There were many reasons why health care reform was necessary when President Obama and the Democratic Congress were overwhelmingly elected to office in 2008.  Not only were health care costs climbing at a rate more than 3 times that of inflation.  Medicare and Medicaid were being overwhelmed by increased costs and unregulated fraud.  More than 30 million people were without access to affordable health care.  Insurance companies were denying coverage to those with pre-existing conditions.  Insurers were also placing lifetime limits on health care for customers.

In addition, corporations were exporting jobs to places like China, Vietnam and Indonesia in order to avoid paying employee benefits.

Faced with these overwhelming problems, along with an economy that had fallen off a cliff and massive unemployment, President Obama and the Democratic majority had little choice but to find ways to bring the health care industry under control.

Of course, Republicans did not want to help.  To enlist their support, Democrats chose to abandon their preference for single-payer universal care.  Instead, they embraced the Republican idea of insurance mandates through private companies.  After all, the idea had worked in Massachussetts under “Romneycare.”  Indeed, the program had proven to be popular.

Not surprisingly, in their anti-Obama fervor, Republicans immediately labeled the plan as “socialist.”  And despite lengthy negotiations in which they offered dozens of amendments and killed the public option, Congressional Republicans voted against their own concept.

Let’s fast forward to 2012:  Several provisions of the Patient Protection and Affordable Care Act (PPACA) have already been proven to work.  Children up to age 26 may now be covered under their parents’ insurance plans.  Insurance companies may no longer refuse coverage to those with pre-existing conditions.  A number of wellness programs have been implemented.  And Medicare fraud has been curtailed.

However, the majority of the provisions of the PPACA, including those which will have the greatest impact on costs, will not take effect until 2014.  But there’s a chance that we may not be allowed to see those benefits.

If the conservative-laden Supreme Court rules that “Obamacare” is unconstitutional, the ever-increasing number of people (now roughly 60 million) who will be unable to afford health care will grow.  And health care costs will continue to rise, dragging down our economy and jeopardizing Medicare.

And what of the federal deficits and debt that Teapublicans claim to be so worried about?

According to a report by the Government Accountabiity Office, the Patient Protection and Affordable Care Act (PPACA) would have “a major effect on the structural gap between revenues and spending driven by rising health care costs and demographics gap.” In other words, “Obamacare” would go a long way toward reducing our deficits and debt.

Without the PPACA, we can expect the cost of health care, along with our deficits and debt, to grow dramatically.