The forgotten 35 million uninsured

Physicians for a National Health Program - 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, co-payments, 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 co-pays, 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.