (guaranteed medical care for erery last one of us, welfare for anyone who decides it is too hard to work for a living) we will end up turning the USA into a communist type society which has proven itself a failing idea. Founding fathers were individualists, rough and rugged, who would never have dreamed people would be SO dependent on the government for everything.

EmmaG, RN · Nov 1, 2007

Quick answer: no Can't imagine how the founding fathers would have ever imagined the federal government paying for health care considering what health care was like at that time.

Ah, but they did. Not 'universal healthcare' per se, but it laid the framework that allowed our government to address future issues the Founders never dreamed of. They were smart enough to realize that restricting the power of Congress to enact laws to only certain issues would be self-defeating and the government would not survive. Hence the power "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 or Officer thereof." It's vague simplicity is why it has survived for over 200 years, and remains as relevant today as it was when written.

Did the Founders envision the need for Federal laws providing protection against internet child predators? They were very forward-thinking men, but I doubt even they could have foreseen this as a serious issue requiring Federal legislation and enforcement. Yet the Constitution provided the framework giving the government the power to do so.

Brilliant document, eh?

Shaggyb2000 · Nov 1, 2007

"They are not to do anything they please to provide for the general welfare, but only to lay taxes for that purpose. To consider the latter phrase not as describing the purpose of the first, but as giving a distinct and independent power to do any act they please which may be good for the Union, would render all the preceding and subsequent enumerations of power completely useless."

Thomas Jefferson

SuesquatchRN, BSN, RN · Nov 1, 2007

Yes.

.....

EmmaG, RN · Nov 1, 2007

"They are not to do anything they please to provide for the general welfare, but only to lay taxes for that purpose. To consider the latter phrase not as describing the purpose of the first, but as giving a distinct and independent power to do any act they please which may be good for the Union, would render all the preceding and subsequent enumerations of power completely useless."
Thomas Jefferson

Ah, context:

1. To lay taxes to provide for the general welfare of the United States, that is to say, "to lay taxes for the purpose of providing for the general welfare." For the laying of taxes is the power, and the general welfare the purpose for which the power is to be exercised. They are not to lay taxes ad libitum for any purpose they please but only to pay the debts or provide for the welfare of the Union.

http://courses.pasleybrothers.com/texts/Jefferson_on_BUS.htm

His objection was to the establishment of a National Bank, which he argued was unconstitutional.

A snippet of Hamilton's rebuttal (it is very long...): http://www.yale.edu/lawweb/avalon/amerdoc/bank-ah.htm

It is certain that neither the grammatical nor popular sense of the term requires that construction. According to both, necessary often means no more than needful, requisite, incidental, useful, or conducive to. It is a common mode of expression to say, that it is necessary for a government or a person to do this or that thing, when nothing more is intended or understood, than that the interests of the government or person require, or will be promoted by, the doing of this or that thing. The imagination can be at no loss for exemplifications of the use of the word in this sense. And it is the true one in which it is to be understood as used in the Constitution. The whole turn of the clause containing it indicates, that it was the intent of the Convention, by that clause, to give a liberal latitude to the exercise of the specified powers. The expressions have peculiar comprehensiveness. They are thought to make all laws necessary and proper for carrying into execution the foregoing powers, and all other powers vested by the Constitution in the government of the United States, or in any department or officer thereof."

To understand the word as the Secretary of State does, would be to depart from its obvious and popular sense, and to give it a restrictive operation, an idea never before entertained. It would be to give it the same force as if the word absolutely or indispensably had been prefixed to it.

Such a construction would beget endless uncertainty and embarrassment. The cases must be palpable and extreme, in which it could be pronounced, with certainty, that a measure was absolutely necessary, or one, without which, the exercise of a given power would be nugatory. There are few measures of any government which would stand so severe a test. To insist upon it, would be to make the criterion of the exercise of any implied power, a case of extreme necessity; which is rather a rule to justify the overleaping of the bounds of constitutional authority, than to govern the ordinary exercise of it.

--------------

It leaves, therefore, a criterion of what is constitutional, and of what is not so. This criterion is the end, to which the measure relates as a mean. If the end be clearly comprehended within any of the specified powers, and if the measure have an obvious relation to that end, and is not forbidden by any particular provision of the Constitution, it may safely be deemed to come within the compass of the national authority.

BTW, the bill providing for a National Bank was signed into law

In other words, Jefferson was pwn'd.

(sorry... feeling a bit silly today :) )

EmmaG, RN · Nov 1, 2007

The OP is asking two separate and distinct questions (with the thread title and the first post). Can the Congress create a single-payer or universal health plan and should they do so. Clearly, they can. Whether they should is where the debate comes in. I vote "yes" to both :)

ZippyGBR, BSN, RN · Nov 1, 2007

"General welfare of the United States", meaning the citizens, a country as a whole? Tax-paying citizens? Illegal immigrants too?
Come one, come all ..... and we'll pay your hospital bill!?

even in the single payer universal systems it;s only 'free (or there abouts) at the point of delivery ' for eligible residents of the country in question ( be they citiziens of the that country, citiziens of countires with reciprocal health coverage agreements e.g. the 'E111' counties of europe or others deemed eligible by the system)

in the case of the NHS Ambulance and A+E treatment is free unless you are involved in an RTC ( when themotor insurer can be billed) - as a non eligable individual if you get admitted to an nHS hospital you will be billed but and there are sysems to recover the costs - assuming that when you are booked into the hospital the correct data is input over your NHS eligibility...

ERGirl83 · Nov 1, 2007

My quick answer is no.
My long-winded answer is that the question is faulty. The "government" has no money of its own, and therefore pays for nothing. The question would be more accurate if it asked whether taxpayers should pay for the health care of anyone who wants or needs it. My answer would still be no, BTW.

A big fat ditto here...My family can't afford COBRA ( it's $1200 a month, more than our HOUSE payment ) and is being turned down for private insurance because of laughable things (ie a rear-end accident in which we were NOT injured, and my c/o fatigue after my son was born), while those who are in this country illegally are receiving free health care from MediCal and Medicaid, on MY dime. I can't say NO enough times.

EmmaG, RN · Nov 1, 2007

A big fat ditto here...My family can't afford COBRA ( it's $1200 a month, more than our HOUSE payment ) and is being turned down for private insurance because of laughable things (ie a rear-end accident in which we were NOT injured, and my c/o fatigue after my son was born), while those who are in this country illegally are receiving free health care from MediCal and Medicaid, on MY dime. I can't say NO enough times.

Apples and oranges...

A single-payer system would do away with that $1200/month COBRA payment, and denials based upon "pre-existing" conditions.