I'm not a patient woman, and this wait for the Supreme Court decision on the Affordable Care Act is making me crabby as hell.

People keep asking me what I think will happen, and I really don't have a clue, so why waste time guessing? My guess means nothing, and neither does yours.

But I have done a lot of thinking about what will happen after the decision.

If the law is struck down:

•  2.5 million young adults will be dropped from their parents' insurance plans and be vulnerable to financial ruin from illness or injury.
• Seniors will lose help with the costs of their prescription medicines.
• Children who are born with disabilities or illnesses will be denied coverage for having a pre-existing condition.
• Millions of adults will loose all hope of getting any coverage because of pre-existing conditions.
• Small businesses will lose the tax credits they're receiving to help them get coverage for their employees.
• Insurance companies will be able to spend as little as they want on actual services, since the provision requiring them to spend 80 to 86 percent on what they take in will be gone.
• Insurance companies will be able to place annual and lifetime caps on coverage.
• Companies will be able to return to charging women up to 50 percent more than men for the same coverage.
• Mammograms, colonoscopies and other screening tests no longer will be free for people with insurance coverage.
• Nearly 100 years of trying to get health coverage to all Americans will be struck down by five conservatives on the basis of an ideological bent.

The court also could strike down the expansion of Medicaid, although this would be unprecedented. In the nearly half-century Medicaid has existed to offer care to the most needy, no court has struck down any expansion of the program.

If the court strikes down just the individual mandate, the provisions already in effect stay in place, but there will be no way to get healthy people into the insurance pool, thereby lowering rates for everyone. This could cause major problems for the success of the law, although it could be remedied by giving consumers a choice with a public option. Competition -- real competition -- would force the insurance companies to keep rates lower and to behave better because they will lose customers and revenue if they don't.

The court also could strike down the mandate and other key provisions, including the mandate that insurance companies cover pre-existing conditions or that they charge women the same price as men for coverage. It also could remove the "80 percent  rule," allowing companies to spend far less on actual services and more on lobbyists, advertising and marketing and on huge bonuses for their executives.

So, will the court rule based on its coziness with big business, or will the justices look honestly at the law and decide based on its true constitutionality? Your guess is as good as mine, but in any case, the fight for quality care for all is far from over.

The food produced by these companies is less nutritious and far more fattening than fresh food, but even after their heavy marketing and their influence on government not to be regulated, Big Food blames its victims for not taking responsibility for their own weight.

These companies market their bad food to children (toaster tarts, sodas, sugary cereals, "chicken" nuggets, cheese-food product, deep-fried chips and fast food), who then pester their parents. Often, parents have little or no idea how bad these foods are; they often join their children in feasting on this stuff.

Unfortunately, there are just too many opportunities to eat junk. I gave blood yesterday and was offered a free lunch -- fast food from several restaurants. I declined and went and got some real food.

My 19-year-old granddaughter gave up soft drinks (soda and sweet tea) nine weeks ago and has lost 15 pounds already -- without doing anything else.

A study 10 or so years ago found that for every soda a child drinks per day, he or she adds 4 pounds of excess body weight in a year (one soda a day, 4 pounds, two sodas a day, 8 pounds, etc.)

Most sweet drinks are sweetened with high-fructose corn syrup now and despite what the "corn sugar" industry says, your body does know the difference. The more high-fructose corn syrup you ingest, the more likely you are to develop Type 2 diabetes. The stuff is metabolized differently than sugar and it affects the way your body makes and uses insulin.

And speaking of corn, the toxin used to genetically modify Monsanto's sweet corn kills bugs by causing their stomachs to rupture. Monsanto claims the toxin disappears after the corn is harvested, but rats that were fed the corn displayed organ damage and the toxin has been found in the tissues of pregnant women.

Even so, Congress killed the attempt by Vermont Senator Bernie Sanders to require Monsanto and others to label its genetically modified foods.

Big Food has big sway over government. That's how sugar got into the food pyramid, and how Monsanto got to force more farmers to use its seeds. It  owns the DNA structure of its corn and if the corn cross-pollinates with that on another farm, Monsanto sues the farmer for patent infringement. So family farms are going under and Monsanto just buys up more land to grow its corn.

Industrially farmed meats also are less nutritious, and less safe. The meats are higher in saturated fats and cholesterol and the meat is filled with growth hormones and antibiotic, leading to more resistant and deadly strains of bacteria. They also have less flavor than animals fed what they should be eating.

If Big Food was so safe, why do we have so many people who are both obese and malnourished?

Yet these Big Food companies are influencing nutrition all over the globe. They join in public-private partnerships with governments and with the United Nations as "experts" on nutrition and peddle their bad food and bad policy.

So, how do we fight them? Simple. Eat local food. Go to tailgate markets to do your shopping. Buy organic when you can't get something locally. Make more things from scratch so you know what's in your food. Grow some of your own food. If you don't have room for a ground garden, have a patio garden.

Yes, it's somewhat more expensive, but you will have lower medical costs, and you will learn to appreciate and understand good nutrition.

When my kids were little, I baked all their snacks from scratch. They wanted the forbidden Hostess and Little Debbie cakes, but once they tried them, they realized homemade tastes better. It's also a lot cheaper and it's not hard to make.

When you become aware of what you're putting into your body, you begin to foil Big Food. They're counting on you to believe what they say is good for you.

Want to know more about good and bad food? Try reading Michael Pollan's "Omnivore's Dilemma" or "In Defense of Food," or Marion Nestle's "Food Politics: How the Food Industry Influences Nutrition and Health."  You can also rent the movie, "Food Inc."

Knowledge is power, especially when it comes to your food.

Life o' Mike is part of Together NC, a coalition of groups devoted to working toward public policies that align with the needs of the public.

As we have watched the policies -- and the budget -- of the current state legislature shred the social safety net and harm our schools and universities, we have tried to educate the public about the harm these cuts will cause to real people.

This week, though, we had a little fun. We figured that since the legislature is taking us back to the 1950s and earlier, we would celebrate it with a "Backwards Budget 0.5K."

It was just a loop around Halifax Mall outside the Legislative Building in Raleigh, and no one broke any bones trying to run backwards. Most of us were sensible enough to walk backwards.

There were some powerful stories there, though. Lee Storrow, once a Sunday school student of mine and now a Chapel Hill City Councilman, was there representing a tobacco-prevention group whose funding has been cut.

Kristy Andrews was there with her mother-in-law, Janice, and son, Jeffrey. Kristy's husband died of lung cancer when he was just 30. The cause was tobacco. Janice and I have both lost sons to corporate greed, even though the death certificates both say cancer. Without prevention education, more teens will be lured into tobacco use, even though the tobacco companies say they don't market to kids. I remember their denials of  "No sir, I don't believe tobacco is addictive," even as my father struggled to quit smoking after he was diagnosed with emphysema.

I'm with Kristy and Janice. I want the money for anti-tobacco education restored to the budget.

The Legislature also cut funding to Planned Parenthood, which is the only access to care for tens of thousands of women in North Carolina. I know when my kids were little I wouldn't have had access to care without them, and the need is even more urgent today. We're talking about breast and cervical cancer screenings and vaccinations against the HPV, which causes cervical cancer. Women go to Planned Parenthood to learn how to prevent pregnancy and to get the contraception they need to do so.

I'm tired of hearing how mental health care has been cut or services for people with disabilities have been reduced, or that we can't afford to keep Medicaid at its current, immorally low levels.

I'm tired of hearing that we can't fund pre-K education for children at risk of failing in school without it, or that we have to cut back on food stamps for hungry people so that the wealthy can enjoy even more money, or that our public schools, colleges and universities will have to live with less.

So, I went to Raleigh and walked backwards around the Halifax Mall to make the point that we should be moving forward as a society, not backwards. Now I'm back in Asheville working toward a day when we all will have access to quality health care.

Employees of Buncombe County, NC, where I live, have to wait 6 months after being hired for their health insurance to kick in.

I hadn't heard of such a long wait until County Commissioner Holly Jones told me this morning. The county will have to change its policy by Jan. 1, 2014, to comply with the Affordable Care Act, which allows no more than a 90-day wait.

I'm familiar with the wait, since Gannett Co., which owns some of the newspapers where I worked, requires new hires to wait 90 days. Even that is a long time to wait. My son, who works a union job at a plant owned by the Koch Brothers, was covered from his day of hire, even though there is a 90-day probationary period for new hires. That surprised me.

My question is, if the Koch Brothers offer immediate coverage, why can't the county?

But according to the Kaiser Family Foundation Benefits Study for 2010, "The average waiting period among covered workers who face a waiting period is 2.2 months. While 29 percent of covered workers face a waiting period of three months or more, only 6 percent face a waiting period of four months or more." Find the entire study at http://ehbs.kff.org/pdf/2011/8225.pdf

This bothers Commissioner Jones because the county provides public health services and as an employer, should set a better example. I agree. People shouldn't have to work for six months without health insurance.

I figure my son's medical care cost more than $750,000 before he died -- more than two-thirds of it for chemo alone. His funeral expenses are not included in that tally. He could have been helped for about $50,000 if his cancer had been caught early.

But the insurance companies wanted nothing to do with him because of his risk of getting colon cancer.

Instead, they spent $102 million on trying to defeat the law that could have saved my son's life, had it been in place in 2005.

A new report by National Journal shows that the industry trade group America's Health Insurance Plans (AHIP) transferred almost $88 million to the National Chamber of Commerce in 2009 and another $16 million in 2010 so the Chamber could attack the Affordable Care Act and the Democrats who supported it.

I remember AHIP president Karen Ignani meeting with President Obama and promising to play nice. I guess her fingers were crossed behind her back the way I used to do when I promised to be nice to my little sister.

During this time, AHIP pretended to support reform, but its money tells the truth about where insurance companies stand. That money paid to influence public opinion with attack ads. They don't care who dies, as long as they can keep raking in the money.

According to the Journal, "... in its 2009 IRS filing, AHIP reported giving almost $87 million to unnamed advocacy organizations for 'grassroots outreach, education and mobilization, print, online, and broadcast advertising and coalition building efforts' on health care reform. That same year, the chamber reported receiving $86.2 million from an undisclosed group. ... The $86 million accounted for about 42 percent of the total contributions and grants the chamber received."

The same thing -- a donation of $16 million -- happened in early 2010, before the law was passed and signed in March.

While none of this surprises me, it does really piss me off. The other thing that makes me furious is that you won't see this in the mainstream media, because the media are owned by more of the wealthy thugs who oppose reform of our health care system.

I just wonder how many lives could have been saved with that $102 million or the tens of millions more spent by Big Insurance and others to prevent health reform.

And the money is still flowing, by the way, to influence the way states will set up their insurance benefits marketplaces. Will there be sanctions for companies that overcharge or underpay? Who will govern the marketplace? Will insurance companies sit on those boards so they can oversee themselves? What will patient appeal processes look like? Will there be more protections for insurance companies than there are for consumers?

All this is still at stake and you can bet insurance companies' money is being spent to influence the outcome.

Millions -- perhaps billions -- will be spent during the election this year to influence Americans to vote against their own best interests.

It probably would cost less to just offer health care to all Americans, but these people just want their own way, and they can afford to buy it.

In 2003, North Carolina created Medication Assistance Programs (MAPs) for people who are uninsured or on Medicaid or Medicare and who need help to buy medications they need to control chronic illnesses. The Health and Wellness Trust Fund awarded 23 grants totaling $8.3 million over three years. Later, more funding would be added to help seniors understand medication interactions and to add more MAP programs.

The Medication Assistance Program has been a  success by almost any measure.  MAP grantee sites provided more than $68.8 million worth of free medications to nearly 40,000 patients from January 2003 to December 2005, representing a 6-to-1 return on investment.  More than 8,000 of these patients also received medication management (MM) services.

Offering medication to people who have chronic conditions helps save suffering and lives, and, of course, money.

Without medications, high blood pressure leads to stroke; high cholesterol leads to heart attacks; diabetes leads to renal failure, blindness and limb amputation; mental illness leads to suicide. It's more expensive both financially and morally to deny medications to people who need them, yet that's what's about to happen unless we act.

Both the governor and the state House of Representatives agreed that MAP is important and their budgets included funding for it.

But the NC Senate decided that helping alleviate suffering wasn't worth including in its budget, even though the program has demonstrated its worth.

During the next couple of days, the budget will be in reconciliation as the House and Senate hammer out differences. Here's where we all come in: We need to contact members of the committee (listed below):

Co-Chairs: Sen. Peter S. Brunstetter (Forsyth), Sen. Neal Hunt (Wake,) Sen. Richard Stevens (Wake)

Vice Chairs: Sen. Tom Apodaca (Buncombe, Henderson, Polk), Sen. Linda Garrou (Forsyth)

Members: Sen. Harris Blake, Sen. Dan Blue, Sen. Andrew C. Brock, Sen. Harry Brown, Sen. Charlie S. Dannelly, Sen. Don East, Sen. Malcolm Graham, Sen. Kathy Harrington, Sen. Fletcher L. Hartsell, Jr., Sen. Brent Jackson, Sen. Ed Jones, Sen. Eleanor Kinnaird, Sen. Martin L. Nesbitt, Jr., Sen. Louis Pate, Sen. David Rouzer, Sen. Bob Rucho, Sen. Jerry W. Tillman,Sen. Tommy Tucker, Sen. Michael P. Walters.

Each of these senators can be contacted through http://www.ncleg.net/Senate/Senate.html.

We need to do this and we need to do this now.

OK, I had my pity day over the Gov. Walker's win in Wisconsin. It seems the monied interests can spend their way into getting what they want. And I know they want to dismantle what's been accomplished in health care.

So, I'm ready for the fight to keep what we have -- and to build on it.

I don't know what the Supreme Court will do, but I'm ready for whatever happens.

If the court strikes down the entire law, we'll start organizing rallies and other events again to educate people about what needs to be done and why. We'll tell the stories of people who have been helped by the Affordable Care Act already and what they will lose if the law goes away.

If the court strikes down the individual mandate, that likely will do in the rules that insurance companies have to cover pre-existing conditions and at no greater cost to the consumer. You really can't do that unless everyone is in the pool, so we will push for a public option (let me buy into Medicare).

If the court leaves the law alone, we have to educate people about what's in the law and what still needs to be done to give everyone access to appropriate health care because even once the law is fully implemented, some 20 million Americans will be without health insurance.

So, no matter what happens, we health care advocates have our work cut out for us. We have to show people that the poor don't choose to be that way; they are not lazy and they do deserve our care and help. We have to prove that helping people with a hand up works for everyone. People who get appropriate health care cost a lot less than people whose mental illnesses or other chronic conditions are allowed to fester until they reach a crisis point.

Of course, crisis care is far more expensive than chronic illness management -- in other words, more profitable for the big money folks who are paying f0r the election of people who will cater to their interests and not yours.

I spent an hour on the phone with fellow advocate Crystal Roberts yesterday, talking about what we do in each case. We'll organize information events to educate the public in any event; we will push for that public option.

We will tell the stories of people who have died for lack of care and the stories of people whose lives have been saved by the law. We will fight to get the truth out to people in spite of the misinformation being spread by the opponents of health reform.

We're all proceeding with the assumption that the court will uphold the Affordable Care Act, but it doesn't hurt to plan for the alternative.

Apparently, Canada got its health care system province-by-province, so Rep. Jim McDermott (D., Wash.), a physician, reportedly will introduce legislation in Washington that would allow states here to do the same thing.

While that's a wonderful thing if you happen to live in a state that would pass a single-payer plan, I'll wager that most of us don't live in those states.

The Health Insurance Lobby managed to get wording into the Affordable Care Act that makes it more difficult for states to build their own single-payer systems and Rep. McDermott's bill would change that by allowing states to access federal funds to pay for their insurance programs.

Naturally, insurance companies don't want this to happen, and with the GOP in control of the House of Representatives, it's not likely to pass anyway.

But even if it did, insurance company lobbyists would be swarming over every state capitol like army ants on a dead bird. They don't want to give up a cent and it doesn't matter how many people die because of it.

California has tried it twice only to have Gov. Arnold Schwarzenegger veto both bills. Massachusetts only got its plan through because, like the Affordable Care Act, it forces people to buy insurance from private companies. Vermont's plan depends on federal money coming from the Affordable Care Act, so the impact if the US Supreme Court strikes down the ACA would be devastating for its plan.

We the People will have one hell of a fight to defeat these powerful business interests, even if the US Supreme Court upholds the Affordable Care Act.

Even though universal access to health care makes sense financially and morally, we still can't seem to get it in place in this country.

Gerald Friedman, an economist at the University of Massachusetts-Amherst, estimated in a recent paper that a national Medicare-for-all system would cost Americans about $570 billion less annually than the amount spent on private plans.

That's a whole lot of money that's going into insurance companies' pockets and helping them to buy influence with legislators. Think about how many people's lives could be saved with $570 billion.

Yes, your taxes may go up, but your lower health care costs would more than compensate for that -- not that you'll hear that from many people in the corporate media.

So, if McDermott's bill were to become law, do you live in a state that would pass a single-payer plan? I don't think I do.