The ruling last week by the U.S. Supreme Court upholding nearly all of the Affordable Care Act shocked conservatives and liberals alike. After a decade of odious 5-4 decisions, the majority got one right, thanks to a decisive switch by Chief Justice John Roberts from the predictable majority to the liberal minority. Never mind that the remaining four far-right Republicans voted to overturn the entire Act - it was the Chief Justice who saved the day.

As a consequence of this decision, millions of Americans without access to medical care now have it. No Americans will be denied insurance because of pre-existing conditions, under-26 years-of-age Americans can remain on their parents health plans, no lifetime caps on coverage will be imposed by insurers and insurance companies must spend 85 cents out of every dollar paying for actual care, not administrative costs. Americans are now much less likely to lose their homes or suffer bankruptcies because of unmanageable medical bills. These are just a few of the ways the Court's action will, as Paul Krugman put it, enable citizens to benefit from a kinder and more decent society.

While what Republicans derisively call Obamacare is a big improvement on the status quo, America still needs universal health care or, if you like, Medicare for all. Despite the name (Affordable Care Act), medical care is anything but affordable - the annual cost amounts to 20% of GDP, or $8000 per person, the highest in the world and a key contributor to our massive deficit. In addition, at least 26 million people remain uninsured, despite the new law and all it entails. Worst of all, the health insurance companies remain in control. In fact, the individual mandate that Republicans hated so much is a jackpot of riches for health insurance companies - they will make additional billions from the millions of new clients the law sends their way.

All this suggests that there is in America what Michael Moore calls a great divide. In a Huffington Post column published the day after the Supreme Court decision affirming the law, he describes it as follows:

It's not blue state vs. red state, liberal vs. conservative, Democrat vs. Republican. The split we have in America can be boiled down in its simplest form to this: On one side are the people who believe Adam and Eve rode on dinosaurs 6,000 years ago - and then there's everyone else. On that first side are the people who've been fed a diet of fear and lies and hate. And who is feeding them? The 1%. the richest people in the country, the ones who aren't done with us yet because they still don't have enough wealth, have done their best to dumb down the population through destroying our educational system and using media to provide them with a vastly distorted sense of reality. The rich's only obstacle is that they only hold 1% of the votes in the country. So they have to try to get a slim majority of Americans to vote their way. And fear, plus keeping them stupid, usually works. 

If the easily fooled, manipulated and dumbed down Americans hell-bent on voting against their own interests elect Mitt Romney and a Republican Congress, we will all lose the benefits of the Affordable Health Care Act because Romney and the rest of the Republicans will eliminate the law they loath. There will be no chance of expanding Medicare for all. And there will be more appointees to the Supreme Court the likes of Justices Anthony M. Kennedy, Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr.

The 1% agenda is not about a kinder and more decent society, at least not for most Americans, including the rabble who obtain their take on reality from the likes of Catholic bishops, fundamentalist preachers, Fox News, Rush Limbaugh, Donald Trump, Sarah Palin and Rick Perry.

So, where does all this leave us? What can you do if you agree with this  analysis? How about considering two basic strategies, at least for starters: 

  1. Do what you can to promote the chances of re-electing the president - and as many Democrats as possible. I urge this position not because I'm fond of Democrats - I'll support Democrats only because I'm so appalled, sickened, horrified and gobsmacked by the evil ways of Republicans. 

  2. Look after yourself - reduce your chances of requiring medical care by fine-tuning your current REAL wellness lifestyle. The absence of a decent health or medical system will still be a national disaster, but the impact on you personally will be less if you don't have to use it that much. It's hard to believe that half of America is supportive of the poisonous agenda of the Republican Party; it's even harder to believe, though true, that one in three American adults is obese - 78 million fat Americans.


Kurt Vonnegut was a self-described total pessimist. Maybe he was on to something, though an optimistic outlook has almost always been highlighted as a key element in a healthy profile. But, considering the horror that would follow from a takeover by the Republican half of the American divide, it may be that pessimism deserves a second look.

How pessimistic was Vonnegut? In a remarkable commencement address to the 1970 graduates of Bennington College in Vermont, he described his major achievement in three years of teaching at the University of Iowa:   


As nearly as I am able to determine, not one of my ex-students has seen fit to reproduce. 

Now that's pessimism - and it might be something I'll include in future recommendations if Romney is elected president.

But Vonnegut was not a total pessimist, despite his claim to such an outlook. His sense of humor, however dark, was too well developed for that. While he spent most of that Bennington commencement speech urging the young grads to enjoy themselves and lose the idea of saving the world, at the end he said they might want to give saving the world a try, later in life. I love the sendoff conclusion of the address, as profound today as it was 42 years ago:


When it really is time for you to save the world, when you have some power and know your way around, when people can't mock you for looking so young, I suggest that you work for a socialist form of government. Free Enterprise is much too hard on the old and the sick and the shy and the poor and the stupid, and on people nobody likes. They just can't cut the mustard under Free Enterprise. They lack that certain something that Nelson Rockefeller, for instance, so abundantly has. 

So let's divide up the wealth more fairly than we have divided it up so far. Let's make sure that everybody has enough to eat, and a decent place to live, and medical help when he needs it. Let's stop spending money on weapons, which don't work anyway, thank God, and spend money on each other. It isn't moonbeams to talk of modest plenty for all. They have it in Sweden. We can have it here. Dwight David Eisenhower once pointed out that Sweden, with its many Utopian programs, had a high rate of alcoholism and suicide and youthful unrest. Even so, I would like to see America try socialism. If we start drinking heavily and killing ourselves, and if our children start acting crazy, we can go back to good old Free Enterprise again.