Ron Bischof: Government ‘health care’ and the US Constitution

An American flag waves in the wind outside of City Hall in Valencia. Katharine Lotze/Signal

Our republic is again embroiled in a contentious debate over the federal government’s role in “health care.” I use “scare quotes” here because the issue currently under debate is fundamentally about funding of medical services and who pays for them.

My fellow columnists have written thoughtful and concerning columns that have addressed their challenges with PPACA (Obamacare), health insurance carriers and prospective legislative solutions to address the defects in our health-care delivery and financing system.

This column will offer a perspective that’s been largely overlooked in our community discussion, namely: What is the federal government’s authority to regulate health-care services and its financing for more than 320 million U.S. citizen residents in their respective states and territories?

Bear with me a moment as I review the federal government’s defined role in our constitutional republic.

The federal government is one of enumerated powers, i.e., they are specific and defined in our Constitution when addressing the role of the legislature in Article 1, Section 8 ( In it, the structure of the national government, courts, authorization to levy taxes/tariffs, enter into treaties, raise armies, etc., are clearly delineated. The executive and judicial branches are similarly defined in Article II ( and III (, respectively .

Equally clearly, our federal government has been operating beyond constitutionally defined parameters for more than 100 years, and I won’t digress into that history here.

However, this isn’t a rationale for continuation or expansion of unconstitutionality. Instead, it’s an argument for realigning our federal government back to its original role as architected by our Founding Fathers with a concomitant restoration of state powers under control of The People.

Founder and future President James Madison expounded upon the organization of the relationship of the proposed federal government in relation to the States in Federalist 45 this way:

“The powers delegated by the proposed Constitution to the federal government are few and defined. Those which are to remain in the State governments are numerous and indefinite. The former will be exercised principally on external objects, as war, peace, negotiation, and foreign commerce; with which last the power of taxation will, for the most part, be connected.

“The powers reserved to the several States will extend to all the objects which, in the ordinary course of affairs, concern the lives, liberties, and properties of the people, and the internal order, improvement, and prosperity of the State.

The operations of the federal government will be most extensive and important in times of war and danger; those of the State governments, in times of peace and security.

“As the former periods will probably bear a small proportion to the latter, the State governments will here enjoy another advantage over the federal government. The more adequate, indeed, the federal powers may be rendered to the national defense, the less frequent will be those scenes of danger which might favor their ascendancy over the governments of the particular States” (


Here’s why it’s important: once we allow the federal government to operate beyond its enumerated powers, there’s no limiting principle. As recent history demonstrates, what follows is an incremental subtraction of liberty from The People with the siren call of expediency, citing the urgency of the time, often using martial language such as “War on [insert populist cause du jour].”

Our Constitution cannot be dismissed as an obsolete anachronism of a bygone age by those who have diligently studied it and fully comprehend its enduring principles. It is the foundation of the rule of law in our republic and was formulated by men of exceptional ability and vision.

Many scholars consider the Declaration of Independence and the Federalist Papers as the pinnacle of Enlightenment thinking, with the latter being the finest treatise on the role of government extant. The principles and system of government enshrined in our Constitution are timeless.

What, then, is to be done? Others have observed that we are far down this unconstitutional road and perhaps the best “solution” to “health care” is to emulate social democracies in Europe and the Anglosphere with single-payer and other methodologies of socializing medical care costs and its financing with the attendant appeals to popularity, emotion, etc.

Is it wise to “compromise” the principles of limited government and cede liberty to politicians and a legion of technocrats in the unelected administrative state?

We’ll examine the practicality of that premise in another column and I close with this quote:

“Necessity is the plea for every infringement of human freedom. It is the argument of tyrants; it is the creed of slaves.” ― William Pitt the Younger

Ron Bischof is a Saugus resident.


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