Health Care Privacy: Understanding The Us Constitutional Amendment

The US Constitution does not explicitly set forth a right to health care. However, the Supreme Court has held that the Due Process Clause of the Fourteenth Amendment provides constitutional protection for certain rights or liberty interests related to privacy. The right to privacy has been held to include the right to procreate, use contraception, have an abortion, and maintain bodily integrity. While the Supreme Court has held that the Constitution implicitly confers a fundamental right to privacy, it has not elevated health care to the status of a fundamental right. In 2019, Congresswoman Betty McCollum introduced an amendment to the US Constitution, the Health Care for All Amendment (H.J. Res. 17), to make health care a right for all Americans.

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The US Constitution does not explicitly guarantee a right to healthcare

The Supreme Court's decisions in the areas of the right to privacy and bodily integrity suggest that the Constitution implicitly provides an individual the right to access healthcare services at their own expense from willing medical providers. The right to privacy has been held to include the right to procreate, use contraception, have an abortion, and maintain bodily integrity. The Court has also found a right to refuse medical care within the vague right to "due process" contained in the Constitution.

While the Constitution does not contain the words "health," "healthcare," "medical care," or "medicine," Congress has enacted numerous statutes, such as Medicare, Medicaid, and the Children's Health Insurance Program, that establish and define specific statutory rights of individuals to receive healthcare services from the government. These statutes create an incomplete set of rights that reflect the inconsistency at the core of US healthcare.

The healthcare reform debate raises many complex issues, including coverage, accessibility, cost, accountability, and quality of healthcare. Despite the absence of a universal right to healthcare in the Constitution, Congress and the Supreme Court have incrementally crafted an incomplete web of healthcare rights.

The Supreme Court has held that the Constitution implicitly confers a fundamental right to privacy

While the US Constitution does not explicitly set forth a right to health care, the Supreme Court has held that the Constitution implicitly confers a fundamental right to privacy. This right to privacy is derived from the Fourteenth Amendment's concept of personal liberty and restrictions upon state action. The Supreme Court has also upheld that the Due Process Clause of the Fourteenth Amendment provides constitutional protection for certain rights or "liberty interests" related to privacy.

The right to privacy has been held to include the right to procreate, use contraception, have an abortion, and maintain bodily integrity. For example, in Griswold v. Connecticut, the Supreme Court found a right to privacy, derived from the penumbras of other explicitly stated constitutional protections. The Court used the personal protections expressly stated in the First, Third, Fourth, Fifth, and Ninth Amendments to find an implied right to privacy in the Constitution. The Court's decision in Griswold would lay the foundation for a series of other cases on individual freedoms related to sex, marriage, and family.

In Roe v. Wade, the Supreme Court acknowledged that the doctor-patient relationship evokes constitutional rights to privacy. This right to privacy extends to the privacy of any medical information contained in medical records. In Whalen v. Roe, the Supreme Court balanced the state's interests and concluded that requiring physicians to report to state authorities the identities of patients receiving controlled substances did not automatically amount to an impermissible invasion of privacy.

While the Supreme Court has held that the Constitution implicitly confers a fundamental right to privacy, it has not elevated health care to the status of a fundamental right. The Court has evaluated governmental actions involving health care using the less rigorous "rational basis" standard of review. Under this standard, a governmental action will be upheld if it bears a rational relationship to a legitimate governmental interest. For instance, in NFIB v. Sebelius, the Supreme Court upheld most of the Patient Protection and Affordable Care Act (Affordable Care Act/ACA), but did not interpret the Constitution as guaranteeing a right to health care services from the government for those who cannot afford it.

The Fifth and Fourteenth Amendments protect against unwarranted invasions of privacy

While the US Constitution does not explicitly set forth a right to health care, the Supreme Court's decisions in the areas of the right to privacy and bodily integrity suggest that the Constitution implicitly provides an individual with the right to access health care services at their own expense.

The Fifth and Fourteenth Amendments to the US Constitution protect against unwarranted invasions of privacy by federal or state entities. The Supreme Court has held that the Due Process Clause of the Fourteenth Amendment provides constitutional protection for certain rights or "liberty interests" related to privacy. As such, the right to privacy has been held to include the right to procreate, use contraception, have an abortion, and maintain bodily integrity.

The Supreme Court has also found that a fundamental right to privacy exists regarding medical information about a person. This right would extend to the privacy of any medical information contained in medical records. For example, in Whalen v. Roe, a group of physicians joined patients in a lawsuit challenging the constitutionality of a New York statute that required physicians to report to state authorities the identities of patients receiving Schedule II drugs (controlled substances). The physicians alleged that such information was protected by doctor-patient confidentiality, and their patients alleged that such disclosure was an invasion of their constitutional right to privacy.

The Supreme Court acknowledged that the doctor-patient relationship evokes constitutional rights of privacy. As such, private causes of action (against defendants other than federal or state entities) also exist for alleged violations of privacy rights (e.g. "invasion of privacy").

In addition to the Fifth and Fourteenth Amendments, the Fourth Amendment also provides some protection of privacy rights. Critics of mass surveillance programs, such as those implemented after the 9/11 terrorist attacks, argue that these programs are too widespread and invasive to be justified by the Fourth Amendment. Similarly, in Carpenter, the Court found that police needed a warrant to obtain weeks-long records of people's movements generated by their cell phones, refusing to expand the "third-party exception" to the warrant requirement.

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The Supreme Court has never interpreted the Constitution as guaranteeing healthcare services for those who cannot afford it

The US Constitution does not explicitly set forth a right to health care. The Supreme Court has never interpreted the Constitution as guaranteeing a right to health care services from the government for those who cannot afford it. However, the Supreme Court's decisions in the areas of the right to privacy and bodily integrity suggest the Constitution implicitly provides an individual the right to access health care services at their own expense from willing medical providers.

While the Supreme Court has never interpreted the Constitution as guaranteeing health care services for those who cannot afford it, there have been landmark decisions that have incrementally crafted an incomplete web of healthcare rights. For example, in 1976, in Estelle v. Gamble, the Supreme Court found a right to adequate medical care for prisoners grounded in the Eighth Amendment of the Constitution. Additionally, in 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA), guaranteeing a minimum level of medical attention for all who arrive at an emergency department in a hospital that accepts Medicare.

The Supreme Court has also upheld most of the Patient Protection and Affordable Care Act (ACA), which includes the “individual mandate" requiring individuals to obtain minimum health insurance coverage. This mandate is intended to solve two critical failures in insurance markets: not everyone can afford insurance, and insurers can discriminate against the sick by excluding them. The ACA represents a substantial but incomplete step toward operationalizing a more robust and complete right to health care.

Furthermore, the Supreme Court has held that the Due Process Clause of the Fourteenth Amendment provides constitutional protection for certain rights or "liberty interests" related to privacy. This includes the right to procreate, use contraception, have an abortion, and maintain bodily integrity. The Court has found that a fundamental right to privacy exists regarding medical information, and private causes of action can be taken for alleged violations of privacy rights.

In summary, while the Supreme Court has never interpreted the Constitution as guaranteeing health care services for those who cannot afford it, there have been significant steps toward ensuring access to health care for all. The Court's decisions suggest that the Constitution implicitly provides a right to access health care services, and various legislative enactments have been put in place to address the complex issues of coverage, accessibility, cost, accountability, and quality of health care.

The Supreme Court's decisions suggest the Constitution provides a right to access healthcare services at one's own expense

The US Constitution does not explicitly set forth a right to health care. However, the Supreme Court's decisions in the areas of the right to privacy and bodily integrity suggest the Constitution implicitly provides an individual the right to access health care services at their own expense from willing medical providers. This is based on the interpretation that the Due Process Clause of the Fourteenth Amendment provides constitutional protection for certain rights or "liberty interests" related to privacy.

The Supreme Court has never interpreted the Constitution as guaranteeing a right to health care services from the government for those who cannot afford it. Instead, the Court has deferred to Congress's policy decisions on what kinds of spending programs are in pursuit of the "general welfare". For example, in Buckley v. Valeo, the Supreme Court held that federal funding of election campaigns was a proper exercise of Congress's power to spend for the "general welfare".

The Supreme Court has also addressed health care issues in areas such as antitrust laws, drug safety, and religious freedom. For instance, in Whalen v. Roe, the Supreme Court acknowledged that the disclosure of patient identities and medication information to state authorities did not amount to an impermissible invasion of privacy. In Roe v. Wade, the Court acknowledged that the doctor-patient relationship evokes constitutional rights to privacy.

Furthermore, the Supreme Court upheld the constitutionality of the 2010 health care law, affirming the government's power to require that Americans have health insurance or pay a financial penalty. This decision was based on the Court's interpretation that the federal government has the power to impose a tax on those without health insurance, rather than the power to order people to buy health insurance.

While the Supreme Court has not elevated health care to the status of a fundamental right, its decisions suggest that the Constitution implicitly provides a right to access healthcare services at one's own expense.

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