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By Ian Wasser

In the United States, health insurance benefits are often included in employment compensation packages.  Thus, to be insured, one must typically have a job.  But what happens when there is racial inequality in the job market? Does this translate into minority groups essentially being denied health insurance coverage and therefore having an unnecessarily higher mortality rate?

The answer might be yes.  According the the Bureau of Labor Statistics, unemployment rates differ between majority and minority groups.  For instance, in 2003, the unemployment rate for white males was 5.0% while the unemployment rate for african-american males was 10.3%.  If health insurance is exclusively linked to employment, then clearly twice as many african-american males are being denied health insurance coverage when compared to white males.

As applied, the health insurance regime in the United States clearly violates the equal protection clause of the Fourteenth Amendment.  Specifically, the practice of linking health insurance to employment places an often already disadvantaged class of people into a position of further disadvantage.  This translates into poorer health and higher mortality.  Can it then be said that employment-linked health insurance, on the whole, is Unconstitutional?



  1. I think you are going to need a radical reinterpretation of current constitutional law doctrine before an equal protection violation will exist. We can start with the current understanding of the “state action” requirement of the 14th amendment equal protection and 5th amendment due process/equal protection. Also, one does not “need” a job to obtain health insurance. One needs money and respectable health.

  2. I agree–the Constitution should have much of the judge-made legal variations removed or re-interpreted or both. The Fourteenth Amendment was enacted after the Civil War, as a response to provide equal treatment to all people.

    Specifically, a state may not “deny to any person within its jurisdiction the equal protection of the laws.” I read this to imply that states are required to enact legislation that provides equal protection for all people in a multitude of situations. One such situation is mandated health care for all people.

    I fail to see an equal protection clause in the Fifth Amendment, from a plain reading of that text. The Fifth Amendment, as enacted, is solely directed to protect the rights of people accused of criminal offenses. The implied equal protection aspect of this Amendment is that every person receives this same protection when accused of a crime.

    The skewed variations of the Supreme Court, including introducing illogical interpretations on the Fourteenth Amendment like “substantive due process,” has ruined the intent of the enactment of this Amendment.

    I would also agree that one doesn’t necessarily need a job to have health insurance. Someone needs money, which usually comes from a job.

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