Now the American people have the chance—indeed the responsibility—to secure the future of American health care.

Only a few weeks ago the Supreme Court ruled that the Patient Protection and Affordable Care Act, dubbed ObamaCare, meets the test of constitutionality in its most significant aspect, the individual mandate. This highly complex law, touted by the Obama administration as its signature piece of legislation, was frantically rushed through Congress in 2010 during the final days of two years of unchecked power held by the Democratic Party.

The law was explicitly shaped to transform health care toward a European-style system: shifting nearly twenty million more people into a financially unsustainable and scandalously inadequate government Medicaid insurance program; dictating required insurance benefits and the price of coverage; and imposing massive taxes and penalties on private sector employers, entrepreneurs, and investors that will undeniably cost jobs and threaten innovation.

The Supreme Court concluded, while endorsing the mandate to purchase insurance, that the requirement is actually another massive tax on Americans, and therefore within constitutional bounds.

Americans must realize that the law ultimately was built upon a truly cynical mischaracterization of America’s medical system, obfuscating its renowned excellence despite the facts about superior access, more choice, and unsurpassed disease outcomes thoroughly documented in the world’s medical literature. The law’s advocates further propped it up with massive exaggerations of the magnitude of the uninsured population and the cost of care for those without insurance, and by repeating the false claim that no insurance means no access to care. They put forth a series of mistruths—crafted to frighten Americans and undermine the greatest medical system in the world—to justify a social program that sets out on the path toward the single-payer system long dreamed about by liberals and favored by our president.

Meanwhile, despite all these facts, the ideologically aligned mainstream media remained silent about the sad reality that the law fails by all estimates—including the government’s own—to address the costs of America’s health care, the single most urgent problem burdening the health care system and the main reason change was needed in the first place.

As private insurance rates increase as expected and more patients are shifted to public programs, a re-elected president and those who support his agenda, having nothing to lose, would be likely to redouble their efforts to heighten regulation and government oversight in a second term. Expect a further dumbing down of American health care and even a renewal of a more overt public insurance expansion aimed at “single payer,” the stated favored plan of the president and many of his supporters in Congress.

Voters soon will decide whether they accept these developments. They have a clear choice in the upcoming presidential election between radically different views about American health care. On one hand, a vision of empowering individuals by improving choices, restoring rational analysis to the tax treatment of the health care dollar, and eliminating government barriers to increase private sector competition. This would maintain excellence and improve access to health care while driving down costs. On the other hand: efforts to expand government authority, dictate insurance requirements, limit consumer choice, and necessarily restrict access to care—all while shedding jobs and threatening the innovation responsible for the advanced medical technology and life-saving cures that embody the exceptionalism of American medicine.

All presidential elections pivot on critical issues. Health care reform will not be voters’ only concern in November, but no issue more starkly illustrates the importance of the choice voters will face. The stakes are extraordinarily high.

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