"The inevitable yet unpredictable need for medical care and the guarantee that emergency care will be provided when required are conditions nonexistent in other markets. That is so of the market for cars, and of the market for broccoli." — U.S. Supreme Court Justice Ruth Bader Ginsburg, Affordable Care Act separate opinion, June 2012

A landmark Supreme Court decision regarding the ACA, otherwise known as "Obamacare," finally was handed down in June. The "individual mandate," the crux of the legislation, was upheld, ultimately requiring all Americans either to carry health insurance, or, alternatively, to pay a fee, in the form of a tax to the Internal Revenue Service. Individuals with employer-sponsored insurance (by some estimates, approximately 60% of the U.S. population) essentially will be unaffected by the mandate.

There has been much debate about the individual mandate; however, its origins have been traced to conservative organizations and a conservative governor. If you have been a practicing occupational therapist in a healthcare system that treats trauma patients, you may be all too familiar with the all-terrain vehicle rider or the motorcyclist who has been flown in to your ED by life flight for trauma care, and who was, unfortunately, uninsured. Devastating injuries must be treated with surgery and extensive rehabilitation — but, in these cases, who pays? More often than not, the hospital, and, in turn, you and your colleagues pay through employee hiring freezes, salary freezes, pay cuts and layoffs.

Regardless of your political opinion, hospitals must have paying customers to survive. Many OTs and our hospital staff colleagues are employed by large hospital and healthcare systems across the spectrum of inpatient, outpatient and various rehabilitation settings. Our jobs are dependent upon the healthcare system’s budget for hiring and keeping clinical employees. When hospitals are able to provide care for a majority of patients who have the capacity to pay for care, our future is secure.

The Supreme Court did the right thing in finding the ACA to be constitutional. No matter your political leanings, keep this in mind not only for yourself but also for your colleagues when you go to the polls this November. •