The historic ruling by the Robert’s Court based on common law, precedent and moral judgment is a victory all Americans. Opponents of the PPACA claim that it will bankrupt our country. The Office of Management and Budget, OMB, the bipartisan congressional committee which scores the financial effects of bills and laws, estimates that it will cost $200 billion to implement the PPACA. But, that it will save $200 billion in health care cost during the first during decade and it will save $1.2 trillion during the second decade. Benefits to workers, from the PPACA and other safety nets are spent. With secondary spending, markets for goods and services increase. Everyone, including entrepreneurs, profit. Unemployment is reduced and the economy grows.

The claim that citizens dislike the PPACA is bogus. When polls are done, there is an even split for and against it. However, if those polled are then asked about the 10 most important provisions of law, 80% to 95% favor each of them. This disconnect is due the expensive draconian campaign by opponents against the PPACA, to discredit President Obama and Democrats. As the PPACA takes effect though 2014, many more people will benefit from it. It will soon be proclaimed as the greatest social law since Social Security passed in 1937.

The chance of Republicans repealing the PPACA is very low since they are unlikely to gain control of the federal government in the near future. Even if they win the presidency and keep control of the House of Representatives in 2012, it is doubtful that they will acquire control of the Senate. Only one third of Senators will be elected this year. Many Senators who voted for the law will be reelected. The PPACA cannot be voted down by a simple majority. Due to the filibuster rule, 60 votes are required. Sincerely,

SAFETY NETS Americans should support those in Washington and Columbus who protect our safety nets:
· Social Security
· Medicare
· Medicaid
· Food stamps
· Excess farm commodities butter, cheese etc. go to food banks at no cost
· WICK -Women with Infant Children
· Health care for women

Following are among the many provisions of The Patient Protection and Affordable Care Act (PPACA) which saves suffering and prevents deaths. Those provisions which have gone into effect:
· Prevents denying medical insurance for children because of preexisting conditions. This will be extended to all citizens in 2014.
· Children can be covered on their parent’s policy until they are 26.
· Prohibits annual or lifetime limits of care.
· Controls Medicare premium rates and require that 80% of the premiums go to pay benefits and not more than 20% for executive salaries, profits, expenses and buildings.
· Provides for some preventive care: primary, pediatric and for women.
· Medium sized businesses can afford to get coverage for their employees.
· Provides $11 million for health centers for the poor.

Provisions of PPACA which will be in effect by the end of 2014:
· Will provide health care for 41 million of the 49 million Americans who do not have it now.
· It will allow volume pricing of medication, which now costs Medicare patients and tax payers billions more each year than in comparable programs in other countries.
· Will cause more transparency of the activity of medical insurance companies, hospitals and care givers. Will encourage group practice for efficiency.
· Will end physician owned hospital. Patient who will pay are cherry picked.
· Currently some private medical insurance programs have what are in effect “Death Panels”. They can deny expensive drug which could save the lives of patients of all ages with diseases which would be fatal. An example is chemo-therapy drugs to treat some kinds of leukemia.
· Will save from bankruptcy most of the 1.5 million patients, who now become bankrupt each year because of medical expenses.
· It will cost about $2 billion to implement the PPACA. But Health care cost of $ 200 billion will be saved during the first decade, and $1.4 trillion will be saved during the second decade of the PPACA. This is in the report of the Office of Management and Budget, OMB, which is a non-partisan U. S. congressional committee.
· It will eventually end the administration of Medicare by the insurance companies. They now get 10% of Part D and 20% of Part C. This costs tax payers $200 billion/year. It has added $1 trillion to the National Debt to date. It has also cost Medicare patients untold billions.

Already in effect by Executive Order:
· The Minimum Standard of Care will prevent much of the cost of repeated medical tests, unneeded tests, treatment and surgery, and it will prevent most malpractice law suits, because there will be no basis.
· Electronic medical records will save lives, reduce duplication of medical testing, help convict those who make false billings and prevent fraud.
· Evaluation the efficacy and cost of comparable patented and generic drugs will reduce the cost to patients and the government.

These have been paid for by Stimulus Funds.

The Republican Budget proposed by Paul Ryan would destroy Medicare and weaken Social Security, Medicaid, the food stamps program and other safety nets. All Republicans in Congress and the Senate voted for the Ryan Budget. Candidate Romney has endorsed it. They would also try to repeal the PPACA and would not replace it with a favorable law. There would be chaos because some of its provisions are already in effect. We must have a good health care law to have medical care for all our citizens and to control costs. This could be a single payer plan. I prefer that Medicare be made available to all by reducing by one year, each year, eligibility so enough primary care physicians and other care givers can be trained.


Albert A. Gabel
Professor Emeritus
Ohio State University