It is a sad day for those Americans who believe in limiting the federal government’s powers. The purpose of the founding fathers in writing the Constitution was to impose limits on the role of government.

Unfortunately, five of the nine Supreme Court justices did not agree, which was a slim majority.

Obamacare is a legislative monstrosity that will impose the biggest tax increase in the history of the United States. This monster will raise health care costs, diminish all Americans’ choices and control, and impair the overall quality of health care. It is loved only by those who don’t really understand its effects.

Clearly you cannot add 30 million people to the health care system without increasing costs and without expecting health insurers to pass along costs to those of us who actually pay for our insurance benefits and work for a living. And where are all the extra doctors, nurses, health care workers and facilities supposed to come from to meet the increased demand? They won’t appear overnight, and they may not appear at all if it is not profitable for them, so existing health care will be parceled out and there will be long waits for service.

The court’s ruling was a disappointment for those of us who are more discerning about how free markets work and their ability to provide the best products at the lowest cost. It also now expands the power of the federal government to force consumers to purchase a product. It is a huge federal power grab to control one-sixth of the economy.

All we can hope for is that Congress will be able to repeal this monstrous law and that voters remember this on Election Day.

Eileen and Richard Baty Hall Point Road

Mount Pleasant

Many of my clients in the insurance business, especially my health insurance customers, believed that Medicare was passed with a mandate in 1965, such that those who are 65 years and older had to give up insurance premiums in favor of deductions from their Social Security payments. It devastated the insurance business. It also ended the aged’s independence from government.

Many questions are still to be answered about Obamacare. How are state exchanges to be handled? Eventually overseen by federal eyes?

How will the penalty or tax be enforced? Will the individuals be run down to pay or comply? For that matter, who will enforce fines against small businesses that balk at not paying fines or taxes?

How will health agencies like Blue Cross deal with teachers in associations it covers who no longer pay retirement premiums for coverage because of successful negotiations with Blue Cross and Blue Shield?

In the last few years we have seen executive administration in Washington involving insurance mandates that give dependents at home coverage until age 26 on their parents’ policies. In another mandate, free contraceptives and sterilization were also to be given by insurance companies. Do insurance pools cover this or will it eventually be the taxpayer?

What is the destiny of Obama’s signature law?

Donald Dashnaw Brandt Street

North Charleston

Although “Obamacare” passed the Supreme Court test, it has at least two major flaws: It isn’t a single-payer system, and it keeps the insurance companies in control of health care in the U.S.

A wonderful book recommended by a physician friend, “Healing of America” by T.R. Reid, explains health care in wealthy countries.

The 20 or more countries’ systems vary in the details but not overall principles: everyone gets insurance and everyone pays; insurance companies are non-profit but compete for customers on quality of service; people choose their own doctors (who don’t work for the government except in Great Britain) and insurers; costs of treatment are uniform and transparent; employers don’t pay for their employees’ health care. No country, with the possible exception of Great Britain, practices “socialized medicine.”

America has the highest technology and the best medical professionals in the world, but lags all the developed countries in costs (twice that of the wealthy nations) and outcomes (one example: the U.S. is last in keeping newborns alive). Insurance companies waste 20 percent of premiums on administration (vs. 3 percent for Medicare). Our system is unnecessarily complex and confusing.

In the U.S. we already have rationing and “death panels.” Health care is for those who can afford it (or go to emergency rooms for someone else to pay), and even so 30 percent have their claims denied. Insurers decide in secret who gets the operation and who doesn’t, or a clerk reads from a menu. Have you ever had to fight with an insurer?

Americans are the world’s least satisfied health insurance customers. Why do we put up with it, and blindly accept the “socialized medicine” rant? Read the book.

Michael Griffith Sterling Marsh Lane

Johns Island

I respect the positions and appreciate the fears of alternative thinking on the matter, but for less fortunate Americans who have not had access to the American Dream through no fault of their own, or worse have suffered the indignity of purposeful oppression, I’m proud of the U.S. Supreme Court and our judicial processes. I applaud their decision to uphold Obama’s health care initiative.

The free market health industries have raised their compensation to criminal proportions. Something has to be done or we’ll be filling out home equity loans just to see a doctor.

Now it looks like our nation is on course toward providing access to basic health care to all Americans. It’s my hope that the Affordable Care Act, at tax penalty gunpoint or otherwise, will level the playing field and create a framework in which every American can contribute an equitable share in the cost.

I’m happy for those employers who have wanted to provide health insurance for their employees and couldn’t because of the exorbitant cost. Employers will soon have a more clearly defined and hopefully more cost-efficient mechanism with which to improve the lives of their workforce, and thereby raise the standard of living for everyone.

I think Americans will look back on the court’s decision and equate it to such landmark leaps in social well-being as the Nineteenth Amendment, the Civil Rights Act, and Roe v. Wade. I can’t help thinking that America’s standing on the world stage has just been raised in the eyes of citizens in countries still struggling for even the most basic standards of living.

Nelson Ohl Lempesis Lane Folly Beach

Now that the U.S. Supreme Court has ruled the Patient Protection and Affordable Care Act constitutional, it’s time Republicans stopped calling it Obamacare and begin referring to it as the “Obama Cares Act.”

Carl Nandrasy Olympic Lane Mount Pleasant

Perhaps now with the Supreme Court’s 5-4 decision to uphold the Affordable Care Act, the liberals will stifle their decade-plus whine about the five-to-four decision in Bush v. Gore upholding George W. Bush’s election.

Frank Leister Archdale Street

Charleston

This Supreme Court decision on the Affordable Care Act has me totally confused. If I go out and buy a pair of shoes, I have to pay a tax.

However, if I don’t go out and buy a pair of shoes, I don’t have to pay a tax. With their logic if I don’t buy a pair of shoes, I have to pay a tax. What? With this decision, if I don’t buy insurance I have to pay a tax. How stupid is that?

Warren Harris Waterlily Way Summerville