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I believe it's already firmly established that the Preamble to the Constitution does not, in and of itself, grant the federal government any powers whatsoever.

The means by which the federal government is permitted to "promote the general welfare", together with some restrictions on those means, are detailed in the Constitution itself.

I think you all are talking past one another.

The Constitution gives Congress a number of powers, but imposes very few 'duties' on it. Congress has a lot of powers to raise and support federal armies and other matters of national defense, but Congress is not obligated to exercise any of them. Indeed, a number of the Founders had strong feelings about whether to have a national, federal army at all - though ultimately the Congress has always provided funding for national forces.

The Constitution also gives Congress the power, but not the duty, to spend money to provide for not just the common defense, but also the "general Welfare." Whether this allows Congress to spend on anything that it deems to be in the general welfare or whether such spending had to be in furtherance of one of the other enumerated powers was a subject of considerable debate early in the country's history, with Hamilton and Madison disagreeing strongly (Hamilton favored the former, Madison the latter). SCOTUS has consistently ruled in favor of the Hamiltonian approach - Congress has the power to spend money on anything that provides for the general welfare, which is how programs like Medicare and the like are permissible.

Again, Congress has no duty to fund either an army or health care, but has the power to fund either or both if it chooses.


Note that the power to spend in furtherance of the general welfare is not the same as the power to regulate in furtherance of the general welfare.
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