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Obamacare and liberty


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The Supreme Court heard arguments this week for and against the constitutionality of the Affordable Care Act of 2010 (aka "Obamacare"), specifically its chief funding mechanism, the individual mandate that requires everyone either to purchase health insurance or pay a substantial fine. To make the system economically feasible, the pool of insured must include lots of young, healthy people who pay into the system but require few if any of its services. That's how insurance works. It's a risk-management system. It depends on the willingness of people who fear disaster but never end up suffering it paying for the comparatively few people who end up needing help. But free people are free to judge their own risk and free to buy into an insurance pool if they wish.

Obamacare is a government-controlled healthcare system, though not a government-funded one. Congress and the Obama administration could have provided universal healthcare as a tax-funded government service, but there was no majority support for it by lawmakers. So instead they went the individual mandate route. The problem is that in this free republic the federal government has no authority to make people buy things unless as a condition of something they choose to do, e.g., the way state governments require people to buy auto insurance if they choose to drive. The administration argues that buying health insurance is a condition of using the healthcare system that everyone eventually uses. The issue for proponents is not people's freedom to judge their risk, but who will pay the inevitable hospital bills. For them it is not a question of liberty but of responsibility.

But hospital bills are not inevitable. I knew a farm wife in Iowa named Norma. She was in her 80s and had never been to the doctor because she had never been sick a day in her life. Eventually something put her in the hospital, where she soon died. Her modest estate was more than sufficient to pay for any bills she left behind.

Norma was an American citizen with the right to security in her property. Our system of government is called "liberal constitutionalism." It is constitutionalist because the government that governs us is itself governed by a fundamental law, the Constitution. It may do only what the Constitution says it can do. It is liberal in that its purpose is to preserve everyone, not just most people, in his or her individual liberty. Government is not free to violate even one person's rights, not even for what it considers the greater good. In these ways it is "limited government." When government exceeds those limits, it's called tyranny. When the court invalidates an unconstitutional act, it's not being an activist court; it's just doing its job.

In June, the Supreme Court will announce its decision on whether the individual mandate violates the Constitution, i.e., whether it's tyrannical. I hope the court considers that if it is tyrannical to one person, someone like Norma, then it is simply tyrannical and cannot legitimately govern a free people.


D.C. Innes

D.C. is associate professor of politics at The King's College in New York City and co-author of Left, Right, and Christ: Evangelical Faith in Politics. He is a former WORLD columnist.

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