And Now For Something Completely Different

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I thought I might like to go off topic and write about something other than medical tourism and its implementation into workers’ compensation.

Many of you may have certain views and beliefs about the Affordable Care Act (ACA, or PPACA), and believe that government-run, tax supported health care is unconstitutional, despite what the Supreme Court ruled. However, you will be surprised to learn, as I did the other night, that some of the Founding Fathers, namely John Adams, Thomas Jefferson, Alexander Hamilton, and Jefferson’s Treasury Secretary, Albert Gallatin, supported the establishment of federal marine hospitals under an Act signed into law by John Adams in July 1798.

In an earlier life, I was a double major in Political Science and History, among other Social Science and Humanities courses, and hold a Masters’ degree in American History from New York University. Generally, when one studies American history and American politics, emphasis is usually placed on such acts as the Alien and Sedition Acts, or the very important first cases heard by the Supreme Court such as Marbury v Madison or McCulloch v Maryland. But the Act for the Relief of Sick and Disabled Seamen was never a part of my courses, even when I studied American social or labor history.

As reported in two separate articles in Forbes magazine in January 2011 by Rick Unger, a Forbes Contributor, Unger describes how the 5th Congress, presided over by Thomas Jefferson in the Senate, and Jonathan Dayton, the Speaker of the House, who was the youngest man to sign the Constitution, passed the first government run and mandated health insurance program.  

In the first article, “Congress Passes Socialized Medicine and Mandates Health Insurance – In 1798”, Unger explains that the Founders realized that foreign trade was essential to our young economy, and they relied on the nation’s private merchant ships and sailors to carry out that trade. What precipitated the enactment of this law was that the job of a merchant sailor was very dangerous and difficult, and the sailors were exposed to tropical diseases and hurting themselves. This caused a reduction in manpower, and often left a ship’s captain without enough men to get out of port, which was bad for business and for the economy.

Recognizing that a healthy maritime workforce was needed, the Congress and the President did something about it. When it passed, it authorized the creation of a government operated marine hospital service, and mandated that privately employed sailors be required to purchase health insurance.

The Marine Hospital Service was a series of hospitals built and operated by the federal government to treat injured and ailing, privately employed sailors. It was paid for by a mandatory tax on the sailors (a little more than 1% of their wages) that was withheld from their pay and turned over to the government by the ship’s owner. This was not optional, if you wanted the job, you had to pay.

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Ships were no longer permitted to sail in and out of our ports without the health care tax being paid. This was the first national payroll tax. A sick or injured sailor would be given a voucher (in those days they actually paid off) once his payments were confirmed to have been collected and paid to the government, then the voucher would allow them to be admitted to the hospitals.

A few of these hospitals were privately operated, but the majority of the sailors were treated at federal maritime hospitals. This was expanded to include the Mississippi and Ohio rivers. This program eventually became the Public Health Service, and still exists today.

The second article, “Thomas Jefferson Also Supported Government Run Health Care”, published in Forbes four days after the first article, confirms that other Founding Fathers supported the idea of mandated health coverage and a government run hospital system.

So what does this mean? It means that the Tea Party/Libertarian/GOP attempts to overturn the ACA (aka Obamacare) because it mandates that all individuals purchase health insurance, is not only Constitutional, but that the very men who started this nation, Adams and Jefferson, and those who signed the Constitution, believed that such a mandated health care system for merchant sailors was necessary. And since the Constitution is for all the people, not just a certain class of people, like merchant sailors in the 18th or 19th centuries, or today’s military personnel, their spouses and children, veterans, old people, the poor or rich, white Men and a few Women in Congress who get taxpayer supported health care, but the rest of us do not.

It also means that Grover Norquist must be a Monarchist or a traitor to the Republic because he stated that his goal was to take back the country before the Socialists took over. Before learning about this Act, I thought that meant Theodore Roosevelt, Woodrow Wilson, FDR, Kennedy, Johnson, Nixon, and Obama, but now it seems it means that John Adams, Thomas Jefferson, Alexander Hamilton (Really?… Alexander Hamilton, the guy on the ten dollar bill and the guy who assumed all of the debt the original thirteen states incurred during the Revolution and started our national economy), as well as a former Treasury Secretary and Speaker of the House were Socialists, according to Norquist and the Tea Party-types. Then I guess the British Crown really was a Capitalist enterprise. Who knew? The American Revolution was fought for Socialism, except Socialism did not exist for a few more decades, and Karl Marx was not even born when this Act was passed.

So whenever anyone tells you that health care isn’t a right, that it is an entitlement and that forcing people to pay for health care is un-American, or un-Constitutional, refer them to the Act for the Relief of Sick and Disabled Seamen. 

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8 thoughts on “And Now For Something Completely Different

    1. richardkrasner Post author

      Thank you, Joe. I have been battling some tea Party morons on Examiner.com under an article a nurse I know wrote recently on that site. Then I decided to see if there was anything about health care and Jefferson, and lo and behold, I found those articles.

      Listen, good or bad, the ACA is just more of what the Founders originally thought of, only it does not leave out certain classes of people, even if it still won’t cover everyone, as many say it won’t do.

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  1. Matt Frye

    Great article, Richard, & while, as not only a Risk Manager but also as the administrator of my company’s benefits plans, I don’t agree that PPACA is the right legislation for American businesses, I do concede that if we expect to be a leader in the western world and the global market place for much longer we need to “do right” by all of our citizens, not only those that can afford it. In my experience, however, PPACA isn’t making healthcare more affordable for anyone, least of all those that already have it.

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    1. richardkrasner Post author

      Thank you, but you will have to admit, that PPACA is Constitutional, and conversely, if it fails, and a better alternative replaces it, such as single-payer, which even some conservatives recognised as the next step, will also be Constitutional because of the “Act for the Relief of Sick and Disabled Seamen”.

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    2. richardkrasner Post author

      Thank you, but you will have to admit, that PPACA is Constitutional, and conversely, if it fails, and a better alternative replaces it, such as single-payer, which even some conservatives recognised as the next step, will also be Constitutional because of the “Act for the Relief of Sick and Disabled Seamen”.

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  2. Bill Cobb

    Careful here – the Affordable Healthcare Act (or any other legislation) is not automatically presumed to be Constitutional because of the ‘Act for the Relief of Sick and Disabled Seamen’. That was merely a law passed by Congress and signed by the President. It is presumed to be Constitutional unless challenged. Then, it is the Supreme Court that decides.

    Also, Alexander Hamilton did not assume the national debt – he proposed a National Banking system and later was the head of it. Incidentally, Andrew Jackson thought a national banking system and national debt was evil. He abolished the banking system and paid off the national debt – something we haven’t see since.

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    1. richardkrasner Post author

      Bill,

      You are right, except that the 1798 Act was never challenged, and SCOTUS never ruled it wasn’t Constitutional, so that makes it so, just like Medicare and Medicaid was never challenged, nor were any other pieces of legislation that created health care for certain classes of people like children, the spouses and families of military personnel, and veterans.

      I think you are wrong on Hamilton and the debt. It was the debt of the states that was incurred during the Revolutionary War. He assumed those debts and paid it off by borrowing from Europe. David Mc Culloch’s book on John Adams, which was made into a mini-series mentions this during a meeting with Washington, Jefferson, Adams, and Hamilton present.

      Andrew Jackson did eliminate the Second Bank of the US.

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    2. richardkrasner Post author

      From Wikipedia:

      Report on Public Credit[edit source | editbeta]
      In the Report on Public Credit, the Secretary made a controversial proposal that would have the federal government assume state debts incurred during the Revolution.[59] This would give the federal government much more power by placing the country’s most serious financial obligation in the hands of the federal government rather than the state governments.

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