By Douglas V. Gibbs
Healthcare has become an important issue in the United States, and it should be. Being able to manage one’s health ranks high along with housing, food, and many of the modern conveniences most of us take for granted in today’s world. With the emergence of Obamacare in 2010 the “Affordable Care Act” changed the face of health insurance, and the federal government’s intrusion into an issue that the United States Constitution provides no federal authority for.
When it comes to the Constitution the rule of thumb is that if an issue is mentioned in the Constitution it is likely a federal power, and if it is not it is a State power. The Enumeration Doctrine establishes that all powers authorized to the federal government must be expressly enumerated in the Constitution in order for the federal to exercise any authority over the issue in question. However, per the Tenth Amendment, if the power is not delegated to the federal government by the Constitution, and it is not listed in the Constitution as a prohibition to the States, then the States (or the people) possess authority over the issue and may make laws regarding the issue as they see fit – providing that there is no conflict with their State Constitution.
Some might argue in favor of a concept known as “Implied Law,” which states that the federal government possesses implied powers that are not necessarily enumerated in the Constitution, but are implied by its language. Using that argument those who believe the Constitution fell short in the number of powers it gives to the federal government have historically used the General Welfare Clause as an excuse to make pretty much any law they desire. Using the General Welfare Clause, a concept also referred to as the “Common Good,” to give Congress nearly unlimited power when it came to their ability to make law was rejected by nearly all of the Founding Fathers save for a few like Alexander Hamilton. During the Constitutional Convention Hamilton argued that the federal government should possess more powers than provided by the Constitution, later calling the document frail and establishing the concept of Implied Powers while arguing for the creation of a central bank which eventually emerged as the First Bank of the United States. His opponents feared Implied Law would open the floodgates that would lead to a “National Government” that would become all-powerful over the States, and one that would eventually erase State Sovereignty and lead America down the path to tyranny, and ultimately its demise.
Using the originalism point of view regarding the Constitution, one might argue that the Enumeration Doctrine dictates that the federal government has no authority whatsoever regarding health care. Health, medicine, medical procedures, nor insurance are mentioned anywhere in the first seven articles of the Constitution, nor in any of the subsequent amendments. Therefore, healthcare is none of the federal government’s business. Any and all laws regarding the healthcare system, health insurance, and ultimately the Affordable Care Act are unconstitutional, despite the United States Supreme Court’s controversial ruling in 2012.
That all said, there is also no clause in the Constitution that prohibits the States from passing any laws regarding healthcare. It’s a local issue, an originalist might argue, so while the federal government has no authority regarding the issue, barring any prohibitions in its State Constitution any State may create any laws it believes it needs to make regarding healthcare.
Historically, the whole healthcare issue became problematic because of federal interference in the first place. Long ago doctors operated in a truly free market system when it came to providing healthcare services to their patients. Doctors competed for your business, which in a free market tends to drive up quality and reduce the cost of the service or product being offered. Competition in a truly free market is a wonderful thing. As time passed, the wealthy created a collectivistic concept of pulling together their money into health insurance programs which would allow one to pay into that pool of money regularly, and then if a medical emergency came up the pool may be accessed to cover the medical costs that had emerged due to the medical situation. Lower economic classes tended to live paycheck to paycheck so the luxury of health insurance was typically not available to anyone outside the upper elite economic realm.
An exception to the health insurance for the wealthy concept was jobs that were hazardous. Often employers who offered employment in fields that placed one’s health at risk resorted to offering health insurance in order to convince people to become employed in the dangerous line of work being offered; an offer that began to become more and more common during the late nineteenth century. During the first few decades of the twentieth century there were a number of pushes for government mandating health insurance for workers in all fields, but the legislative response never seemed to materialize.
Family doctors, competing for the average citizen’s dollar, provided unique services such as house calls, and most doctors performed services that we only see at hospitals today because most folks couldn’t afford a hospital stay. The family doctor, for example, often performed surgeries, and the birthing of children during their normal work week. The results were often not as sterile or professional as one might receive in the hospitals, or by doctors who catered to the wealthy who had health insurance, but the services were provided nonetheless and the average person usually found a way to afford those services. Doctors might even personally set up payment plans with their patients to help them along with the affordability part.
During the Great Depression the Roosevelt Administration put into place wage controls in the hope of assisting the working man in securing a job, and keeping down inflation. Since employers could not entice the best candidates with higher pay, they began to throw in benefits, and health insurance became one of the benefits being offered by employers at the time. The practice spread, and by the time the Depression was over the concept of employers offering health insurance became common. In 1954 the IRS Code was amended to allow employers to deduct expenses associated with offering health insurance, and in the 1960s Medicare and Medicaid emerged. In 1974 the Employee Retirement Income Security Act, in 1985 the Consolidated Omnibus Budget Reconciliation Act, and in 1996 the Health Insurance Portability and Accountability Act all added federal requirements to assist employees if they leave or change jobs. During the 1990s HMOs became the norm, encouraged by legislation passed by many States with the aim of making it easier for smaller companies to offer health insurance. A mandate requiring employers to offer health insurance was attempted in 1974, and again in 1993, but neither proposal made it through Congress. Some States have created mandates, but it’s not universal. A federal employer mandate, or as close as you could get to a mandate, was written into the Affordable Care Act, and Employers have been essentially mandated to offer health insurance to their employees since 2016. The mandate, however, is technically voluntary, but to not offer health insurance if a business employs fifty or more full-time employees results in an additional tax. As a result, some companies have all but eliminated full-time employment to avoid the penalty. Over time the tendency to avoid the mandate by not hiring full-time weakened, and by 2018 the increase of part-time employment as a result of Obamacare was considered negligible.
Which brings me to the whole point of this article…
One of the unfortunate consequences of Obamacare was that it drove up the cost of private insurance. The Obamacare programs themselves have not been much cheaper, and despite its promises, often users found the healthcare costs from their Obamacare program partially deducted from their tax returns later. While the Obamacare game was in full swing, and being debated on The Hill and adjusted by The Courts, I was in the Construction industry. Up until 2008 I had a PPO through my employer, which was costly but I could afford it – and we appreciated its benefits. When the Housing Bubble burst I found myself in a company that went from working seven crews six days per week to one crew working two days per week. I could no longer afford to take care of my family in the residential construction industry, so I left my job and began driving a sand and gravel truck. After fourteen months with a company that paid by the hour I moved over to a company that paid by the load in order to make more money and be rewarded for working harder and longer hours. Shortly after, California changed its laws, and being paid by the load was no longer legally allowed; killing a good chunk of my income and forcing my wife and I to cut back and live literally paycheck to paycheck. Then, in 2014 I was struck by a vehicle on a job site, and my Worker’s Compensation situation changed my life forever.
The damage to my back and right shoulder was such that it made it difficult to perform my tasks without considerable pain. The ability to lift the arm of my trailer to reconnect it to the truck after finishing dumping my sand or gravel load became nearly impossible. It was taking me considerably longer to perform my tasks, and it was becoming more and more painful with each passing day. When I asked my employer about Worker’s Compensation so that I could properly heal, and then come back to my position later once I was good to go he offered alternatives, doing all he could to keep me out of the Worker’s Comp loop. The industrial doctors he kept sending me to would evaluate me has having bumps and bruises, and then would write that I could return to full duty; but I knew I couldn’t. So, I got a lawyer, demanding Worker’s Compensation. Then, it became an all-out war on the legal battlefield. Unfortunately, I wasn’t real good in the perception game. As a red-blooded American male, despite the pain, I made sure I still took out the trash, and carried out other household chores, while going to my medical appointments throughout the week. Investigators took their pictures and their films, and it was used as incriminating evidence against me. Never mind the grimace on my face as I performed those duties, as far as the lawyers and the courts were concerned, if I could take out the trash and drive to a radio studio once per week, then I could return to my full duty on my job. The company then fired me, and I received no more medical care through the Worker’s Compensation program.
The pain continued and even worsened as the weeks passed, and I knew I could not perform well enough on a job to take care of my family as I had. My health insurance went bye-bye along with my job, and the cost of health insurance through my wife’s employer, an employer who conveniently kept her just under the hours that would make her a full-time employee in order to avoid the Obamacare punishment, was nearly equal to her paycheck and so the result would be not good for us financially. We basically had a choice. I needed to somehow find employment and work in pain so that we could afford health insurance, or I needed to not work but then to pay the bills through her paycheck and my VA Compensation which would mean we would have to forego having any health insurance for the time being. We opted for the latter, hoping that my work with my endeavors regarding teaching the Constitution would eventually add up to enough income to buy health insurance – a cost that had been driven up to unaffordability thanks to Obamacare.
So, since 2014 my wife has lived under the specter of no health insurance and we have hoped and prayed every day since then that she would not get sick. I am a partially disabled military veteran so I receive care through the Veteran’s Administration family of medical facilities and hospitals, but she was completely uninsured and our economic welfare was dependent upon her not getting seriously sick or injured.
As luck would have it, her health remained fairly good, until last week.
When arguing with lefties about Safety-Net programs, like state-sponsored health care, food stamps, and other benefits typically offered to folks who reside in an economic region we typically call “poverty,” I explain that the federal government possesses no authority to offer any kind of welfare programs or health insurance programs, whatsoever. However, if a State wishes to offer those programs, they are constitutionally more than welcome to do so. Programs can be a very good thing for folks when disaster strikes, but I have never believed that anyone should make using those programs a lifestyle. Utilize them to resolve your situation, get back on your feet, or whatever you need to do, and then leave those programs behind and provide for yourself. That attitude has never changed, despite my sudden need for assistance of late.
As the old saying goes, Stuff Happens (okay, perhaps that first word that begins with “S” typically is of a four-letter version of itself, but this is a family website so we’ll go with “stuff” for now) and every once in a while even those you don’t expect require a hand-up every once in a while. In our case, we had already thrown the dice, one might say, quite a few times when it came to our healthcare gambles. During that time my wife has become diabetic, and her blood pressure is higher than it ought to be. I, myself, have bounced around the borderline when it comes to diabetes, but with diet and other changes to my lifestyle as well as some holistic methods that includes Cinnamon, Chromium, and Apple Cider Vinegar my numbers of come down a bit and I don’t worry about blood sugar levels quite like my wife needs to.
Earlier this year my wife got sick, and without health insurance I took her to the emergency room where they announced her blood sugar was dangerously high – 700. They would not let her go until their IVs and other efforts brought her level down below 400. The bill was a tad bit north of $6,000, which we began paying payments on, but I was happy she was alive and relatively back to normal. By early July we sold our house in Southern California and paid off the hospital and most of our other obligations (there’s still a couple left with balances, but we are finally free from the paycheck to paycheck lifestyle) thanks to the fact that when my father died in 1999 he left me a property on the Oregon Coast, and at the time I absorbed its mortgage into my own mortgage in Southern California so that the property in Oregon would be paid off when we decided to finally move there. On July 9 of this year we drove the second, and final, U-Haul down the driveway in Murrieta and arrived at our new-used home the next day.
We celebrated forty years of marriage in August, and since we’ve been at our new location our marriage is stronger than ever. We joke about it, saying it’s “us against the world.” The absence of the distractions of family drama and influences sure has been nice, too.
My constitutional efforts in the form of live classes, and teaching U.S. History to kids in various homeschool programs, came to an end, therefore I lost a significant part of my income, but my VA Benefits as a military veteran is enough to live up here without her having to work anymore. She retired on July 6, mere days before our departure, and while she has no pension or 401K or anything like that, our life outside the rat race here has been more than satisfactory.
We returned to Southern California for a few events last week, since I am still doing the public speaking thing. I spoke in Torrance on September 12, Fallbrook on September 13, and Murrieta on September 14. A friend put us up in his casita at his house, helping us keep the cost of the trip down, and after all of the dust settled we pretty much broke even. Nonetheless, it was a rewarding trip, and it was great to see old friends again.
Somewhere between Torrance and Fallbrook my wife was bitten on the arm by some kind of bug. The bites bubbled up, and then a rash of hives and red splotches began appearing all over her body, including one of her cheeks. By the time of our departure she was fearing the rashes and hives that had spread all over her body might cause bigger problems, and the original bites were getting infected. So, we hit an Urgent Care location in Temecula, a place we’d used many times before, to have a doctor take a look at it. He advised he believed it to be a reaction to a bug bite, and told me to continue the Benadryl I had been giving my wife, plus he added an anti-biotic and a topical ointment for the skin issues. He also added Prednisone, a steroidal medicine, but advised it would spike her blood sugar and with her being diabetic it was to be a last resort should her condition not improve after a couple days. Her condition did not improve, so a day after we arrived at our home in Oregon, on Tuesday, she took one Prednisone pill.
The following morning my wife was changed. Altered. Childlike. I have a friend whose wife has dementia and my wife was acting like her. She had also become very weak, and unbalanced when she tried to stand. Her eyes were not the eyes of my wife, but of a confused and simple mind. I had to lift her out of bed and guide her to the toilet. She was confused regarding what was going on, and suddenly unfamiliar with the things that should have been familiar to her. She could no longer perform simple tasks, form coherent sentences, and her eyesight was blurry. Frightened, I took her to the local emergency room where the staff began testing her for everything, which included an MRI, a Cat-Scan, and other very expensive tests and treatments. The day we had been fearing might arrive when we began to gamble with not having health insurance had finally arrived. I just knew that we were finally going to be totally financially ruined by her sudden turn for the worse. I talked to the financial lady in the Emergency Room with the electric cart on wheels so that she could take down one’s insurance information and she referred me to someone else at the facility to discuss what I could do to get some kind of insurance for my wife – something we had neglected to procure up to that moment – and the response was that I make too much money with my VA Benefits to get the State program, and while I could get private health insurance started, they are in business to make money and would not cover the sudden medical avalanche we were experiencing.
In my mind I was in a sudden panic.
Despite being told we did not qualify, I called the State of Oregon to find out more about their OHP program, and it turns out that my VA Benefits do not count against their maximum income requirements. From their point of view our income then is pretty much zero, aside from the pennies I make with book sales. The program accepted my wife with approval, and my fears of bankruptcy vanished like popping soap bubbles.
Now, for the takeaways…
Worker’s Compensation has been so screwed up by fraudulent cases that the ability to be approved has become tough, especially if the employer decides to hire a cut-throat law firm and a really good insurance investigator. You better play the part, and set aside your pride of getting things done despite the pain, or your case won’t see the light of day.
Unfortunately, it almost sounds like you have to be deceptive, but unless you are pretty much bed-ridden or dragging your lifeless limbs behind you for the camera, you are not going to win your case.
Constitutionally, the federal government has no business making any laws regarding health care, and if we think they should be able to then there needs to be an amendment to the Constitution. Insurance has killed the free market aspect of medical care, as has governmental interference and malpractice lawsuits, but despite all of the flaws we still have the best health care system in the world, largely due to the free market components that encourages innovation and competition. That said, I can say first-hand that I appreciate the fact that States have put in place programs such as Oregon’s OHP. It, for lack of a better way of saying it, saved our butts financially. That said, thank you, Oregon, but once I am able to afford it, I want the government less involved in my life and I will be seeking private insurance down the road, thank you very much.
Finally, it is amazing how politics influences all parts of our lives. Our healthcare journey was filled with many political potholes and a handful of smooth roadways, depending upon which part of the journey you are referring to. Which reminds us of three things: 1) Life can throw some pretty wicked curveballs our way so always be ready for them; 2) While State-sponsored programs can be expensive and shouldn’t be a way of life, they sure are handy when the chips are down and the craziest of things hit you square in the face during your life; and 3) Just because someone says the federal government has no business being involved in an issue that does not mean that the person is saying that the States shouldn’t be, either. The federal government is not supposed to be all things, nor involved in every issue. The Founding Fathers believed in localism, leaving the external responsibilities to the federal government, and the local stuff to the States. That’s a large part of what has made this country such an awesome place to live.
I hope this provided some clarity or retrospect for you in your own life, and thank you for believing in the principles that the Founding Fathers established.
— Political Pistachio Conservative News and Commentary
