Maryann Tobin

Whatever the Supreme Court decides in the Affordable Care Act case, the impact will be profound.

The whole point of the Affordable Care Act, also known as “Obamacare,” was to make health insurance more affordable and more accessible to more Americans. It does achieve that goal. In it's first year, the Affordable Care Act helped add more than 1.2 million people the the rolls of the insured, according to Forbes.

However, if the Supreme Court decides that the individual mandate is unconstitutional, the entire health insurance industry will change dramatically.

"If the mandate goes, people can literally buy coverage on the way to the hospital and then drop it the next day," BCBS Senior V.P. Alissa Fox told the Huffington Post.

What the Supreme Court is really deciding is if the entire U.S. health insurance system will be unraveled.

Premiums in “Obamacare” are based on a large pool of both healthy and unhealthy people sharing the costs of insurance for all. This is much like the car insurance pools many states have, which make sure that insurance is available to all.

If you take away the larger pool, all that is left are the people with conditions that require ongoing care, or are more prone to diseases, such as the elderly. In other words, the most expensive customers in the health insurance market make up the bulk of the pool. For insurance companies to continue to pay claims and still make a profit, they will have to raise premiums dramatically.

So how does this lead to a U.S. single payer healthcare system?

In a relatively short period of time, millions more Americans will not be able to afford health insurance. Even people who get insurance through their employers may have to drop coverage as increasing premiums are passed along through payroll deductions. With pressure on politicians to solve the problem of health care for few but the wealthy, they may have few options other than to turn to an expansion of Medicare and Medicaid.

Medicare for all was briefly considered an option during the heat of the health care reform debate in 2009, but it was quickly shot down by strong lobbying from health insurance and drug companies.

More than 30 countries have either single-payer or mandated healthcare systems including Canada, the United Kingdom, Germany, Sweden, Australia, and Japan.

It should be noted that countries with single-payer or mandated healthcare systems do not share the runaway costs that have plagued the US heath insurance system for decades. Their costs do rise, but not nearly as drastically.

So if a single-payer health insurance system helps control costs and provides care for the entire population, why are Americans against it?

As with many new concepts, fear may be the driving force behind America's inadequate health care system. But that fear is unfounded and mostly fueled by the advertising of lobbyists who profit from the status quo.

In fact, more than 70% of American's polled support Medicare, which is a government run, single-payer, guaranteed health insurance program.

Medicare has what most people want, but can't buy from private insurers.

With Medicare, there is no exclusions for pre-existing conditions, premiums are affordable, there are provisions for free preventive medicine screenings, deductibles and co-payments are generally affordable, and payments are done through a government-run single payer system.

If faced with the choice between no health insurance, or an opportunity to get comprehensive coverage through a single-payer system like Medicare for all, why would any American say they would rather have no health insurance at all?

In an election year where healthcare and the economy are at the top of many voter's priorities, what the Supreme Coourt decides could have a profound impact on the 2012 races across the board.

If Republicans fail to come up with a valid alternative to "Obamacare" and provide affordable health insurance plan, voters may reject them for leaving them with no health care.

Democrats could face sharp critism for pushing through a healthcare law that was declared unconstitutional.

So the stakes are high in 2012, not just for politicians, but for the future of all Americans, particularly when it comes to their options for healthcare.


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