From The Heritage Foundation:

We have heard a great deal about the costs and benefits of a “public option” and  “single-payer system.”  We have heard about the financial costs—and the other costs—of allowing the government to interfere with matters of life and death.  However, we haven’t heard whether the Constitution gives Congress the power to enact these plans. What does this say about the status of the Constitution in the minds our policymakers today?  If a concerned citizen asks a proponent of nationalized healthcare to point to the constitutional authority for such a law, he may hear that the “General Welfare” clause, the “Necessary and Proper” clause, or the “Interstate Commerce” clause enables Congress to create national public health insurance to act.

None of these clauses—or any others found in the Constitution—gives Congress the power to create a government healthcare system.

The “General Welfare” clause gives Congress the 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.”  This clause is not a grant of power to Congress (as constitutional law professor Gary Lawson has shown). It is a limit to a power given to Congress. It limits the purpose for which Congress can lay and collect taxes.

During the founding, some Anti-Federalists were concerned that this clause “amounts to an unlimited commission to exercise every power which may be alleged to be necessary for the common defence or general welfare.” But James Madison, the “Father of the Constitution,” explained very clearly that it granted no power to Congress. If the “General Welfare” clause gives Congress the power to promote the general welfare, then why specifically list the other powers in Article I, such as the power to establish post offices and post roads, or to coin money? Wouldn’t it be redundant to list them?

In short, as Madison argued, Congress derives no power from the general welfare clause, which merely serves to limit Congress’s power to lay and collect taxes.  Congress can only do so for purposes of common defense or general welfare, in the service of the powers granted to it elsewhere in Article I.

Second, “Necessary and Proper” gives Congress the power “to make all laws 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.”  Like the general welfare clause, this clause was not a stand-alone grant of power to Congress.  Rather, it authorizes Congress to make laws that are necessary (and also proper) to make the other grants of authority in Article I effectual.

In other words, the necessary and proper clause cannot itself authorize national public health insurance.  One would have to show that national public health insurance is necessary and proper to execute some other power granted in the Constitution.This puts the proponents of nationalized healthcare back where they started.

Lastly, proponents might argue that national health insurance is part of Congress power “to regulate commerce…among the several states.”  While progressives have often used this clause to expand the federal government, it does not apply especially to the creation of a national health insurance, because to create and engage in commerce is not the same thing as regulating commerce among the several states.

Nobody during the framing generation expected the commerce clause to expand the federal government’s authority to anything relating to or resembling commerce.  James Madison wrote that it is a power “which few oppose, and from which no apprehensions are entertained.”  The clause was designed to prevent some states from taxing goods that passed through their boundaries as those goods proceeded to market.

In case proponents of government healthcare latch on to another clause, the three clauses above and rest of Constitution are explained in depth in the Heritage Guide to the Constitution .

Of course, most progressive advocates of national health insurance are unconcerned whether the Constitution authorizes such a law when a pseudo-constitutional reasoning to reach the desired result will suffice.  But constitutionalists should not allow such attempts to dismiss the Constitution go unanswered.

More:

How’s That Government-run Health Care Working Out Britain?

The Telegraph reports:

Family told by NHS: Alzheimer’s is not a ‘health condition’

NHS Worcestershire ruled that Judith Roe, 74, did not qualify for NHS funding because her condition was a “social” rather than “health” problem, even though she was so ill she could not make a cup of tea and regularly left the stove on.

She was forced to sell her £200,000 home to pay her £600-a-week nursing home fees, which would have been funded if she had been categorised correctly.

Mrs Roe’s family appealed to the Health Service Ombudsman, which ruled that Mrs Roe’s assessment had been incorrect and her treatment should have been funded by the NHS. NHS Worcestershire has now reimbursed them for six years of care.

Her son, Richard, 40, urged other families in a similar situation to fight for the care they are entitled to.

He said: “The way the health trust behaved was scandalous. It has been very stressful.

“All the time we were told we were wrong while believing we were right.

“They told me I should count myself lucky because there are people that are more ill than my mother, which was an outrageous thing to say.

Substitute “Health Service Ombudsman” for the White House’s Independent Medicare Advisory Council and this story is exactly what life will be like for Americans under Obamacare.

Helen Evans a registered general nurse and citizen of the United Kingdom, details how her country slipped into a government-run health care rationing system:

The NHS was established in 1948. It is a single-payer health care system, directly administered by the British government, funded through taxation, and provided mainly by public-sector institutions. Because the NHS is a fully nationalized entity, the central government specifies the capital and current budgets of its regional health authorities and determines the expenditure on drugs by controlling the budgets given to each general practitioner. Overall, NHS health care is rationed through long waiting lists and, in some cases, omission of various treatments.

For the British government, the practice of HTA facilitates rationing by delay. It is a tool that aims to ensure that expensive new technologies are initially provided only in hospitals that have the technical capacity to evaluate them. While the NHS Research and Development Health Technology Assessment Programme is funded by the Department of Health and, according to its criteria, researches the costs, effectiveness, and impact of health technologies, the Medicines and Healthcare Products Regulatory Agency (MHRA) ensures that drugs and devices are safe.

In 1999, the government went a step further and set up the National Institute of Health and Clinical Excellence (NICE). At its heart is the Centre for Health Technology Evaluation that issues formal guidance on the use of new and existing medicines based on rigid and proscriptive “economic” and clinical formulas. With the NHS obliged to adhere to NICE’s pronouncements, criticism of NICE has been ceaseless, particularly from various patient organizations.

NICE is a controversial body. It has tried repeatedly to stop breast cancer patients from receiving the powerful breakthrough drug Herceptin and patients with Alzheimer’s disease from receiving the drug Aricept. The criteria by which this agency makes its decisions have been kept largely secret from the public. As is inevitable with any nationalized health care system, life-extending medicines such as those to treat renal cancers are refused on the grounds of limited resources and the need to make decisions based not on genuine market economics but on an artificial assessment of the benefit that may be gained by the patient and society “as a whole.”

In 2001, NICE deliberately restricted state-insured sufferers of multiple sclerosis from receiving the innovative medicine Beta Interferon. Claiming that its relatively high price jeopardized the efficacy of the NHS, patients with the more severe forms of the disease were told that they would have to go on suffering in the name of politically defined equity.

In more recent years, patients with painful and debilitating forms of rheumatoid arthritis have been informed by NICE that in many instances they will not be allowed to receive a sequential range of medicines that have often been proved to be of significant benefit. Instead, the institute decreed that “people will be prevented from trying a second anti-TNF treatment if the first does not work for their condition.”

Similarly, in August 2008, patients with kidney cancer continued to be denied effective treatments designed to prolong their lives, often by months or even a few years. The calculations used by NICE have been systematically disputed by clinical experts who are more concerned with patient welfare than with vote-seeking, but the institute has also come under fire for not involving doctors who are active on the front line of medicine: “With Sutent for instance, there was just one oncologist on the panel.”

In January 2009, patients with osteoporosis also fell foul of NICE. The institute declared that only a small minority of patients with this debilitating disease would receive the medicine Protelos, and even they would receive it only as an extreme last resort. While clinicians and osteoporosis support groups have pointed out that more than 70,000 hip fractures result in 13,000 premature deaths in the U.K. each year and that these otherwise avoidable episodes needlessly cost the NHS billions of pounds, not only are patients being denied necessary treatments, but taxpayers’ money is wasted.

Indeed, according to its annual reports and accounts, NICE is now spending more money on communicating its decisions than would be spent if it allowed patients access to many of the medicines it is so busy denying them. The money that the institute now spends on public relations campaigns “could have paid for 5,000 Alzheimer’s sufferers to get £2.50-a-day drugs for a year,” according to The Daily Mail.

Devoid of a market and the language of price, this top-down system ironically ignores many of the societal costs associated with failure to treat severe illness, such as illness-related unemployment. Moreover, the fact that preventing access to more costly medicines may save money in the short term overlooks the costs for the future. If older medicines lead to more rapid deterioration of a condition, the effect could be a more expensive hospital or nursing home episode later.

More:

• Obama’s Bait & Switch
• Obama Says He’s ‘Absolutely Confident’ He’ll Get a Health Care Bill—With or Without Republican Votes
• 400 Percent Profit Increase for Health Insurers Cited by Health Care Bill Backers is Selective, ‘Meaningless’ Number, Say Analysts
• Health Care Reform Bills Would Not Verify Citizenship Status of Beneficiaries, Conservative Analysts Say
• Poll: Majority of Americans Say No Health Care Reform Better than Passing Current Bill
• Obamacare to be 1 big ‘death panel’
• PROOF: Obamacare will lead to ‘Medical Murder’

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