Moving Forward: Health Reform After the Supreme Court Ruling

By Michael W. Cropp, M.D.

The Supreme Court ruling to uphold the constitutionality of the Affordable Care Act (ACA) is good news. Originally introduced to provide millions of Americans with access to quality, affordable health care, the ACA provides a framework for health care reform. While the legislation is a good first step for those of us who believe health coverage is something all Americans should have, it does not prescribe the solution to lower health care costs. This responsibility is best left to our local communities.

With the Supreme Court’s ruling, it is critical that cities and regions throughout the country continue efforts to find innovative solutions to help control health care costs in their respective communities. Meaningful health care reform requires a careful and balanced approach to improve quality, accompanied by efforts to contain costs, eliminate wasteful spending and enhance efficiencies.

Efforts to increase coverage, improve quality of care and reduce the medical cost trend should focus on five key actions: promoting prevention and wellness; revitalizing and growing primary care; implementing payment reform; achieving alignment of the diverse sectors of the health system to help better coordinate care; and enhancing the use of health information technology.

The goals of health care reform cannot be achieved by one entity alone.  It is a collective responsibility requiring community ownership, wide-ranging partnerships and renewed collaboration among the public and private sectors.

A recent study by the Commonwealth Fund Commission demonstrates how in Buffalo, N.Y., we are making a positive impact through collaborative efforts.  In March, the Commonwealth Fund issued the first-ever scorecard on local health system performance, which examined several key indicators in more than 300 regions across the U.S. The scorecard ranks the Buffalo region 54th nationwide, in the top 10 percent for access and affordability, and in the top quartile for prevention and treatment, and overall performance.

Our region’s ranking is especially impressive, considering Buffalo’s status as the third-poorest city in the U.S. and the association between low-income areas and lack of access to quality care, relative to high-income communities. The Commonwealth Fund report highlights the correlation of improved access with better care and lower costs, and underscores the need for collaboration.

As the Commonwealth Fund report demonstrates, by taking action to reshape health care in our respective regions, we can place our nation on a path toward greater economic and health care security.


Dr. Cropp is president and CEO of Independent Health in Buffalo, N.Y., and is a board-certified family physician. To hear more from Dr. Cropp on health care reform go to


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