Tuesday, July 28, 2009

Universal Health Care and The Constitution

A quotation from the Constitution of the United States of America:
"We the People of the United States, in Order to...promote the general Welfare...do ordain and establish this Constitution for the United States of America."
I would like to analyze this part of the Constitution. I do so in light of the current discussion regarding Universal Health Care in the United States. Does the statement that the constitutional government is responsible for the "general Welfare" of the country imply that universal health care is indeed guaranteed by the Constitution?

It would seem that two important words in this statement need to be understood to properly interpret the semantic message: "promote" and "Welfare." If promote implies something along the lines of "provide," "cause to exist," "ensure," or "guarantee," then the government is required constitutionally to provide Welfare generally to those it presides over. Then, if "Welfare" implies something along the lines of "physical health" or "well being," the government must promote that. If both words have those certain meanings, the constitution can be said to require that which it creates to provide physical health generally.

First, "Welfare."

In 1996, the Random House Webster's Dictionary defined welfare as "the good fortune, health, happiness, prosperity...of a person, group, or organization; well-being." This is how we might define it today. However, how was it defined in 1787 and 1788? The oldest American English dictionary I have access to is the 1828 American Dictionary of the English Language by Noah Webster. Although meanings of words can change much more quickly than thirty years, I will use this dictionary out of convenience.

The 1828 Webster's Dictionary defines welfare when used in the context of "states" (as opposed to "persons") as "exemption from any unusual evil or calamity; the enjoyment of peace and prosperity, or the ordinary blessings of society and civil government." The same word as applied to "persons" is defined as "exemption from misfortune, sickness, calamity or evil; the enjoyment of health and the common blessings of life; prosperity; happiness." Note the critical differences as they apply to the context of this examination! When applied to persons, sickness and health become part of welfare. So, is the Constitution referring to the "general Welfare" of the country or of the people?

Let's look at the entire paragraph for additional context:
"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, 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."
Note the syntactical structure of the paragraph. It may perhaps be rewritten like this:
"We the People of the United States, in Order to [form A, establish B, insure C, provide D, promote E, and secure F]...to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."
So, looking at it in this way (if this way is proper as applied to late Eighteenth Century English), it would seem that the Constitution was ordained and established, in part, to "promote the general Welfare...to [our forefathers] and [us]." Therefore, it would seem that the guarantee of "general Welfare" is applied to "persons" rather than a "state."

In light of that information, the definition in this examination of "Welfare" as used in the opening paragraph of the Constitution will be "exemption from misfortune, sickness, calamity or evil; the enjoyment of health and the common blessings of life; prosperity; happiness." This gives us a more expanded meaning: "promote the general Welfare" becomes "...promote the general exemption from...sickness..." or "promote the general...enjoyment of health...," in part. (I should note here that in many instances, I am shortening the quotations to provide an easier read by only including things that are most obviously associated with the context of this discussion.)

We now must examine the meaning of the word "promote."

The 1996 Webster's Dictionary defines "promote" as used in such a context as "to help or encourage to exist or flourish; [to] further." The 1828 definition is "to forward; to advance; to contribute to the growth, enlargement or excellence of any thing valuable..." This shows that our meaning today and the meaning in 1828 is not as different as one might think.

Armed with this extremely brief examination, here is what might be a possible rewording of "promote the general Welfare":
"to help or to encourage to exist...the general exemption from...sickness..." or "to help or to encourage to exist...the general...enjoyment of health..."
How does the organization that the Constitution creates (the government) "help...or encourage...the general...enjoyment of health?" In other words, how does the government help each citizen enjoy "[good] health?"

There are, of course many ways to do this. One way is through Universal Health Care. This provides an equal guarantee of good health to each citizen whether they are rich or poor. In my opinion, each citizen should only be provided government sponsored health care if they cannot afford it on their own. However, with 300,000,000 people to deal with, it is probably unfeasible to create any sort of regulation on such a system without it becoming too general and missing important special cases. Therefore, in the interest of compromise, I am entirely supportive of a Universal Health Care system to be established in the United States of America...

...if the collection of taxes becomes more fair.