Justin Raphael: Understanding the health care crisis

Of all the forms of inequality, Dr. Martin Luther King Jr. said, "Injustice in health care is the most shocking and inhumane." These days, the legacy of the civil rights movement indeed finds its strange manifestation in the fight for affordable health care.

For years, much like the Freedom Riders who stormed Southern bus terminals four decades ago, American seniors have chartered buses to Canada where prescription drugs are exponentially cheaper. Congress took up their fight, passing legislation signed by President Clinton that permitted the importation of such medicines from our neighbor to the north. Yet Republicans included a provision requiring the Secretary of Health and Human Services, in consultation with the Food and Drug Administration, to certify the safety of all imported prescriptions. Ostensibly benign, the mandate amounted to an effective importation veto despite extensive parallels between Canadian and American regulations.

In response, local and state officials across the country have begun to develop their own importation initiatives for civil employees and Medicaid beneficiaries. Dismissing "a misperception that reimportation from Canada is some risky endeavor in which we give up safety to use a Third World apothecary just to save a dime," Minnesota Governor Tim Pawlenty, a Republican, sent officials to Canada to negotiate with licensed drug firms sanctioned by the state. Pawlenty, like many advocates of importation, believes that "Canada's pharmaceutical regulatory system is strong and effective."

In similar efforts to effortlessly save millions of dollars, New Hampshire Governor Craig Benson, also a Republican, as well as officials in Illinois, Iowa, Maine and West Virginia, have explored similar options. Senator Edward Kennedy, the powerful Massachusetts Democrat, recently endorsed a Boston plan to import medicines meeting rigorous safety standards for 7,000 city employees. Kennedy, dismissing safety concerns, charged that, "The administration is worried about the safety of the profits of the prescription drug industry."

Indeed, while prolific GOP fundraising among pharmaceutical companies is well documented, the behavior of conservatives raises a suspicion based upon more than contingency. For years the right has attacked the escalation of bureaucratic authority at the federal level, particularly impediments to free commerce. Yet now these conservatives have a blind faith in the infallibility of the FDA, one of the most sloth bureaucracies in the federal government, and HHS, a department denigrated by the right as a mere welfare service. Suddenly the Commerce Clause has gone from a socialistic enemy of laissez-faire to a vital safeguard of American interests.

What is more, conservative faith in free markets and open trade appears to have collapsed into a luxurious brand of the protectionism the right so abhors. NAFTA was the darling flower of free-trade conservatives, but now even the wonders of the cross-border open market have limits. Concerns about labor and environmental standards in trade agreements are lefty nonsense, but drug safety is something with which those maple syrup guzzlers just can't be trusted. True conservatives used to believe that open markets and unfettered competition was the best economics for all involved. Now it seems they are against all protectionism except the kind they like.

But railing against money in politics is the epitome of beating a dead horse. More interesting are the ironic echoes of civil rights slowly gaining volume on the issue. Lawyers at the FDA have informed states and municipalities that they could be sued for damages from "unsafe drugs" and its rhetoric has implied that such programs are in violation of federal law. Defiant importation plans continue to move ahead, legal or not; hence, a kind of warped echo of Selma, one which calls out to the feds not for intervention, but abstention.

Decades ago, civil rights advocates argued for federal jurisdiction over voting rights, an explicitly and traditionally state matter. Today, the movement's inheritors turn that formulation on its head. Indeed, they go further, asking for the implicit definition of a right to health care, at odds with Supreme Court precedent defining such matters not in terms of rights but in terms of policy, to be determined by Congress and not the courts.

So while the cost of health care in America is out of control, the answer is not to subvert the sanctity of federal law in the name of self-defined rights supposedly inherent in the welfare state. The motives of conservatives are suspect, but the actions of rebellious state officials are threatening, not only to federalism, and thus the union itself, but to the civil rights and other social services that depend upon it. If "law," as John Kennedy said, is "the link between mankind and freedom," those who would use it as a political tool threaten both, for as Dr. Martin Luther King demonstrated, laws are unjust when they corrupt their intent, not merely when we disagree with their content.Justin Raphael is a sophomore American history major from Westport, Conn. Uncommon Sense appears on Tuesdays.

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