IDA HELLANDER, M.D., ida at pnhp.org, @pnhp
ROBERT ZARR, M.D., M.P.H., rlzarr at yahoo.com, Also via Mark Almberg, mark at pnhp.org
Hellander is director of health policy and programs at Physicians for a National Health Program, a 19,000-member organization of doctors headquartered in Chicago. She co-edits PNHP’s newsletter, is a frequent contributor to the International Journal of Health Services, and is co-author of the book Bleeding the Patient: The Consequences of Corporate Health Care.

Zarr is a pediatrician at Unity Health Care in Washington, D.C., where he cares for a low-income and immigrant population. He is president of Physicians for a National Health Program. Almberg is the group’s communications director.

The group just released a statement: “Today’s decision by the Supreme Court in King v. Burwell to uphold the Affordable Care Act’s premium subsidies in about three dozen states will spare more than 6 million Americans the health and financial harms associated with the sudden loss of health insurance coverage.

“For that reason alone the decision must be welcomed: Having health insurance is better than not having coverage, as several research studies have shown.

“That said, the suffering that many Americans are experiencing today under our current health care arrangements is intolerable, with approximately 35 million people remaining uninsured, a comparable number underinsured, and rapidly growing barriers to medical care in the form of rising premiums, copayments, coinsurance and deductibles, and narrowing networks.

“The unfortunate reality is that the ACA, despite its modest benefits, is not a remedy to our health care crisis: (1) it will not achieve universal coverage, as it will still leave at least 27 million uninsured in 2025, (2) it will not make health care affordable to Americans with insurance, because of high copays, deductibles and gaps in coverage that leave patients vulnerable to financial ruin in the event of serious illness, and (3) it will not control costs.

“Why is this so? Because the ACA perpetuates a dominant role for the private insurance industry. Each year, that industry siphons off hundreds of billions of health care dollars for overhead, profit and the paperwork it demands from doctors and hospitals; denies care in order to increase insurers’ bottom line; and obstructs any serious effort to control costs.

“In contrast, a single-payer system — an improved Medicare for All — would achieve truly universal care, affordability, and effective cost control. It would put the interests of our patients — and our nation’s health — first.”

ADAM GAFFNEY, M.D., gaffney.adam at gmail.com, @awgaffney
Gaffney is a research fellow in pulmonary and critical care medicine at Harvard Medical School and Massachusetts General Hospital. He is a frequent writer on health policy, blogging at theprogressivephysician.org and publishing in USA Today, Salon, Dissent, Jacobin, In These Times, Truthout, and elsewhere.

Last week Gaffney wrote an article in Jacobin that included the following comments: “It is important to understand that the Affordable Care Act isn’t — and is never going to be — adequate for delivering health care justice. At the same time, the sudden withdrawal of private health insurance from millions of Americans would be a human travesty that no sensible left should countenance, much less celebrate. Yet such an acknowledgement must not mean turning a blind eye to the deep structural inadequacies of our health care system, which will persevere, whatever the decision of the Supreme Court, until more fundamental change — a single-payer health system — is won.”