It makes me crazy to see the latest news about a Federal Court striking down the tax credits (subsidies) offered on the Federal Affordable Care Act health exchanges because I know the media commentators will go crazy analyzing the politics of it all. The Republicans are celebrating; the Democrats are scrambling. And the people who hate the ACA/Obamacare as well as those who are pushing to achieve a longer term solution through single-payer reform will claim victory. The camp that will once again be completely ignored in this whirl of political analyzing will be the patients and the caregivers whose lives and security are threatened once again.

We won't hear the patient and caregiver stories unless and until some of the politicians decide it would benefit them to prop us up in front of a camera in support of their particular position on health reform. While there are some very limited efforts going on to record stories, it has been since before the ACA/Obamacare was passed since anyone really cared to hear what happens to average people about their struggles with the profit-driven, dysfunctional US health system. No, Michael Moore will not be making another updated version of SiCKO and gathering stories for it as some have suggested to me -- the original version still holds up well, sadly.

In the current matter, it will be months before people really know if the tax credits/subsidies they thought they would have to help pay insurance premiums will stay in place or go away. The hardships are not tough to imagine. And thinking that my fellow Americans in another state may suffer more than I because of some decision their elected officials made about creating a state exchange is troubling, to say the least. The consequences in terms of the overall viability of the ACA/Obamacare are also probably predictable, though a bit less so. Politicians will argue this well into the next Presidential election season. Those who thought health care would be a back burner issue should now know without doubt that health care will stay front and center.

What I know for certain is that so long as the US health care system is based on trying to keep the market-based model for profiting off suffering and illness, we will continue to have these push-me, pull-me changes in how much it costs to get and keep health coverage, who is eligible for coverage, and who benefits politically or economically from the current whim of the courts, Congress, the President, media ratings or readership, religious beliefs claim by corporate persons, and many other changeable forces. That's no way to handle the health and well-being of our society and communities.

The forces needed to move this country away from this horrible system of changing fortunes and misfortunes in health policy will have to be those of us who can best speak to the real consequences of this continual uncertainty. And unless we have joined forces with one another to gather our stories in the post ACA/Obamacare period, we won't be able to demand the kind of stability an improved and expanded Medicare for all for life system would bring to us all. If only a few highly educated, predominantly white, socially and economically well-positioned, largely middle-aged and older, self-elevated spokespersons for health policy change continue to speak for us and about us but largely without us, the movement to achieve transformational change in the health system will not be able to overthrow the powerful, wealthy forces we all know are against putting people before profits.

What I really first thought when I saw the latest hit to people who need and want those tax credits/subsidies was too colorful to write here, but it wasn't because I would lose anything as a result. I was so angry that more months and years of political manipulation would damage so many people when the solution that could heal us is so readily available and has been for almost half a century now. Medicare turns 49 on July 30th. We would do well to celebrate the program's successes, acknowledge improvements we need to make, and share with our neighbors and friends how badly this nation needs to extend Medicare to all for life.

We cannot end our uncertainty about when or how we might get hurt or become sick enough to need care, but we surely can stop this terrible political dance that surrounds whether or not we are able to seek care when those times come. And part of ramping up our pressure to make that change happen is telling the stories -- true and loud and over and above the pundits on all sides. Watch for more news here about sharing your health care realities. Every person in every state needs to be covered by improved, expanded Medicare for all for life.