By:  The Redheaded Pharmacist The United States Supreme Court has just ruled to uphold the Affordable Care Act.  The 5-4 decision settles the legal argument surrounding the 2010 healthcare reform legislation passed by Congress under the Obama administration. The landmark decision by the Supreme Court upholds what most people consider to be President Obama’s signature piece of legislation.  Under the ruling the healthcare reform law is upheld under the argument that the controversial individual mandate is in fact constitutional by classifying it as a tax. That legal clarification allows the healthcare law to stand.  The remaining provisions of the healthcare reform law that haven’t already been implemented are scheduled to phase into the U.S. healthcare system by the end of 2014. So what does this all mean?  The decision today can be considered a big victory for the Obama administration.  It also means that at least the legal questions surrounding the law and it’s constitutionality have been resolved for now. What isn’t resolved is the political debate surrounding such a controversial piece of legislation.  In a presidential election year, both major political parties in America will use the Supreme Court’s decision today to fuel their agenda and platform leading up to the November elections. As I’ve argued before, changes were inevitable for the United States healthcare system regardless of the Supreme Court’s ultimate decision on the Affordable Care Act.  If implemented fully, our healthcare system will fundamentally change.  If struck down or repealed later, alternative plans would have been introduced to address the same issues that prompted the passing of this legislation by Congress in the first place. There is a great need in the United States for affordable and quality healthcare.  People want the freedom to choose their own practitioners and providers and they want healthcare coverage that doesn’t price themselves out of the health insurance market.  Those facts are true whether we are talking about President Obama’s Affordable Care Act, a Republican led opposition plan, or no plan at all. So the real question we face today isn’t what happens to the Afforable Care Act.  The real debate is how does a nation address the healthcare needs of its citizens in a smart and affordable manner?  How do we ensure that as many people as possible have health insurance while still containing the cost burden to the individual and to society as a whole? It is those issues that will be at the forefront of the political debate leading into the 2012 U.S. presidential election this November.  Democrats will declare victory over the healthcare debate and stand behind the Supreme Court’s decision with pride.  Republicans will use this decision to try and rally public opposition to the healthcare reform law and shed bright lights on the shortcomings of the legislation. But in the end we as a nation are left with a healthcare system that is struggling to meet the needs of its citizens in an efficient, effective, and financially feasible manner.  And because of unmet needs, there are opportunities for anyone willing to look beyond politics to find real solutions to healthcare implementation and logistical problems. And from my vantage point, the profession of pharmacy is uniquely positioned to address shortcomings in our healthcare system and change patient care models to more efficiently and effectively care for the elderly, the sick, the poor, and any other subgroup of the U.S. healthcare system.  Pharmacists interventions work.  Medication therapy management services can be a gateway for a new tommorrow for the profession of pharmacy.  The possibilities are endless. But as I clamor for my great profession to step up and address the unmet needs of our country’s healthcare system, I worry about the logistical and legal challenges that face pharmacists who want to make a positive difference.  How do we find the time to include new patient care practice models into already hectic pharmacist practice settings?   How will we meet the legal roadblocks involved in expanding our roles within the healthcare system? All these issues our profession now faces require organization and involvement from individuals within the profession.  Will we have what it takes to stand up for ourselves?  Can pharmacists thrive in this evolving world of healthcare that includes more government oversight and regulation?  Will we stand by and let others determine our ultimate fate? At least now we have a ruling on Obamacare from the Supreme Court.  But with political opposition to repeal the healthcare reform law coming do we really have a clearer picture of the changes facing the U.S. healthcare system than we had say yesterday or last year?  Probably not and I would argue that clarity doesn’t necessarily equate to professional security anyway. Pharmacists, to really impact the healthcare system in a meaningful way, have to look past the legal arguments and the politics of the Supreme Court’s decision today and try to find ways to better serve patients and manage diseases.  Are we capable of separating ourselves from the debates surrounding healthcare reform and simply offer real solutions to a system in desperate need of workable solutions?  Are we willing to do so not only for the good of public health but for our own survival as a profession?  I sure hope so.