The Project

Why Do We Need a Healthcare Constitution for the United States?

America’s healthcare system isn’t working very well. In its current form it is very expensive, financially unsustainable, leaves millions of people uncovered, and produces medical outcomes that aren’t as good as they should be. It simply doesn’t function efficiently or fairly. While some people get all of the coverage they need, others can’t buy insurance at a price they can afford – or sometimes at any price. Even if you have good health coverage you’re probably paying too much for it. We all deserves a healthcare system that works better and delivers more value for the money we pay.

While most people seem to agree that the existing system needs to be changed, it’s been slow going. Successive Congresses and Presidential Administrations have either ducked the issue or made little headway. Most attempts to change things have been intensively partisan affairs, with lots of fighting but no real progress. Many of the laws and regulations that have been implemented over time have made things worse rather than better. Most importantly, there has never been any broad vision or agreement on exactly what it means to “reform” healthcare in America. Is it just about insuring everyone? Or just about lowering costs? Or is about providing the best quality of care possible, or some combination of all of these? Without a generally accepted plan for what we’re trying to accomplish it’s pretty much impossible to create wise, appropriate legislation that everyone can accept.

We need a national vision of what we want our healthcare system to be to get us out of this mess. And then we need enough statesmanship on the part of all of our leaders to make it happen.

The Founding Fathers would immediately recognize this problem as similar to the one they themselves faced after independence. The former colonists wanted an effective, unified and independent nation, but there was no consensus on exactly what that meant. The “firm league of friendship” spelled out in Articles of Confederation was not up to the task of managing a modern country. The only remedy lay in defining a new long-term plan, and having the guts (and good sense), to compromise if necessary to get the job done.

To decide what sort of government they wanted, the leaders of the day convened the Constitutional Convention in 1787. There George Washington presided over the presentation of at least four well-thought out and comprehensive proposals for the structure of a federal government. Although the most obvious product of this meeting was the Constitution itself, an even more important result was public debate and agreement about what it meant to be truly united states.

It is now time for us, as Americans, to do the same thing for healthcare. It is an opportunity to show that we can, when the stakes are high enough, pull together in a show of reason and statesmanship rather than politics. That’s what this project is all about.

Purpose

Con-sti-tu-tion (kän(t)-stə-tü-shən, -tyü-)

noun

5 a: the basic principles and laws of a nation, state, or social group that determine the powers and duties of the government and guarantee certain rights to the people in it b: a written instrument embodying the rules of a political or social organization

(From: The Merriam-Webster Online Dictionary)

At U.S. Healthcare Constitution.org, our goal is to work with all interested Americans to create the first generally accepted healthcare constitution for the United States. A good healthcare constitution should lay out the general design and configuration of the healthcare system we wish to have, as measured by a general consensus of the population. It will never be possible to get everyone to agree, but most people ought to feel that this is a system they can live with.

Once we’ve agreed or compromised on an overall healthcare plan, it should be possible for our current and future political leaders to create and pass laws and regulations that support this plan. By doing so, they will be carrying out the will of the people.

Process

The U.S. Healthcare Constitution Project is a collaborative effort that begins on the Internet, but will ultimately end in your community. Here’s how it works:

• As the Founding Fathers did for the U.S. Constitution, people propose general models of how the American healthcare system might be broadly organized so that it will function better – and with more popular support – than the system we have now. A model is a plan (often associated with a diagram), that shows the basic elements of the proposed system and the general relationships between them. For example, for the U.S. Constitution, the models created by the Founding Fathers included a law-making body of representatives (Congress), a chief executive to ensure the laws were carried out, and a judicial branch of government to interpret the laws. Different models contained different variations of this general theme.

• Everyone is encouraged to participate in a moderated discussion of these models. Each discussion has three parts: comments in favor, comments opposed, and suggestions for improvement. Our job at U.S. Healthcare Constitution.org is to try to summarize these arguments and invite their incorporation into a new model that may work better and gain more support from project participants and the public at large.

• Any constitutional model for healthcare has to be relatively specific in order to be useful. By relatively specific, we mean that it needs to spell out the proposed rights, responsibilities, powers and limitations of the primary participants within the healthcare system. For example, if one is proposing that the federal government provide healthcare for all, does this mean that the government has the right to launch its own hospitals to care for the general population, or simply the obligation to provide insurance for everyone? Each model needs to construct an accompanying set of guidelines for its implementation. Here too, we invite everyone to participate by providing arguments for, arguments against, and recommendations for improvement.

• When the leading models are well-formed and well-explained, these alternatives will be presented in communities throughout the United States. Our goal is two-fold: to educate and to obtain a consensus on the most acceptable alternatives through well conducted polls and community meetings. The results will be widely disseminated via the Internet and the news media.

It is important to understand that the goal of any healthcare constitution is not to draft specific legislation, detailed regulations, or tax law. These are for legislators and administrations to create, and the courts to interpret when necessary. Instead, the goal is to provide a blueprint for the types of laws and regulations that should be adopted – and prohibited – when legislating and regulating healthcare in America. Instead, the constitution’s job is to keep all of these laws, regulations and rulings on the “straight-and-narrow” path intended by the people and expressed through the framing and adoption of the constitution itself.

Participation

The U.S. Healthcare Constitution Project welcomes the participation all Americans. To make the project manageable, it’s important that everyone follow the ground rules found here. These are intended to encourage healthy discussion and debate. Instructions for submission can be found within each section of the website. In addition, your sponsorships make this effort possible. Many thanks to everyone who has contributed their time, ideas and dollars.