Last week’s historic ruling by the US Supreme Court preserving nearly all of President Barack Obama’s landmark health law may have finally settled some legal questions, only to shift a re-energised debate about improving the American health-care system to the political arena.In addition to providing health coverage to some 32 million uninsured Americans, other changes in the Patient Protection and Affordable Care Act will affect nearly every patient as it overhauls the US$2·7 trillion health-care system. MORE