In March, the Supreme Court of the United States began holding hearings on the Patient Protection and Affordable Care Act, otherwise known as “Obamacare”, one of the key pieces of legislation under the Obama administration. The Supreme Court has convened to decide if the act, which requires individuals to purchase health care, violates the U.S. Constitution. The Affordable Care Act was signed into law in 2010 in response to the deeply felt need for health care reform amongst the U.S. population. There are 50 million Americans who have no health care, and those who do have health care face rising health care costs. Two thirds of all personal bankruptcies in the U.S. are linked to health care costs. The Affordable Care Act is an attempt by the Democrats to make political capital out of this crisis, without infringing on the profits of the health care industries and in fact without changing much of the health care system at all.

The Affordable Care Act does not create a publicly subsidized, universal health care program on the model of European States. It leaves the U.S. health care system intact. However it begins to regulate this system in two ways. Before the Affordable Care Act, the health care companies in the U.S. were free to charge individuals higher premiums or even reject them for health care based on so-called “pre-existing conditions”. In other words, the worse the health of a person who is applying to a health care company, the higher the cost for health care. The Affordable Care Act changes this system by creating standards which companies must meet. It makes it illegal to deny health care to patients with pre-existing conditions. And it sets the prices of monthly health care payments in order to make them somewhat. It also raises the age under which children can be part their parent’s health care plan by two years to the age of 26.  Overall the affordable Care Act will bring 23 million uninsured Americans under some sort of health care plan.

In return for these real limitations on the Health Care companies’ right to profit, there is one key feature of the Affordable Care Act – It requires individuals to buy health care. In other words it will be illegal not to be a customer of one of the health care companies. Those who do not take out health care plans will be subject to fines.

The presentation of the debate by the media and politicians presents a picture in which the lines are clearly drawn between the political parties. On the one side is the Obama administration and the Democrats, trying pose as reformers, for the first time in U.S. history imposing some kind of limitations to the profits of the health care companies. While on the other side those who oppose the affordable Care Act, mostly the Republican Party opponents of Obama, raise all sorts of hysterical objections – that this is a creeping socialist agenda on the part of the Obama administration.

The irony is that the Affordable Care Act is based on a policy already in place in Massachusetts, where Republican presidential candidate Mitt Romney is Governor. There in Massachusetts we see the real outcome of this policy.  The minimum health care plan for an adult costs $5,600 per year in fees. Then, there is a 2,000 deductible before the insurance pays for any treatment. So before a person gets any health care they have to pay $7,600 of their own money. Multiply this profit by the number of uninsured Americans and we get a sense of what the Health Care companies stand to gain in return for regulating their practices. This policy is the future for American health care unless the Affordable Care Act is shot down in the Supreme Court.

So what is really happening? In fact this case is simply political theater.  The U.S. Supreme Court will make its decision as to whether or not forcing individuals to buy health care violates the U.S. constitution. Either way the Democrats and Republicans will capitalize on the results to mobilize for the coming election. And either way the Health Care companies are guaranteed to come out with their profits unscathed.

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