If you look at the government from a bottom up approach, the individual is a citizen of two governments - federal and State. (Conversely, the state and federal governments have separate and dual regulatory jurisdiction over the individual and NOT over eachother. It is not hierarchial in form.)
It is the individual who is the original sovereign force. It is the individual who compacted with other individuals to create a form of self government and to breath life into it through a delegation of limited authority - retaining certain rights from government. The “or to the People” portion of the 10th Amendment is the most important part as the People retained individual rights, set aside from being governed by either the State or the federal government.
A constitution, as Justice James Iredell stated, was “a declaration of particular powers by the people to their representatives, for particular purposes. It may be considered as a great power of attorney, under which no power can be exercised but what is expressly given.”
This is why special conventions were formed in each state for the one and only purpose of considering replacement of the Articles of Confederation by ratifying the Constitution. The State legislatures were found to be incompetant to the task because authority flowed from the People, themselves.
This was not a new comcept. Declared the author of “The Genuine Principles of the Ancient Saxon, or English Constitution,” if the constitution were to be a “sett of fundamental rules by which even the supreme power of the state shall be governed,” it must “be formed by a convention of the delegates of the people, appointed for the express purpose.” Only then would it be unalterable, “in any respect by any power besides the power which first framed it.”
The government formed was fractionalized into layers and branches in order to protect the individual and his retained rights from the will of the majority and the efficient and abusive reach of government.
Said John Taylor in “An Inquiry into the Principles and Policy of the Government”:
“It is our policy to consider the people as retaining a vast share of political power, and as only investing their government with so much as they deem necessary for their own benefit...Power is first divided between the government and the people, reserving to the people, the control of the divident allotted to the government. The divident allotted to the government, is subdivided between its two branches, federal and state.” Then these two portions were further broken up and “distributed in quotas still more minute” to the various departments and branches of the government... all our governments are limited agencies.” “Power is divided by our policy, that people may maintain their sovereignty...”
Unfortunately, as the Union was created by and originated from the People, it cannot be dibanded by a mere creation of the People (the State.) Likewise, the State does not stand in a hierarchial position between the individual and the federal government. It cannot nullify or block a Constitution federal law with application directly upon the individual. It can, however, refuse to participate in extra-Constitutional federal programs that offer funding in exchange for State cooperation and implementation.
The federal Health bill is clearly not in the power of Congress to enact, (unless some weird interstate commerce justification is used,) and enforce directly upon the individual. If it requires State collaboration, that must be purchased voluntarily from the State through strings attached to program funding. In that case, the State has it in its power to say no.
Specifically, the "people" argument finds is said to rest on two parts of the constitution - the famous "we the people..." preamble and the ratification clause.
The matter of the preamble is a load of bunk because the Convention records clearly show that it came about as a stylistic truncation to avoid an obnoxiously long list of states ("We the people of Maryland, Virginia, New York, Rhode Island and Providence Plantation blah blah blah"), as had been the case in the Declaration of Independence.
The ratification clause is a bit more complicated, but again convention records do not impress any grand philosophical significance to the act. Gouvernour Morris, the primary stylistic editor of the Constitution, was actually content to let each state choose its own manner of ratification for itself. When the proposal came about to use "conventions" it was done out of the belief that they would be a more expedient means of ensuring that ratification was successful, with the whole business of it being about "the people" amounting to little more than an afterthought. James Madison openly admitted as much:
Mr. Madison considered it best to require Conventions; among other reasons, for this, that the powers given to the Genl. Govt. being taken from the State Govts. the Legislatures would be more disinclined than conventions composed in part at least of other men; and if disinclined, they could devise modes apparently promoting, but really, thwarting the ratification. The difficulty in Maryland was no greater than in other States, where no mode of change was pointed out by the Constitution, and all officers were under oath to support it. The people were in fact, the fountain of all power, and by resorting to them, all difficulties were got over. They could alter constitutions as they pleased. It was a principle in the Bills of rights, that first principles might be resorted to.
Earlier on Madison had elaborated on this point by stating that he believed the Articles of Confederation were "defective" because they set the bar too high for achieving ratification. And he was essentially alone in even referring to these so-called "first principles" or much of any other reason besides expediency. Everyone else who spoke in favor of it did so simply because they thought it would be easier to ratify that way.
Rufus King: "Conventions alone, which will avoid all the obstacles from the complicated formation of the Legislatures, will succeed, and if not positively required by the plan, its enemies will oppose that mode."
Nathaniel Gorham: "urged the expediency of "Conventions""
Pierce Butler: "was of opinion that the alteration of the confederation ought not to be confirmed by the different Legislatures because they have sworne to support the Government under which they act, and therefore that deputies should be chosen by the people for the purpose of ratifying it"
James Wilson: "did not fear, that the people would not follow us into a national Govt. and it will be a further recommendation of Mr. R.'s plan that it is to be submitted to them and not to the Legislatures, for ratification."
Hugh Williamson: "observed that some Legislatures were evidently unauthorized to ratify the system. He thought too that Conventions were to be preferred as more likely to be composed of the ablest men in the States."
Save for its plainly secondary place in Madison's arguments, the aura that some today now afford to conventions of "the people" simply wasn't there in 1787. The delegates were looking for a way to get the thing ratified quickly and with as few hangups as possible. They believed the state legislatures would bottle ratification up for years as they picked the Constitution apart in the grist mill of the committee system, whereas a convention - being only temporary and being convened for the purpose of ratification alone - would get it done quickly.
Horse feathers!!
Article VII of the Constitution stated that the Constitution would become the law of the land when the delegates of nine states had ratified the same and that the Constitution would become the law ONLY in those states so ratifying the same. In other words "we the people" of each state, acting for our own benefit, acceded to the Constitution!