Constitutional Right to Health Care–
High Road to Disaster
Should Oregon pass a Constitutional Amendment guaranteeing every legal resident access to health care as a “fundamental right”? Such a proposition was passed today by the Oregon Legislature and will be decided by the voters at the next General Election. Your opinion on this important question matters, please read on.
Just think of it, by the vote of the people, health care could become a fundamental right guaranteed by the Oregon Constitution. All 3.6 million Oregonians would have a “system designed to provide”¦effective and affordable health care on a regular basis.” This is the high and lofty goal inherent in my friend, Representative Mitch Greenlick’s, House Joint Resolution 18.
Who could oppose having the government provide such an important benefit to all Oregonians and why did House Joint Resolution 18 barely pass the House with a 32 to 27 vote, largely along party lines? Since health care is not and should not be a partisan issue, the answers to these questions relating to HJR 18 give insight that partially defines the basic political and philosophical differences between Oregon’s “conservatives” and “liberals.” (For Rep. Richardson Floor Debate speech on “YouTube”, click here.)
Who could oppose having the government provide such an important benefit to all Oregonians and why did HJR 18 barely pass the House with a 32 to 27 vote, largely along party lines? Since health care is not and should not be a partisan issue, the answers to these questions relating to HJR 18 give insight that partially defines the basic political and philosophical differences between Oregon’s “conservatives” and “liberals.”
Health care issues have been a primary focus for me since beginning my work on the Ways and Means health care subcommittee two years ago. I have studied Oregon’s key health care issues; I understand the need for comprehensive health care reform; and, I am committed to the goal of enabling all Oregonians to have access to affordable health care for themselves and their families. Yet, with all due respect to Representative Greenlick, there are two main reasons why I believe voting to place health care in Oregon’s Constitution would be a devastating mistake for Oregon: Cost and Constitutional.
Cost. Although a government guarantee of health care sounds plausible on the surface, its costs would be prohibitive. Oregon’s health care spending for 2008 is forecast to be $19.3 billion. Even if we deduct the $7.8 billion of Medicare, Medicaid and other federal payments, $11.5 billion dollars a year for Oregon health care is still a lot of money.
Where would Oregon get the money to fund the fundamental right to health care, if HJR 18 is passed by Oregon voters? You guessed it””a humongous tax increase. One source being bantered around the Capitol is a payroll tax to pay for universal health care. Since a 1% payroll tax would generate approximately $650 million per year, it would take an 18% payroll tax to fully fund the proposed “fundamental right” for just one year.
Unfortunately, health care costs increase at more than 7% annually. Since wages increase at only 3% annually, the required payroll tax would need to be increased every year just to maintain health care cost inflation levels.
Consider for a minute what Oregon employers and potential Oregon employers would think about having to pay an additional payroll tax of 18%, plus anticipated annual increases every year thereafter. Although unlikely, there might be employers who already pay more than 18% of payroll for group health care benefits. If you can find one, that employer might not mind replacing group insurance costs with such a payroll tax, but there are no guarantees that any money would be saved if Oregon’s Constitution require state payment of health care as a “fundamental right.” In that event the Oregon Legislature would be required to raise the money, however necessary, to meet the “fundamental” Constitutional requirement imposed by the people’s vote on HJR 18.
One final thought on the exorbitant cost of meeting the constitutional mandate for health care which would result from making health care a Constitutional right. When payroll taxes are unable to pay the escalating costs of universal health care, the largest pot of state money to dip into will be that allocated for K-12 education. What irony to imagine the Legislature diminishing its financial support for K-12 education because of the unanticipated high costs of paying for constitutionally mandated health care. Our children might be ignorant, but, by golly, they will be healthy. In such a world, Oregon’s undereducated youth will need to be healthy”¦manual labor is hard work.
Constitution. All Oregonians want access to health care when they need it, yet amending the Oregon Constitution is serious business. A constitutional amendment should only be considered after careful consideration of its consequences. There is a reason why in our nation’s 220 year history, neither the U.S. Constitution nor the constitution of any State has successfully implemented and retained a constitutional amendment promising statewide health care. For Oregon to do so now is a social experiment, and would effect a monumental change in the role and power of Oregon government.
Historically, from Thomas Jefferson’s foundational statement in the Declaration of Independence, America’s vision was to have a government limited in scope, and intended to protect its citizens, to regulate trade, currency and commerce, and to enable its citizens to enjoy their God (“Creator”) given rights to maintaining life, maintaining liberty and to being free to pursue personal happiness. Essentially, federal and State government were intended to be a shield to protect their citizens and enable them to live their private lives, pursue their personal interests and participate in their community affairs to whatever extent they felt appropriate within the constraints of orderly and lawful society. This political philosophy of limited government as proclaimed in the 10th amendment of the U.S. Constitution, and summarized in Thomas Paine’s, “That government is best which governs least”continued for nearly 140 years.
The American concept of such “limited government” prevailed until the era of President Roosevelt’s, New Deal politics of the 1930’s. In 1936, in response to the President’s “Court Packing” threat, the U.S. Supreme Court capitulated, reversed its prior rulings and granted Congress almost unrestrained power to spend on “general welfare” programs.
(This history review is important to the effects of HJR 18, so please read on.)
In 1938 the Court decided, United States v. Carolene Products Company, 304 U.S. 144 (1938). Carolene Products created a doctrine that established different levels of judical review with the highest level of protection reserved for “fundamental” constitutional rights. Essentially, a “fundamental” constitutional right will receive the highest level of Court scrutiny and protection. This brings us back to HJR 18. Mandating in the Oregon Constitution that health care is a “fundamental” right, which is a direct quote from HJR 18, may well result in Oregon’s Supreme Court determining that the Legislature must fund universal health care above other “non-fundamental” expenditures, regardless of the costs or consequences on other State programs, such as education.
Thus, in my opinion, although Oregon has already traded the “limited government” enjoyed by our forefathers, for the post New Deal era of social-welfare programs passed by Congress and State Legislatures, HJR 18 will result in a new and historic, Constitutionally-mandated “fundamental” right to State-funded health care”¦in other words, Constitutional Socialism..
HJR 18 is new ground. If Oregon is going to blaze the trail to Constitutional Socialism by providing government guaranteed solutions and “essential safeguards to human life” for health care, what about other and even more fundamental human needs? IF the people are going to be asked to mandate the State to provide health care, should the people also be asked to mandate other “fundamental rights,” such as for food and clothing and shelter?
Consider the logic. What benefit is health care if a person is malnourished, inadequately clothed or homeless? Should not a caring society that requires government mandated universal health care also address other, more basic needs for human survival? To point out the fallacy of HJR 18’s myopic focus, Representative Ron Maurer and I crafted an amendment and made a Floor Motion suggesting HJR 18 be sent back to committee to consider the appropriateness of the HJR 18-B11 Amendment.
The -B11 amendment merely states that if health care is worthy to become a fundamental government guaranteed right, then, by the same logic, the committee should give equal consideration to guaranteeing all 3.6 million Oregonians their food, clothing and shelter, as additional “fundamental rights” and “essential safeguards to human life.”
No one who voted for referring HJR 18 to committee supported the HJR 18-B11 amendments, but the debate made its point. Amending the Oregon State Constitution is serious business, and before making health care a “fundamental” right, we would be wise to consider the unworkable precedent it sets for other important “essential safeguards to human life.” In sum, I believe HJR 18 will introduce Constitutional Socialism to Oregon and to America and is a dangerous political experiment we should avoid.
Conclusion. HJR 18 is a misguided response to the high and escalating costs of health care insurance and treatment in Oregon. The cost of health insurance and health care treatment is beyond the reach of many individual and family budgets. Skyrocketing health care costs are a real problem, but a problem not solved by HJR 18. Oregon needs health care reform. I have explained my concerns about this serious issue in a prior newsletter. Meeting the need for universal access to health care will require time, effort and cooperation of government, industry, business and taxpayers. There will be no such coalition if a constitutional amendment mandating to the government responsibility to provide a “fundamental” right to health care to all legal residents of Oregon. Once the government is required to solve the problem, private participants will no longer have the same motivation to remain involved and invested in contributing to the solution.
In sum, although HJR 18 is well-intended, it places Oregon on the high road to disaster. It would implement Constitutional Socialism, while favoring health care ahead of food, clothing and shelter. It will make health care a “fundamental” right and require the Legislature to fund the costs of providing a “system” of universal health care to all 3.6 million legal residents of Oregon. And, it will mandate a state system of health care regardless of the costs to Oregon business, Oregon education, and Oregon taxpayers.
In the months ahead there will be much said about the pros of HJR 18. (It will be given a different Ballot Title and number). When the campaign promises sound too good to be true, I hope you will review this newsletter. I received valuable information from those who participated in the Real ID survey, and I hope you will spend 30 seconds to send me your vote on HJR 18’s idea of a constitutional amendment for health care.
Please click on my one-question survey below.