The blogosphere and talk radio are awash with opinion that the healthcare bill just passed violates the Constitution. The 10th Amendment is suddenly back in the headlines for the first time since, oh, about 1791. Various attorneys general are signalling their intention to challenge this legislation on constitutional grounds — even before it has been signed into law.

For 220 years now, the federal government has been on a singular trajectory: MORE. This healthcare bill is not a change of direction in that regard; it is simply the latest instance. I can’t say whether that is, overall, a good thing or a bad thing. The empirical evidence is that we have two hundred plus years of federal expansion, during which we have become the greatest nation on earth. Apparently, at the very least, federal expansion does not preclude national greatness.

That being said, I would like to see something from our elected officials who have blasted this bill for being unconstitutional. They should consistently vote in opposition to the myriad of federal programs that have accumulated over the years which have no more constitutional validity than this healthcare package. If this new health bill is unconstitutional, then surely so too are Medicare, Medicaid, and Social Security. What’s the difference? Why do those programs deserve annual appropriations but this new one does not?


I’ll start by saying I have zero respect for the doomsday predictions of the Republicans. This will not end life as we know it, or magically make us “socialists,” or break the budget. Rule #1 is never listen to extremist rhetoric.

Of course, that rule applies to the claims of the left, too. This bill will not solve the healthcare crisis, or fix Medicare/Medicaid for the coming generations, or bring the cost of healthcare down to a manageable level.

But, considering what it does do, and doesn’t do, I think it’s an okay step. It will create mechanisms to include most Americans in the healthcare insurance market. Funding their insurance is clearly better than funding their bankruptcies and their routine care delivered through expensive emergency rooms. It will begin to rein in Medicare entitlements, to the tune of half a trillion dollars over the next decade. (I still don’t understand why conservatives were vehemently opposed to the constraint of an entitlement program.) It fixes any number of obviously dysfunctional aspects of the current insurance markets: pre-existing conditions, lifetime and annual caps, capriciously dropped coverage. It begins to rectify the problem of the millions of Americans who decline insurance, and then mooch off the system when they get sick or injured. And it makes a dent, albeit a modest one, in future federal budget deficits by imposing a reasonable tax.

I have said from the beginning of this debate that the only thing worse than this bill is the status quo. I still generally believe that, in the sense that there were incalculably better bills that didn’t survive the political firestorm. But I’ve mellowed a bit in recent weeks. I came to see that there were multiple minority camps: one that favored universal coverage; another thatĀ favored the public option; and another (lesser sized) one that favored a health-savings account approach. None of them was able to muster a clear majority. And in that environment, getting this bill done is an astonishing political feat. Bottom line, we will be better off. Just nowhere near as well off as we would could have been.