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La Stampa: Obamacare and American Exceptionalism


Originally published in LA STAMPA.

Many Europeans by now must be shaking their heads in either disgust or bewilderment at America’s ongoing debate over health-care reform.

Two years ago, President Obama signed into law the “Patient Protection and Affordable Care Act,” better known as Obamacare. Last month, the U.S. Supreme Court heard arguments that the law’s central provision—the government requirement that every adult buy health-care insurance—was unconstitutional. Though most everyone agrees that the nation’s health-care costs are out of control, Americans remain deeply divided over what to do about it.

Europeans—who consider universal health care the mark of a just society—wonder why the richest and most generous country in the world resists a government effort to provide quality health care for all its citizens. Do Americans care more about “free markets” than they do about taking care of their sick?

The answer goes to the heart of American Exceptionalism: our insistence on the fundamental rights and sovereignty of the individual citizen against the claims of the State. James Madison, the key architect of the U.S. Constitution, put it this way: “The people are the only legitimate fountain of power, and it is from them that the constitutional charter, under which the several branches of government hold their power, is derived.”

For the American Founders, it was not enough to have a separation of powers between the executive, legislative and judicial branches of government. Nor was it sufficient to have a “bill of rights,” a parchment promise that might be shredded by the State. To preserve liberty, the American Constitution must also severely limit the power of the national government—even with the noblest social goals in mind—to reach into the sovereign realm of the states.

Why? Because the American Founders held a view of government that was shaped not only by the Enlightenment, but also by Protestant Christianity. They designed a Constitution that was realistic about human nature: aware that our capacity for reason and virtue is constantly threatened by the lust to dominate. Madison summarized their view thus: “The truth is that all men having power ought to be distrusted.”

Most Americans reject Obamacare because it grants too much power to the institution most likely to abuse it—the national government.

What Obamacare mandates is something the Constitution does not authorize. Private companies are forced to provide services deemed necessary by the State—in the case of contraception, free of charge—subject to government controls. For the first time, private citizens are ordered by the federal government to purchase a service from a private company, whether they want it or not.

This is why Supreme Court Justice Anthony Kennedy—a moderate on the Court—declared bluntly in arguments last month that the law “changes the relationship of the Federal Government to the individual in a very fundamental way.” Kennedy suggested that the State carried “a heavy burden of justification” to show it was empowered “under the Constitution” to act in the way it did. Only those living in a liberal echo chamber could be shocked by such concerns.

Most critics of Obamacare agree that there’s a role for the national government in health care. But they want the states and the private sector—those institutions most accountable to the people—to take the lead in reform. The great hubris of the Obama administration, embodied in the 2,100-page law, is to assume that only entrenched elites in Washington, D.C. can solve the nation’s health-care problems.

But this is a recipe for failure and disillusionment with government—a condition afflicting Europeans in profound ways. When I travel in Italy, I am often struck by the cynicism of many Italians with their government. While in Naples a couple of years ago, during election season, I noticed this campaign slogan from one of the candidates: “Non faro nulla, ma lo faro molto bene.” (“I will do nothing, but I will do it very well.”)

A Supreme Court decision over the health care law is expected in June. If the Obama administration wins its argument in court, it will be a dark victory. Not only will the law fail to slow the costs of health care. More importantly, it will open the floodgates to government regulation and coercion in vast new areas of social and political life. It will worsen our political divisions. The remedy will be worse than the disease.

Europeans baffled by America’s resistance to national health care might recall James Madison’s warning about such remedies: “We are right to take alarm at the first experiment upon our liberties.” By constitutional standards, Obamacare is a radical experiment upon our liberties, and Americans in large numbers are greatly alarmed.

Giuseppe Loconte, PhD, is a professor of history at The King’s College in New York City and the author of The Searchers: A Quest for Faith in the Valley of Doubt.

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