Paul J. O'Rourke's Links
MARCH 24, 2010 4:24PM

News: Pres. Signs H-Care Insurance Mandate-212 Years Ago!

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A Lesson in American History, Healthcare and the Constitution for 14 State Attorneys General

Let’s begin today’s history lesson with the following news:

(CNN) -- Officials from 14 states have gone to court to block the historic overhaul of the U.S. health care system that President Obama signed into law Tuesday, arguing the law's requirement that individuals buy health insurance violates the Constitution.

Thirteen of those officials filed suit in a federal court in Pensacola, Florida, minutes after Obama signed the Patient Protection and Affordable Care Act. The complaint calls the act an "unprecedented encroachment on the sovereignty of the states" and asks a judge to block its enforcement.

"The Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty, that all citizens and legal residents have qualifying health care coverage," the lawsuit states.

The history lesson

In July, 1798, Congress passed, and President John Adams signed into law “An Act for the Relief of Sick and Disabled Seamen,” authorizing the creation of a marine hospital service, and mandating privately employed sailors to purchase healthcare insurance.

This legislation also created America’s first payroll tax, as a ship’s owner was required to deduct 20 cents from each sailor’s monthly pay and forward those receipts to the service, which in turn provided injured sailors hospital care. Failure to pay or account properly was discouraged by requiring a law violating owner or ship's captain to pay a 100 dollar fine.

This historical fact demolishes claims of “unprecedented” and "The Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty...”

Perhaps these somewhat incompetent attorneys general might wish to amend their lawsuits to conform to the 1798 precedent, and demand that the mandate and fines be linked to implementing a federal single payer healthcare insurance plan.

The other option is to name Presidents John Adams, Thomas Jefferson, James Madison et al. in the lawsuits. However, it might be difficult to convince a judge, or the public, that those men didn't know the limits of the Constitution.

Because the attorneys general research is obviously lacking a comprehensive review of history and the Constitution, I’m providing a copy of the 5th Congress’ 1798 legislation.

CHAP. LXXVII – An Act for the Relief of Sick and Disabled Seamen

Section 1.  Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled -

That from and after the first day of September next, the master or owner of every ship

or vessel of the United States, arriving from a foreign port into any

port of the United States, shall, before such ship or vessel shall be

admitted to an entry, render to the collector a true account of the

number of seamen, that shall have been employed on board such vessel

since she was last entered at any port in the United States,-and shall

pay to the said collector, at the rate of twenty cents per month for every

seaman so employed; which sum he is hereby authorized to retain out

of the wages of such seamen.


SEC2. . And be it further enacted, That from and after the first day

of September next, no collector shall grant to any ship or vessel whose

enrolment or license for carrying on the coasting trade has expired, a

new enrolment or license before the master of such ship or vessel shall

first render a true account to the collector, of the number of seamen,

and the time they have severally been employed on board such ship or

vessel, during the continuance of the license which has so expired, and

pay to such collector twenty cents per month for every month such

seamen have been severally employed, as aforesaid; which sum the said

master is hereby authorized to retain out of the wages of such seamen.

And if any such master shall render a false account of the number of  men, and the length of time they have severally been employed, as is

herein required, he shall forfeit and pay one hundred dollars.


SEC3. . And be it further enacted, That it shall be the duty of the

several collectors to make a quarterly return of the sums collected by

them, respectively, by virtue of this act, to the Secretary of the Treasury;

and the President of the United States is hereby authorized, out of the same, to provide for the temporary relief and maintenance of sick or

disabled seamen, in the hospitals or other proper institutions now established

in the several ports of the United States, or, in ports where no

such institutions exist, then in such other manner as he shall direct:

Provided, that the monies collected in any one district, shall be expended

within the same.


SEC. 4. .And be it further enacted, That if any surplus shall remain

of the monies to be collected by virtue of this act, after defraying the

expense of such temporary relief and support, that the same, together ,

with such private donations as may be made for that purpose (which the

President is hereby authorized to receive) shall be invested in the stock

of the United States, under the direction of the President; and when,

in his opinion, a sufficient fund shall be accumulated, he is hereby

authorized to purchase or receive cessions or donations of ground or

provision for buildings, in the name of the United States, and to cause buildings,

when necessary, to be erected as hospitals for the accommodation of sick and disabled seamen.


SEC5. . And be it further enacted, That the President of the United

States be, and he is hereby authorized to nominate and appoint, in

such ports of the United States, as he may think proper, one or more

persons, to be called directors of the marine hospital of the United

States, whose duty it shall be to direct the expenditure of the fund

assigned for their respective ports, according to the third section of this

act; to provide for the accommodation of sick and disabled seamen,

under such general instructions as shall be given by, the President of

the United States, for that purpose, and also subject to the like general

instructions, to direct and govern such hospitals as the President may

direct to be built in the respective ports: and that the said directors

shall hold their offices during the pleasure of the President, who is

authorized to fill up all vacancies that may be occasioned by the death

or removal of any of the persons so to be appointed. And the said

directors shall render an account of the monies received and expended

by them, once in every quarter of a year, to the Secretary of the Treasury,

or such other person as the President shall direct; but no other

allowance or compensation shall be made to the said directors, except

the payment of such expenses as they may incur in the actual discharge

of the duties required by this act.


APPROVED July 16, 1798.


Here's a link to more details in another article on this subject written about how this act relates to the issue of government single payer healthcare insurance.

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I apologize to those who notice I've written about this before, but I'm waiting for TPTB to take notice. This is a rather large debunking of the Republican healthcare memes.
What a waste of time and effort on the part of these AGs. I'm curious to see where this one is heading.
So, Mr. O'Rourke. I don't mean to sound ignorant but do you think this is precedent enough? I mean, what the hell is going on here? Just looking at this from my somewhat uneducated position, it looks like they've either lost their shite or are attempting to make a statement, regardless of the validity of the lawsuits. Is there a snowballs chance that they'll find a crazy loophole? Wouldn't the Prez and Congress be a bit more hip to the legalities? Oh, so many questions and so little time...birdog
It is precedent enough on the issue of both "public option," single payer healthcare insurance and the constitutionality of federal insurance mandates.
The difference between public/private insurance is, perhaps, a legitimate arguable point, compared to this 1798 legislation.
Even without this info, the lawsuits are, in my opinion, mostly about political theater.
Of course it's theater: the red, white and blue bullshit company. The stunts are getting more ridiculous by the day. I guess the American people are getting even stupider.

Thanks for this, my friend, rated.
I agree with you on the "political theater." I guess my concern is, as you said, the difference between public and private. It looks like the 1798 legislation was most definitely public. Now we have a brave new world of private that are being protected by our very own Supreme Court and such. I'm just thinking...
Sounds like a great argument for a public option, single payer, and federal government mandates for public services. As for an argument in favor of forcing people to pay money to a private company for a service? Not so great.
I'm against mandating private insurance purchases, but you're right, this provides precedents for both.
I'd like to think this is merely theater, Theater of the Absurd, but given the ruling in Bush v Gore and Citizens United, I wouldn't be surprised at any ruling by this SC. I know justice is supposed to blind, but is it supposed to be deaf and dumb as well?
I wouldn't be the least surprised to see this Federalist Society SC rule HC reform unconstitutional...just before they strike down the 1st amend. church/state separation.
Our stupid AG in Washington has joined this bullshit and he will pay for it. Isn't it great how the Republicans hate lawyers?
While I agree that the individual mandate is constitutional, your argument is not particularly forceful.

Passage by Congress does not mean a bill is constitutional, nor does it set "precedent". However, from an originalist point of view, one could say the passage of a bill during the founding period suggests that the understanding of the Constitution at the time it was written was that the bill was constitutional. However, this is clearly not always the case. The Alien and Sedition Acts were also passed under John Adams, even though the Acts are clearly unconstitutional under current first amendment jurisprudence, and many would argue were unconstitutional even under an original understanding of the constitution. Congress has always been capable of passing unconstitutional acts (well as soon as judicial review of constitutionality was created).

The Alien and Sedition Acts were never challenged in court, so there was no precedent created that the Acts were constitutional. It is the same with this particular piece of legislation.
It's a little bit dishonest not to also include that Obama-care includes huge unfunded mandates for states under Medicaid, and that is also a basis of the suits. California faces $2-3 billion a year extra, and it's broke, Florida has $1.6 billion extra. Can the Federal Government force the states to absorb this extra costs when none of them are in that solvent a state?
So, I didn't read all the posts but I am wondering if anyone noticed the very first point: privately employed sailors.... not private citizens. Not you and y0ur grandmother. Privately employed sailors. How does this compare to "you shall buy insurance"? Call me out if I am wrong but being a sailor at the time was a choice. (As long as you were not shanghaied)
The difference between the Alien and Sedition acts and the above insurance act would be a question of what violates a natural right, and for what reason. While you do have a free speech right, that, like the others, is dependent on questions of public safety/good. So, it's less about the law and more about the justifications to limit rights.
The defeat of the Sedition act and subsequent denouncements then and throughout history did nothing to prevent the 1918 Sedition Act, which was ruled constitutional. It was at least as onerous as the first, yet was "justified," like the first, by war. Later SC rulings rendered it unconstitutional, though it was never directly litigated.

There is no natural right to not be taxed, so the 1798 act was well within the bounds of our social contract, and was justified on economic grounds. The treasury depended on trade, and healthy sailors are essential to that end. While some would wish a libertarian template upon the Constitution, this 1798 act shows their misinterpretation of Art1, Sec 8 - I think intentional - to be dishonest.
The 1798 act reeks of necessary and proper and general welfare.

The same 5th Congress passed both the Alien and Sedition acts and the healthcare insurance act. Just pointing that out.

I think the argument that weighs the difference between being compelled to buy insurance from yourself, in essence, and from a private concern, at least on a federal level, perhaps has some merit.

The focus of this piece was insurance mandate. I owe no duty to expand this beyond that. Your claim of dishonesty is in error.

These privately employed sailor were private citizens. A year after the 1798 act, another was passed opening the system to the new Navy until they had their own. The system was also expanded to inland waterways over the years, and so any suspicion this was related to the military is unfounded. Private citizens who happened to be privately employed merchant marine sailors.
You make a point, however, I think O'Rourke's use of "unprecedented" in his article was not meant to be read as "challenged in court" unprecedented. I too mistakenly read it as such. There is no precedent set, legally, until there is a challenge to a law or mandate. In any event, it'll be interesting to see where this goes.

Drew, I think you make a good point as well. How are these states, already burdened by huge deficits, going to handle the costs? I will say that passing this bill is one thing; working out the details will keep a lot of people busy for a very long time. birdog.
I live in a country that does a some sort of universal healthcare system, and while there is a lot of moaning and groaning, generally from people left lying on gurneys in emergency department corridors, no one has died because we have it. Yes there are problems, however they are not the system, its the dills we vote in and appoint to run it that stuff things up.
Sorry, I just cant get my head around this debate. Are conservatives saying we deny you the right to be looked after by society when things go a bit pear shaped because the big pharma has a greater right to keep making billion dollar profits? At what point does one state have the right to dictate to others what is best for it's people? Why have a federal government? Just become 51 independant states and look after your own affairs and forget every one else hahahahaha What would the GDP of Virginia be? Wonder what the world markets in political hot air and customised horse floats are like
Gee, got one under the bonnet today. Time for another cigarette, got to get my health care value for money
The problem with comparing the older act to Obamacare is that the provisions were under the tax-and-spend powers of Congress. The tax-and-spend power is also what Social Security was passed under. The tax provisions of both the old act you cite and Social Security are based on legitimate excise taxes - employment and/or income taxation.

Obamacare, on the other hand, if you want to consider it under the tax-and-spend power, runs into a huge hurdle. Excise taxes are taxes on events, transactions, sales ... a change in the incidence of ownership ... and are indirect taxes, and only need to be uniform throughout the U.S. The "tax" or "penalty" is not on *any* sort of event or transaction or activity ... it is applied to someone who is not doing anything ... just sitting there ... and is applied to a person's status (the status of being uninsured). As such, it is a capitation tax. The problem ... if it's such a tax, it must be apportioned.

If Obamacare is found to be done under commerce clause power, it runs into another constitutional problem, and that is the individual mandate is applied to someone who is *not* engaged in commerce, and who may have no economic link to the commerce being sought to be regulated. That *is* unprecedented. It is *not* the same as auto insurance, because auto insurance is *only* required when you are driving on the road. You have never had to have auto insurance if you are not using the roads and availing yourself of the privilege of driving. Obamacare is like telling a 90-year-old woman who doesn't have a car and doesn't drive that she needs car insurance even though she is not engaged in any driving activity whatsoever.
I got my point across. You used the weakest part of their argument to refute, and ignored the stronger arguments. Can the Federal Government require a state to bankrupt itself to fulfill this mandate?
Sir, I must most respectfully disagree with your premise for the writing of this article. The 1798 Madison insurance rule is not a precedent for nationalized health care, and furthermore, is a terrible example to use if you are wishing to strengthen a point in support of the current health care bill.

First, I would like to point out that this 1798 rule was later abandoned for a number of reasons, one of the strongest of which was in brought up in 1881, where it was argued that a sailor, (paraphrased, not quoted) with neither ability or right to challenge takings from his wages or ability to challenge the legality of these takings, a sailor was reduced to the status of a ward of the state, and treated no differently than a slave to be held as property of the ship's captain.

This "ward of the state" view of sailors was held as a legal point until the early 20th century. A merchant seaman signing onto a ship's crew literally signed away his rights for the duration of his contract. The mandatory hospital payments taken from his check were only one of many indignities set upon this profession. I cannot fathom where a current citizen of the US would stand for that situation for very long.

Another reason to not cite this 1798 law in defense of the current passage is that it was very, very different from the current bill. The current states suing against "Obama-Care" are arguing, among many other reasons, that the federal government cannot establish such an overarching expensive ruling and then demand the states pay for it or that private citizens should risk jail time for an inability to carry said insurance .

In comparison, The Madison case you bring up was made during the Quasi War of 1798 for merchant seaman only. It was created because the sailors were being targeted by French privateers and the shipping insurance rates were skyrocketing due to the very real risk, making merchant sailing too expensive to continue in some cases. Furthermore, Madison's rule only required only a certain set amount be taken from the paycheck of a very specific profession for the set up of a very specific system of hospitals. These "hospitals" were also extremely basic, and in practice, would only treat a sailor if they were able to return to work for, and were only geared for a profession who found themselves on the front lines of wars, but were not covered under military medical systems already in place.

This 1798 ruling is not a good comparison to use for a systematic ruling calling for the set up of a nationalized health system in the US as is called for by the Health Care Reform Act.
There is nothing about the Quasi War shipping insurance rates that has any relation to whether or not sailors were healthy. That the system was expanded, over the years, down the Ohio and Mississippi rivers, where no warships interfered is a good bit of evidence the justification for the act was economic. Further, it also covered sailors on ships that never saw battle, and dealt with commerce along the coast. Had this been strictly about merchant marines injured in battles with warships and pirates, the act could have easily been exclusive to that.

The 1798 act shows us that, despite the rather constant insistence of the "conservatives" and Libertarians, the Constitution does, obviously, allow for government involvement in healthcare.

Your 13th amendment challenge is an interesting one, but I doubt it would hold up considering the precedents established by Soc Sec and Medicare rulings. We're all "wards of the state" under that broad brush description. The very essence of the Constitution includes "coercion" by majority rule, with limits on how much and for what reason it can be applied.

The Constitution isn't based on Libertarian philosophy. It is based on the more comprehensive Liberal philosophy.

Yes, the hospitals were basic, at least in care, as care was also un-advanced and basic. However, this is about principle, not comparative function at that level.

There is a difference between private and public insurance, and I'm open to arguments involving that aspect. That this 1798 act is an example of a federal single payer system, though, is interesting, considering the misguided pronouncements of "socialism" heard from the political chatterboxes.

The argument about mandating states to pay is a separate one, and has no relation to this article. The main point here is that insurance mandates aren't unprecedented in history, and that because the Founders applied them, it makes that point more strongly than, perhaps, the court precedents on SS and Medicare.

As such it renders specious the "Constitutionalist" posturing of those claiming to wanting to return us to the "Constitutional principles."

Thanks for responding.
While I don't like this historial law, to say it provides precedent for this "healthcare" bill passed by Congress is pretty weak. Federal government regulation of the open seas is on far more solid Constitutional ground than a bill that regulates intrastate commerce.

Furthermore, to use the interstate commerce clause to regulate healthcare is a breathtaking act of intellectual dishonesty. If the interstate commerce clause can be used to justify controlling people's access to health products and services then there is no limit to the power of the federal government, which makes the premise untenable. And forget about the "general welfare" clause, as James Madison in Federalist Paper #41 blows that away as an argument for federal authority outside the enumerated powers.
Article 1, Section 8 blows away that oft repeated fiction about "enumerated powers" being the ONLY powers of Congress.
Read it again.
Further, Congress actively avoided inserting the word "expressly" before "delegated," in the 10th amendment just to make sure people like you didn't get confused.
Thanks for stopping by.
OK, so Congress passed that and the Pres signed it way back then. That still was not a tax on all the people, only a small segment of them. Nor was it written as a Constitutional Amendment. Thus that blows this author's "precedent" theory.

Also, as I understand it, the various AGs are not trying to take away anyone's benefits or right to those benefits. Rather, they are putting the mandate for health insurance in its proper jurisdictions - the states. So far as I know, the feds don't administer or require any other type of insurance for all the people. Home insurance, auto insurance, whatever kind you can think of, are all enacted and enforced by the individual states, not by the powers that be in DC. And that's how it should be for this as well. Let each state craft its own insurance requirement that is right for its people, same as they do with other types of insurance. I don't believe a one-size-fits-all approach is the right way to go with this. This country is too big and its people too diverse for that to work effectively.
I don't know where you got the idea that a precedent has to be a Constitutional amendment, but I hope you saved the receipt.
There may be a 10% restock fee for poor thinking.

You say: "So far as I know, the feds don't administer or require any other type of insurance for all the people."

Social Security...Medicare?

Try again.
Thanks for dropping by.
The insurance mandate that Adams signed into law is fundamentally different than the one contained in Obamacare. The law cited in your article only mandated private insurance coverage for seamen employed by vessels of the United States that visited foreign ports. Consequently, this tax is constitutional because it is authorized under Art. II, Sec. 8 which grants Congress the power to regulate commerce with foreign nations.

Obamacare's mandate requires individuals to purchase health insurance that as a condition of citizenship. When Clinton attempted to pass his health care reforms in '93, the CBO specifically determined that Congress had never passed such a far-reaching requirement.
As has been pointed out by others, the old Act was a very limited one and originally dealt with the merchant marine, who were basically serfs on the high seas. The Captain was THE law, no disputes allowed, basically what he said was law. So are you postulating that is the future for all Americans ? Cravenly cower before our masters in DC or suffer the consequences? Maybe 25 lashes for the first offense in not buying a government mandated plan?

The new Act also denies the equal protection of the laws as certain, favored, unions are allowed to maintain their plans.

Under the old Act, the ship master could be fined. Under the obamanation Act American Citizens are subject to fines and possible prison terms if they refuse to buy a health plan for themselves. The old Act offers no direction nor precedent for the new Act.
I admire your ability to extrapolate dire implications from the creatures of your own creation. The Waterway to Serfdom!

However, if you had an argument, I must assume you would have used it, even in this limited venue. While I dismiss your base inflation and conflation of the phantoms and demons you create, it would find much acceptance were you to submit it for Glenn Beck's consideration (I use that word generously).

There are many laws that aren't applied equally, either through direct legislation or as a consequence of the inequalities of wealth or profession.

Are you suggesting that we should enforce such social and economic equality? Are you a income leveling Marxist or a racial and moralist-leveling Nazi? I am stunned that you would support mass murders such as the world saw with the Soviet pogroms or the Holocaust !

See? I can craft an "argument" as well as do you. Touche!

The 1798 act provides historical precedent for mandates and fines. Your distinctions provide no difference in principle.

What I like most about this act, though, is it demolishes the oft repeated argument that "the Constitution doesn't grant authority for government involvement in healthcare." Notice that, after promoting that slogan for years, these mostly Republican AG's don't dare use what one would think, given their addiction to it, would be their Strong Constitutional Argument.

I'm not for private insurance purchase mandates for several reasons, none expressed as poorly as you have above.

Thanks for commenting.
Thanks for overreacting to my hyperbole. 25 lashes for you.

Your argument holds no water however. You are, at best, comparing apples to oranges when talking about the two Acts. Only a hard core statist would see the original Act as somehow offering illumination to the Constitutional viability of the current Act. And I do not believe that you are such a statist, hard core or otherwise.

That the current Act places fines on Americans if they refuse to buy something is a new dawn. If it is Constitutional, and God help us if it is, there is no limit on what Congress can compel a Citizen to buy, even when that Citizen does not want to buy it. Why not compel every American to buy government bonds each month then?

The old Act fined the master, not the merchant sailors. The old Act did not offer three hots and a cot at club fed for recalcitrant Citizens. Nor did any IRS personnel (there was no IRS then, of course) attempt to "educate" the recalcitrant Citizen. Coercion is a much better word though. This, and so much more, is part of the new Act.
I understand this as mandating that employers (in a specific profession) carry health insurance for their employees. This seems very different from mandating that all citizens carry health insurance or be penalized.
I do not compare the two acts per se. I address this:

This historical fact demolishes claims of “unprecedented” and "The Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty...”

Healthcare insurance mandates have precedent, both historically, and I argue Constitutionally, given the absolute connection between the 1798 act and those leaders who made it law. Also, SS and Medicare have passed muster, so to say unprecedented is a stretch.

I noted in the article the difference between private and public insurance, which forms the basis of your reply. I'd say rebuttal, but you take my point, so yours is an expansion of that argument, not a separate one.

I grin at the use of "statist" because the system we have now - designed by lobbyists, enabled by regulatory capture, highly monopolized - is also "statist." Probably better described as conservative statism.

I favor a typical large corporation response to rising healthcare insurance costs. We, the people should self insure, as do many large corporations. Then, the function of for profit insurance, if we choose to go that route, is to profit from administering the system, not from every payment exchange.

Now, can we go back to the whipping of citizen-serfs and Soviet pogroms? I had this real cool storyline about invading Marxist paratroopers landing on Main Street, USA.

Thanks again.
Thanks JLee,
Always good to see you.
Mandatory? Was anyone forced to be a sailor? NOPE. Sorry, not a good argument in the least.
I hear that my state (Indiana) A.G. is going to join in. We are required by the government to purchase liability insurance in order to get auto license plates. Precedent, anyone?
Nonsense. The Statute was a precursor of the Veterans Administration and authorized under Congress' authority to raise armies. So the government, acting as an employer, had the authority to do so.
You are wrong, and the 1798 act eventually evolved to be cited as the historical background to the establishment of the Social Security Administration.
The 1798 act had zero to do with the military.
What other "facts" can you pull out of your wazoo?
The key here is that people are being forced to buy something for just "existing". That is the needle hole that the AG's are trying to drive this truck through.

The Act that is refered to in this article is like "workers comp", that we all have paid into since day one of employment. Like Workers Comp, the Sailor act is ment to have a healthy workforce, to help promote and grow Commerce. Secondly, People want to compare the HealthCare act to Auto Insurance, which does not hold up, as you are insuring your liability to others for using PUBLIC roads. Keep in mind, you don't have to insure your own car, just the damage you cause to others. Poeple CHOOSE to insure their own property (car)

The "you can't make me" argument lines up with Fire Insurance for your property, as we are only "forced" to buy it by the bank, to insure their loan to you. Or Life Insurance, we choose to buy it, even though we all will die. We are not mandated to buy it, even though it cost money to plant y'all in the ground. That is where they are going with this.

Personally, this is yet another mistake by the Repub leadership to attack the Insurance Mandate, as that is the one thing the actually WILL keep Insurance premiums down by making the young and healthy buy into the system to defer medical cost risk.

If they had any brains, (which is asking a lot from Republican Leadership) they would go after the crushing Medicaid bill that is comming after the Fed Gov ditches their payment for it and dump it on cash strapped states after 2 years (Nice accounting trick to show HealthCare as being 158 billion in "savings". Since States can't run Deficits...then they will have to *whispers softly* "raise taxes"). This here is rubbing up against the 10th ammendment, As state's assert their sovreity, and this is a very looooooose use of the Commerce clause in the Constitution, making state provide benefits. Before no one could really rebuff, as it was manageable. But now its crushing. This is where I see the legitimate argument is on HealthCare.
I'm sorry, but I think your comparison is flawed. A more apt comparison is between the Disabled Sea Merchant Act and the Davis Bacon Act of 1931. The federal government has always been able to stipulate conditions when they bankroll a private project, just like a private enterprise can stipulate their own conditions as requisite to handing out a contract.

The Davis Bacon Act required all private, non-unionized companies to pay their employees union wages upon receiving a federal contract. It also forced these private employees to pay union dues while working on the project, even though they're not union employees. Similarly, the Act for the Relief of Sick and Disabled Seamen forced seamen to pay into their HC fund, as a condition for employment while being bankrolled by the federal government.

In both cases, employees are free to not take employment if they don't wish to pay either union dues or for this HC fund. The big difference is by mandating the entire country to get HC insurance, employees are no longer free to seek employment elsewhere to escape these extra charges. Now, the federal government mandates that every citizen, regardless if they never received federal funding have to pay for HC insurance, that is indeed unprecedented. It would be similar to forcing every citizen to pay union wages, even if they never worked under Davis Bacon and have never been in a union.
Your post absolutely fascinates me. I am researching to writing a post about health care. May I make reference to this piece? Guess I should have put this in am IM. I will do just that. In the meantime, this is an excellent post
I forgot. It seems to me all of this hooha could have been avoided by simply adopting a single payer system or the public option. Why do you suppose they didn't?
That bill was directed at a specific segment of the population, not for all citizens.
Just try to imagine where we'd be today if, as Harry Truman proposed in 1948, we'd been living with national single payer universal health care coverage for 63 years. The mind boggles. Would it be perfect? Nope. Not a chance. Would we be running ourselves into the ground making health insurance companies ever-richer? Most emphatically not. P.J. - thank you. If we ever meet, I owe you a beer or six. You're da bomb!
Why does John Adams hate America? Well, he did sign a treaty stating that the US was not a Christian nation.