Why health care is not in the Constitution

Of course the idea of health care is not in the Constitution. Neither are astronauts. Health care as we know it did not exist at the time of our nation's founding.

"Any sufficiently advanced technology is indistinguishable from magic." -- Arthur C. Clarke (1917-2008)

Were America's founders to be transported to 2009 they would feel as if they were in a magic land.

None might be amazed so much as Dr. Benjamin Rush, the physician who signed the Declaration of Independence.

(This statue of Rush stands before the Bureau of Medicine and Surgery in Washington, D.C.)

Given a choice between treatment by a native American medicine man and Dr. Rush, I would have advised the shaman, who might at least offer soothing herbs and the placebo effect of ceremony. Choosing between the esteemed Dr. Rush and a barber might be a close contest.

Rush knew all there was to know of medical practices in his time, but those practices were barbaric, even counter-productive. He bled people for nearly any cause. He had no clue that mosquitoes could have caused the 1793 Yellow Fever outbreak in his city.

Everything we take for granted in medicine -- the germ theory of disease, anesthetics, even aspirin -- were unknown during Rush's time. While there is a scene in the John Adams miniseries of Rush trying to cure breast cancer by removing the breast, such cures were, at the time, almost invariably worse than the disease.

So of course the idea of health care is not in the Constitution. Neither are astronauts. Health care as we know it did not exist at the time of our nation's founding.

What is at issue is a more basic question, one I will leave for the trolls to chew on. Is there a right to basic health care, or is it a mere market good?

On that question hangs the larger question of our time.

If there is no right to care, then our present system is fine. But as heft meant wealth in the 19th century and fitness meant wealth in the 20th, so are you making it likely that age will define wealth, with vast armies of young people facing ever-smaller coteries of ancients. That's less Arthur Clarke and more M. Night Shaymalan.

On the other hand if there is a right to basic care, then your solutions for payment are constrained, and the very questions the health care scaremongers are asking move from the private sector to the public.

Which is where I believe they should be.