By Gary L. Wickert Gary Wickert is an author, trial lawyer and town of C e d a r b u r g Supervisor, who lives in Cedarburg with his wife, Lisa and two sons. He can be reached at garywickert@ameritech.net.

Everyone knows in their hearts that the upcoming election will be a watershed political event in American history and a turning point in our country one way or the other. The outcome of the election is uncertain, but one of two things will happen on November 6.

On the one hand, the American left might finally prove Alexis de Tocqueville right. It was de Tocqueville, the French political thinker and historian, who after traveling the breadth of American in the 19th Century astutely observed, "The American Republic will endure until the day Congress discovers that it can bribe the public with the public's money." He noted that a democracy "can only exist until the voters discover that they can vote themselves largesse from the public treasury."

On the other hand, American conservatives and moderates could return the country to the small government, free market, enduring moral code, rugged individualism, and capitalistic ideals which built the greatest nation the planet has even known.

As starkly contrasting as these two alternatives are, I would proffer an even more sobering perspective. Forget redistribution of wealth, Bill Ayers, and Obama's anti- American upbringing. Ignore his wife never having been proud of our country until 2008. Forget the broken promises, the high unemployment, the downgrading of American credit, and the meteoric expansion of small business-killing federal regulations and the size of government. Ignore Barack's endless apologizing for America, Rev. Wright, Fast and Furious, failing to protect our borders, failing to attend his intelligence briefings, the cap and trade climate bill, the massive deficits, our nuclear disarmament, the promotion of abortion, the bailouts or the takeover of General Motors. Put aside even the $787 billion stimulus and the epic Keynesian failures of QE1 and QE2.

As the author of a book on health insurance, I feel strongly that November 6 is more significant than perhaps even most political pundits realize, but for a simpler and must more fatal reason – Obamacare. As goes the speciously-named Patient Protection and Affordable Care Act, so goes the country. If Mitt Romney is elected, Obamacare will either be repealed or every state will be granted an exemption from its totalitarian and devastating requirements. If, however, President Obama is re-elected, Obamacare will fully go into effect and it will be the end of America as we know it. Conservative hyperbole? Not even close.

At the core of understanding how disastrous Obamacare will be for our country is an understanding of how Obamacare works. Yet very few of the people who support it have this understanding. Right now, government-paid health insurance and medical programs – Medicare and Medicaid – don't pay hospitals and doctors for the full cost of medical procedures and health care. They can't afford to. As an example, doctors and hospitals who provide a single Medicare recipient with $17,245.11 in health care receive only $3,245.53 in reimbursement from Medicare – the government program which covers 45 million Americans age 65 and over and 7 million Americans under 65 with disabilities. Medicaid – the second major government program which provides coverage for over 58 million non-permanently disabled and "poor," pays only $10,705.74 of a $98,652.21 hospital bill. The rest of these bills go unpaid because federal law makes it illegal for the doctor or hospital to bill the patient for the difference.

So how do doctors and hospitals stay afloat in spite of such government shortchanging? Simple. They charge private health insurance companies much more than the government reimburses and much more than the value of the services actually received by their insureds. This fact – combined with the gradual removal of the "consumer" from their health care choices thanks to the managed care system which began infiltrating our health care system in the 1970's – explains the high cost of health care. And the high cost of health care explains the high cost of health insurance. And the high cost of health insurance explains the large number of Americans without health insurance.

What is not simple is the devastating effect Obamacare will have on the future of a country already swimming in deficits and debt. Here is how the Patient Protection and Affordable Care Act, signed by President Obama in March, 2010, is designed to work:

1. Individual Mandate. Beginning in 2014, everyone will be required to maintain for themselves and their dependents "minimum essential coverage" – which means coverage obtained from a government program, an eligible employer-sponsored plan, or a plan offered in the individual market. Any person who fails to do this will pay an annual "penalty" (which the U.S. Supreme Court now says is actually a "tax") of $695 per person and $2,085 per family. Starting in 2017, this tax will grow with inflation.

2. Increased Taxes On Individuals and Businesses. Currently, individuals pay two types of employment taxes: Old Age, Survivors and Disability Insurance tax, and the Medicare Hospital Insurance tax. Beginning in 2013, individuals (i.e., most small business owners) making more than $200,000 will see the latter of these taxes increased. The Act will also impose a new excise tax on the manufacture and sale of medical devices ($20 billion), a "Special Needs Kids Tax" of $13 billion which will fall on the shoulders of the parents of kids with special needs, a $123 billion surtax on investment income (Capital Gains tax increases), a $15.2 billion tax increase by limiting long-standing medical itemization deductions, and an $86.8 billion Medicare payroll tax hike on American businesses.

3. Private Health Insurance Coverage. The government will now mandate that private health insurers provide certain coverages and policy/plan language such as:

a. Eliminates lifetime dollar limits on benefits;

b. Eliminates co-pays and deductibles for certain preventative care;

c. Non-discrimination requirements for owners of businesses;

d. Eliminates any pre-existing condition exclusions (which is sort of like saying you can quickly go out and buy fire insurance while your house is on fire);

e. Group health plans (employer-sponsored programs) must provide coverage for adult children (married and unmarried) until age 26;

f. Serious limitations on health savings accounts and flexible spending accounts.

4. Establishment of Health Benefit Exchanges. At the heart of the new law is a vehicle which is – by design – intended to facilitate the government takeover of the health care industry in our country. Obamacare mandates that each state create health benefit exchanges by January 1, 2014 and provides federal grants to help them do this. The exchanges are marketplaces that are to operate "alongside" the existing private health insurance industry through which employers and individuals who have struggled to find coverage can find and purchase health insurance. Insurers can offer plans both within and outside of the exchanges, but only qualified employers and individuals may purchase plans from the exchange and those plans themselves must be qualified and the federal government will oversee the implementation of the qualified plans and benefits.

The problem with Obamacare and the exchanges is that our country is already $16 trillion in debt and already can't pay its bills. More government programs and borrowing will seal its fate. We have seen that the federal government already pays only a fraction of the full cost of health care – in Medicare and Medicaid – leaving the private insurers stuck with picking up the slack. This is why your private health insurance rates continually rise. You're paying for somebody else's medical bills with your premiums. Once Obamacare is implemented, the new government-run exchanges will not even come close to paying the full cost of everyone's medical procedures, meaning that private insurance premiums will be skyrocketing even more in order to cover the losses of the health care providers, and Obamacare will instantly fail at one of its chief goals – keeping down the cost of health care.

Government spending already amounts to 44% of total spending on health care in America. When Obamacare is fully implemented and private health care spending is slowly eclipsed and taken over by the exchanges and public health care spending, government spending will constitute an evergrowing percentage of the U.S. economy. Proponents of Obamacare speciously point out that when it is implemented the nation's health care system will be no more under federal control than Massachusetts fell under state control after Romney signed a similar health care law as governor. But it soon will be. It only makes sense that as private insurance premiums rise and it becomes logical for most employers to drop health coverage for its employees and pay the penalty instead, more and more people will be dropped into the government-run exchanges, and fewer and fewer private carriers will be left to pick up the tab run up by those whose medical bills will go virtually unpaid by Medicare, Medicaid, or the Obamacare exchanges.

Eventually, the gap between private and public health care will be so huge that virtually everybody will have their medical bills paid by the U.S. government, which either (1) will be left paying the full cost of health care, thereby exploding the federal budget and breaking the U.S. economy's back, or (2) won't be paying the full cost of health care, which will decimate the best health care system on earth. The truly sad aspect of this disaster is that when it happens, we will look back and see that the destruction was intended all along. Remember, the Cloward-Piven strategy – inspired by the same Saul Alinsky who was such an influence on President Barack Obama – which urges hastening the fall of capitalism by overloading the government bureaucracy with a flood of impossible demands, thus pushing society into crisis and economic collapse?

The Democrats' promises of more handouts in exchange for votes are empty and lead to the demise of our country. When Obamacare legislation was first proposed, the Congressional Budget Office revealed that it actually steals $500 billion from an alreadybroke Medicare system. That number has been revised upwards to nearly $1 trillion.

Not only will Obamacare overwhelm and destroy the U.S. economy, it will decimate the American health care system. A survey of nearly 14,000 physicians recently revealed that over half of all physicians already limit the access of Medicare patients and 6 out of 10 doctors indicate that they would quit today if they could. Another survey released this summer by the Doctor Patient Medical Association reveals that 83 percent of American physicians have considered leaving their practices as a result of Obamacare. Even without all of these doctors leaving the practice of medicine, there will be a shortage of 90,000 doctors by 2020 and 130,000 by 2025. These doctors know what many Americans may find out only when it is too late – that the Patient Protection and Affordable Care Act will lead to far worse access to medical care for the majority of Americans. Obamacare requires religious organizations to provide free sterilization, contraception, and abortion-inducing drugs to their employees in violation of their religious beliefs. The Independent Payment Advisory Board (IPAB) is the "death panel" Sarah Palin famously alluded to. It's real and will have rationing power over Medicare. How any senior could be supportive of this destructive bill is beyond me. Obamacare requires $575 billion in payment reductions to Medicare and Medicare Advantage plans – causing more physicians to stop seeing Medicare patients. Worst of all, the average price of a family policy has already risen more than $2,200 during the Obama Administration, despite his promises that premiums would be $2,500 lower by 2012. Both taxes and health care costs will skyrocket even more if Obamacare is not repealed or neutralized. And under

Obamacare the government will have control over doctors' decisions via value-based payments, quality reporting requirements, and government comparative-effectiveness boards dictating how and when doctors practice medicine. Under Obamacare, the federal government, already expanding at light speed, will burst like a supernova. There are 159 new boards, agencies and programs put into place with this new law. This is not America.

Obamacare represents the destruction of the American health care system and with it, the destruction of the U.S. economy. Wisconsin U.S. Senate candidate Tammy Baldwin openly supports the government takeover of health care. She is not alone. We were told by Nancy Pelosi that Congress needed to pass Obamacare for us to find out what was in it. We found out, and a majority of Americans oppose Obamacare.

The election on November 6 is America's Alamo. If we don't elect men and women who oppose this devastating piece of destructive legislation, it will spell the end of America as we know it.