PNHP release on King v. Burwell

Health law’s complexity invites attack, even as it fails to cure ailment: doctors group

Physicians for a National Health Program (PNHP), March 3, 2015

King v. Burwell shows how Affordable Care Act’s corporate-inspired, convoluted structure makes it an easy target for opponents

Latest legal challenge threatens to add more than 8 million people to the ranks of the tens of millions who are currently uninsured, leading to an additional 8,000 ‘excess deaths’ annually linked to lack of insurance

‘This case is yet another reason to swiftly move beyond the failing ACA to a simpler, publicly financed, improved-Medicare-for-All system that would cover everyone, make care affordable, and control costs,’ says president of single-payer physicians’ group

March 3, 2015

Mark Almberg, PNHP communications director, (312) 782-6006,

The following statement was released today by leaders of Physicians for a National Health Program, a research and educational organization of 19,000 doctors who support single-payer national health insurance, or “an improved Medicare for all.”

This week’s arguments before the Supreme Court in the case of King v. Burwell demonstrate once again how the Affordable Care Act’s administrative complexity and flaws – largely reflecting its accommodation to the private health insurance industry and other corporate, profit-oriented interests in U.S. health care – make it vulnerable to legal attacks by its opponents.

The ACA clearly lacks the simplicity and legal robustness that a single-payer plan would have. Single payer would be simple: everyone in the U.S. would be covered for all medically necessary care in a single program financed by equitable taxes.

If the court upholds King and his fellow plaintiffs’ challenge to premium subsidies in over 30 states, the health and financial harms to our patients will be considerable. By some estimates, more than 8 million people will quickly lose insurance coverage, increasing the intolerable suffering we already see today.

One consequence of this loss of coverage would be an additional 8,000 “excess deaths” each year – deaths linked to lack of insurance. That figure is over and above the estimated 30,000 annual preventable deaths that are currently occurring under the ACA due to its having left 30 million people uninsured. This is completely unacceptable.

Regardless of how the court rules, the unfortunate reality is that the ACA won’t be able achieve universal coverage. It won’t make care affordable or protect people from medical bankruptcy. Nor will it be able to control costs.

The ACA is fundamentally flawed in these respects because, by design, it perpetuates the central role of the private insurance industry and other corporate and for-profit interests (e.g. Big Pharma) in U.S. health care.

In contrast, a single-payer system – an improved Medicare for All – would achieve truly universal care, affordability, and effective cost control. It would be simple to administer, saving approximately $400 billion annually by slashing the administrative bloat in our private-insurance-based system. That money would be redirected to clinical care. Copays and deductibles would be eliminated.

A growing section of the insured population is already facing very high copays, deductibles and coinsurance, deterring them from seeking needed care. This trend is toxic and unsustainable.

Physicians can’t wait for an effective remedy any longer, nor can our patients. The stakes are too high.

Dr. Robert Zarr, a Washington, D.C.-based pediatrician who will be in front of the Supreme Court building on Wednesday at 10 a.m. Eastern, is president of Physicians for a National Health Program.

Zarr said today: “The King v. Burwell case is yet another reason to swiftly move beyond the failing ACA to a simpler, publicly financed, improved-Medicare-for-All system. Such a system would cover everyone, make care affordable, and control costs. Based on our experience with the Medicare program and the experience of other nations, we know it will work. It’s the only moral and fiscally responsible thing to do.”’s-complexity-invites-attack-even-as-it-fails-to-cure-ailment-doctors-grou



By Don McCanne, MD

The Supreme Court case of King v. Burwell is appropriately receiving extensive coverage in the media since the decision of the Court has the potential to cause perhaps 8 million individuals to lose their health insurance, plus it would adversely impact health insurance markets through spiraling premiums due to adverse selection.

Even though a decision prohibiting subsidies in federally-administered state exchanges would be disastrous, the hype over this case obscures the much more intolerable disaster of perpetuating the inequities and injustices of our current health care financing system. The consequences of continued inaction on single payer reform constitutes proportionately a much greater disaster, regardless of the outcome of King v. Burwell. Over 30 million will still remain uninsured, tens of millions will experience financial hardship in the face of medical need, perhaps even personal bankruptcy, while private insurers will continue to take away our choices of physicians and other health care professionals, take away our choices of hospitals, and take away our choices of pharmaceuticals that our physicians say we should have.

Merriam-Webster includes as two of the definitions of "state": “a politically organized body of people usually occupying a definite territory; especially one that is sovereign,” and “the operations or concerns of the government of a country.” It would be tragic if the court ruled that this silly argument on the meaning of “state” had enough substance to allow a few ideologically-driven Supreme Court justices to deprive 8 million people of insurance coverage. But it would be a much greater tragedy if we allow this to divert us from accomplishing the imperative: establishing a single payer national health program - an improved Medicare for all.