As Americans wait to see whether or not TrumpCare will supplant the Affordable Care Act (Obamacare), the debate over constitutionality has shifted in the past eight years from whether or not Obamacare, a plan involving mandated health care, is constitutional (the Supreme Court ruled that it was back in 2012), to whether or not Republicans’ plan to repeal and replace the ACA is Constitutional.
A growing number of lawmakers are saying it’s not, including New York Attorney General Eric Schneiderman. He recently issued a warning to Congress, stating if legislation to repeal and replace Obamacare passes, he may sue.
Mandated health care for Americans — in 1798?
You may or may not agree with critics who point out that nowhere in the Constitution did the Founding Fathers authorize the United States to mandate that all citizens and legal residents have qualifying health care coverage.
Regardless, our earliest predecessors in the Merchant Marine, as well as those Founding Fathers who penned the Constitution may remember it a bit differently. In fact, Merchant Mariners benefitted from the first law authorizing the creation of a government operated marine hospital service that required privately employed sailors – the earliest U.S. Merchant Mariners – to buy health insurance. When the second President of the United States, John Adams, signed into law “An Act for the Relief of Sick and Disabled Seamen,” Congress at the time had no argument or question regarding its intentions.
So why were those first U.S. Merchant Mariners singled out for mandatory health insurance? Remember, America was an infant nation, trying to build a viable foreign trade in order to drive economic growth. The government depended on sailors and merchant ships to create trade relationships with far-off nations.
But the job of the Merchant Mariner in the late 18th and early 19th centuries was dangerous. Sailors were vulnerable to injuries, infections, illness, and death. When enough of these Merchant Mariners were unable to work, ships would become inoperable, and the nation’s economy would slow.
Congress realized that a healthy maritime workforce was essential to trade. Thus, they took measures to ensure health care was always available for these valuable contributors to the country’s economy.
What the law looked like
The health care law for merchant seamen created a series of hospitals constructed and operated by the federal government. These hospitals treated ill and injured Merchant Mariners. Sailors paid for this program through a mandatory tax. These sailors, who paid just over one percent of their wages, actually had no choice in the matter. If they wanted to work as sailors, they had to pay the tax.
European socialized medical programs work along these lines today, with mandatory health care taxes coming out of everyone’s payroll.
The first law of its kind, the United States government mandated that privately employed citizens pay taxes for health care services. Once the law took effect, ships could no longer sail in and out of ports until the ship’s owner had collected the tax from every sailor’s wage and handed it over to the government – in essence, the first payroll tax in U.S. history!
When a Merchant Mariner became injured or ill enough to need medical treatment, the government made sure he received it. As the U.S. grew, the government expanded this system to include sailors who worked on the nation’s rivers. It still exists today as the Public Health Service, an institution under the supervision of the U.S. Surgeon General.
Why it matters today
So, when you hear arguments that our Founding Fathers never desired mandated health care, remember something important. At the time the Merchant Mariner mandated health care law was passed, Thomas Jefferson was president of the Senate, and Jonathan Dayton was the Speaker of the House. Both men were among the Founding Fathers who drafted the Constitution.
The nation’s founders proved by their actions that they believed mandated health care was permissible within limits. However, today’s opponents are arguing that the founding fathers made no such distinction.
And while the current storm of criticism over Republican efforts to repeal and replace Obamacare has helped divide the nation, remember that the Merchant Marine brotherhood has a pioneering historical link to the Founding Fathers’ belief that mandating health insurance for merchant seamen was a step toward building the nation’s economy, resulting in the establishment of the Office of the Surgeon General of the United States.
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