Newsflash: Founders favored "government run health care"

By Greg Sargent

Forbes writer Rick Ungar is getting some attention for a piece arguing that history shows that John Adams supported a strong Federal role in health care. Ungar argues that Adams even championed an early measure utilizing the concept behind the individual mandate, which Tea Partyers say is unconsittutional.

I just ran this theory past a professor of history who specializes in the early republic, and he said there's actually something to it. Short version: There's no proof from the historical record that Adams would have backed the idea behind the individual mandate in particular. But it is fair to conclude, the professor says, that the founding generation supported the basic idea of government run health care, and the use of mandatory taxation to pay for it.

Here's the background. Ungar points out that in July of 1798, Congress passed "An Act for the Relief of Sick and Disabled Seaman," which was signed by President Adams. That law authorized the creation of a government operated system of marine hospitals and mandated that laboring merchant marine sailors pay a tax to support it.

Ungar argues that this blows away the argument made by many opponents of the individual mandate: That it's unconstitutional to mandate that all citizens purchase health coverage, or that this violates the founding fathers' view of the proper role of government.

Is this true? In some ways it is, according to Adam Rothman, an associated professor of history at Georgetown University. He argues that it's a "bit of a leap" to compare the 1798 act directly to the individual mandate, because the act taxed sailors to pay for their health care, rather than "requiring that sailors purchase it."

But Rothman says that it's perfectly legit to see shades of today's debate in that early initiative.

"It's a good example that the post-revolutionary generation clearly thought that the national government had a role in subsidizing health care," Rothman says. "That in itself is pretty remarkable and a strong refutation of the basic principles that some Tea Party types offer."

"You could argue that it's precedent for government run health care," Rothman continues. "This defies a lot of stereotypes about limited government in the early republic."



Also: Some have argued that the individual mandate is, in effect a tax, but one that cuts out the Federal government as middleman. In this reading, everyone will eventually participate in the health system anyway, and the mandate means the Federal government is merely directing people to buy insurance, rather than collecting a tax and using that money to purchase that same insurance for them.

We will never know whether the founding generation would have agreed with this concept or not. They didn't agree on much even among themselves. But in Rothman's view, they are already on record supporting government run health care, financed by mandatory taxation. So there!

UPDATE, 3:29 p.m.: To be clear, the system of government-run hospitals was established for laboring merchant marine sailors, whose very dangerous work in trade was crucial to the young republic. The history is right here. I've edited the above to clarify.

