Philosophical Struggles with Reform Ruling

“I don’t like the government telling me to do something.”


The Supreme Court’s upholding of virtually all of the health care reform law brought relief to Roland Goertz, M.D., chair of the American Academy of Family Physicians. But Joel Taylor, CIO at Preferred Health Partners, a large group practice in Brooklyn, has mixed feelings.

“We welcome the decision and look forward to making changes in the health care industry to benefit all Americans,” Goertz says. He notes that AAFP has supported health coverage for all individuals for more than two decades. But he was surprised at the Court opinion, believing it would be far more mixed in upholding and tossing provisions than it was.

For Taylor, overturning of the individual mandate would have been expensive and increased financial risk for providers because of investments made in information technology and improved processes during the past two years. Increased use of data analytics, for instance, will improve the continuity and quality of care, he believes.

But personally, on a philosophical basis, he didn’t support the individual mandate. “I don’t like the government telling me to do something.” And he does not believe loss of the mandate would have hurt efforts to improve the coordination and quality of care. “We’ve got to do this anyway; it’s about taking care of the patient. It’s about the welfare of the patient.”

Taylor also philosophically likes that the tweaking of the Medicaid expansion requirement, which is no longer required of states—if they don’t expand their programs, they would lose new related funding from the reform law but not their traditional level of funds. “States need to do their own thing,” he says. “I think the government needs to choose wisely how far they go to meet their ends.”