National Healthcare and American Constitutional Culture

Posted: 3 Jul 2015

See all articles by William P. Marshall

William P. Marshall

University of North Carolina School of Law

Date Written: July 1, 2012

Abstract

The constitutional debate over national healthcare is more than a debate over the specifics of constitutional law. Rather it is debate grounded in constitutional culture — or what may be described as the non-legal traditions, narratives, and understandings that constitute our sense of American exceptionalism and help define who we are as a nation and as a people.

This article addresses whether the creation of a national healthcare program would be consistent with American constitutional culture. Part I briefly expands upon the legal point that there is no constitutional barrier to the enactment of a national healthcare system. Part II.A then identifies and discusses the two aspects of our constitutional culture that militate against the adoption of national healthcare: our belief in rugged individualism and our distrust of government. As this part notes, our national commitment to these narratives is deep and well-founded. But our national commitment to both of these aspects of our constitutional culture is necessarily measured. Neither the commitment to individualism nor to distrust of government is unlimited in scope; both are constrained by strong and compelling countervailing concerns. Part II.B then presents two equally fundamental aspects of our constitutional culture that support the adoption of a national healthcare system: our commitment to social mobility and our vision of the United States as a land of equal opportunity. This article concludes that national healthcare fits well within our constitutional traditions and comports with the aspects of American exceptionalism that best define who we are as a nation.

One important caveat: this article does not purport to address the specific constitutional claims that have been raised in relation to the Patient Protection and Affordable Care Act (PPACA). Although I believe that PPACA is constitutional, my comments are aimed at the provision of a system of national healthcare more generally.

Suggested Citation

Marshall, William P., National Healthcare and American Constitutional Culture (July 1, 2012). 35 Harvard Journal of Law and Public Policy 131 (2012), Available at SSRN: https://ssrn.com/abstract=2625809

William P. Marshall (Contact Author)

University of North Carolina School of Law ( email )

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Chapel Hill, NC 27599-3380
United States
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