Opinion: Let's Change the Health Care Conversation

(April 5) -- The rhetoric on both sides of the health care debate has gotten completely out of hand and is an embarrassment to our people and our government. Republicans and Democrats are talking past each other but not with each other. We need to find some common ground.

First, Democrats and those on the left need to understand that the individual mandate (or tax) is highly offensive to many Americans and for legitimate reasons.

We have been fighting about the appropriate relationship between the state and federal governments since the days of John Adams and Thomas Jefferson. A federal requirement that everyone purchase health insurance or pay a fine is likely to trigger a strong emotional response in those who believe in a federal government of limited powers.

Contrary to what Democrats suggest, there are few examples (if any) where the federal government, or for that matter any government, has required individuals to purchase something from the private sector or pay a tax. Regardless of its real-world applications, or its constitutionality, this individual mandate scares a lot of people, because if Congress can do this, what can't Congress do? These are serious points worthy of discussion and should not be casually dismissed.

Second, Republicans and those on the right need to stop talking about how the "government is taking over health care."

The new law does not nationalize anything. Private insurance companies will still make huge profits (maybe bigger than they make now), and the vast majority of Americans will still receive their health care from private doctors and nurses, not people on the federal payroll. The exaggerated and obviously political claims about "socialism" do not advance the debate.

Third, most of us have the same two goals: lower health care costs and the creation of a more humane and efficient health care system.

We are disagreeing about the means -- how much government involvement should there be, and what should it look like? Let's remember, the fight is over means not ends, and that's a better fight to have.

Finally, the one place not to look for answers to the hard questions we are facing is the Supreme Court. The lawsuits filed by the states are expensive and time consuming, and will ultimately place a veto power in the hands of the branch of government least competent to solve our problems.

The claims based on the 10th Amendment have little constitutional merit, while the claims based on the individual mandate might be received well by the conservative wing of the Court, but then everyone loses.

And for those who believe in states' rights, do we really want to give federal, but unelected, judges the authority to rewrite the health care bill? It is ironic that those most in favor of state autonomy and limited federal government often seek relief in the hands of the only federal officials they can't fire.

We need to have a better national debate on the difficult problem of health care. Let's start by understanding why those on the right are frustrated by governmental overreaching and why those on the left are disturbed by baseless characterizations that the government is "taking over" health care.

The happy truth is that most Americans fall somewhere in the middle.

We can start to locate that middle by re-evaluating the wisdom and necessity of the individual mandate while recognizing that the federal government must play a significant role in ensuring that Americans receive adequate and affordable health care. Let's start talking about this issue with respect and courtesy.

On that point, at least, we should all be able to agree.

Eric J. Segall teaches constitutional law at Georgia State University College of Law and is the author of more than 20 articles on the Supreme Court and legal issues.

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