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Physician Robert Zarr explains how King v. Burwell threatens not only the the Affordable Care Act but the larger fight for universal health care in the United States

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PROTESTERS: No to Obama care! Yes to freedom! ROBERT ZARR, PRESIDENT, PHYSICIANS FOR A NATIONAL HEALTH PROGRAM: So we’re standing here in front of the Supreme Court of the United States of America. It is an important case today called King v. Burwell. King is a 64-year-old veteran who lives in Virginia. He’s one year shy of qualifying for Medicare. And he’s arguing that the 9 million Americans who live in states–this is over 30 states in the country who have not set up state-based exchanges for them to purchase insurance–should not receive federal money, federal subsidies, for them to buy into the federal exchange. TEXT ON SCREEN: The plaintiffs are challenging an IRS rule that says aid must come from exchanges “established by the state.” 34 states have refused to set up their own exchanges, meaning aid in those states is being provided by the federal government and not the state. ZARR: So what’s at stake here is the 9 million Americans, which translates to about 8,000 additional deaths per year if they don’t have health insurance. The point here is that 9 million Americans will probably not be able to afford their health insurance through the exchanges if this goes through, if the Supreme Court favors on the side of King. And what it means is that those 9 million Americans, if they’re not part of the total number of Americans who are covered under the exchanges, then the pool risk goes up, not down, because you need millions more of Americans to bring down the cost. So those individuals, those millions of Americans who remain on the insurance rolls at the exchanges, will have even less affordable care, less affordable health insurance, and very likely, the benefits, the coverage on those health insurance will be decreased significantly. So it really questions the viability of the Affordable Care Act. There are parts of ACA that, yes, have some merit, but in the way in which we’re trying to do this, in other words, leaning on the private, wasteful, inefficient insurance companies to provide this benefit has clearly been fraught with problems since, really, the turn of the century. We know it doesn’t work. Contrast the Affordable Care Act with single-payer national health insurance, or let’s call it improved and expanded Medicare for all. And rather than talk about dozens of millions of Americans, let’s talk about 300 million Americans. So if you had 300 million Americans, part of the same insurance pool, if you had a national health insurance program, then you would significantly reduce the cost to every single American. You would have no more out-of-pocket expenses, no more deductibles, and no more cost-sharing on the part of the individual, except in what we pay in taxes. So that’s a very, very fundamental difference. And one of the reasons why I’m here today is because if these 9 million Americans don’t have health insurance, these are 9 million people who will not see their doctor when they need to. This is 9 million people who will forgo treatment, who will forgo buying medicines ’cause they can’t afford them. They’ll forgo seeing a specialist when they need to see a specialist for their heart or for their lungs or for their kidneys. These are 9 million Americans who will die prematurely and suffer needlessly because there are politicians who are not willing to understand the moral issue here, as well as the financial issue for our country.


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Robert L. Zarr, a physician, is president of Physicians for a National Health Program. He represents some 19,000 doctors and medical students from around the country who advocate for a single payer, not-for-profit healthcare system

Thomas Hedges is a freelance photographer, videographer and writer based out of New York/New Jersey. His work has appeared in The Guardian, Salon, Demos, The Nation, NowThis, Brut. Media, Thrillist, and CBS. Hedges formerly worked as a producer for TRNN. Follow him @TAHedges.