I get a lot of email on a normal day, but yesterday the day after the House passed “The Patient Protection and Affordable Care Act of 2009,” my email box was full of opinions and reactions. Barack Obama himself wrote me to say “thank you.” Because of me, it appears “every American will finally be guaranteed high quality, affordable health care coverage.”

I received notices from the three major pharmaceutical trade organizations, PhRMA, BIO, and GPhA, each one serving up its perspective on the Act. But I’ve also heard from more remote voices from rooms that I don’t usually hear from.

The Americans for Prosperity (AFP) sent me a number of very urgent messages. “Nightmare Becomes Reality: Congress Ignores American People, Passes Washington Takeover of Health Care,” screams one in 36-point type. In the organization’s statement, Phil Kerpen, AFP’s vice president for policy says, “This legislation will demolish the doctor–patient relationship.”

“This reckless law will put a federal bureaucrat between patients and doctors, while giving Washington unimaginable power in deciding the insurance coverage, diagnostic tests, and treatment of individuals.” In addition, “The real cost of this bill is likely to be $2.5 trillion…. Tax increases and massive cuts in government services at the federal, state, and local levels will most certainly occur.” Finally, says the statement, “this bill was also an assault on our democracy.”

Tijana Ignjatovic, strategic healthcare analyst at Datamonitor, wrote to let me know that “Cost strain on private and public payers in the long run will drive market down.” According to Tijana “…imposed discounts and rebates, in addition to raised industry fees will lead to a market dip.” And while Tijana believes that these “negative effects will be offset as revenues begin to rise,” after 2015, she also predicts “greater government participation in provision of healthcare.”

The truth is neither President Obama, nor the AFP, nor the Congress, nor Tijana Ignjatovic knows exactly how this legislation will play out or its long- or short-term consequences. What we do know is that the wealthiest country on Earth cannot provide adequate healthcare coverage for about 10% of its citizens. Among the rest who are covered, only the very wealthiest few don’t worry that a personal health emergency of large enough proportions could wipe them out financially in spite of their coverage. Businesses claim that insurance premiums are a drain on their bottom lines, and many say that without the burden of providing health insurance to their employees, they’d be able to boost salaries. The truth is the current system is broken and needs to be fixed.

Interestingly, the AFP laments that the House legislation still leaves 22 million Americans uninsured. But if the AFP and organizations like it are truly concerned about those Americans, why don’t they propose an acceptable alternative to the current bill, rather than spend their time and resources lambasting the bill on the table? The same goes for all of the Republicans who voted against the bill. Unless they are prepared to defend the system as it is, merely getting in the way of some solution—albeit an imperfect solution—is not good enough. There is still time for opposition voices to join those in favor of reform to craft a bill that addresses the problem and doesn’t just add to the general din of dissention and dissatisfaction.

*With apologies to Truman Capote.