Its not perfect, but we need to change health care and this is a start in the right direction, said Dr. Robert Morgan. Staying the same is not the answer.

Morgan who is a board certified family practitioner and senior managing partner of Oswego Family Physicians said that although the parts of the law that were upheld will do a lot of good, there is still years of work ahead to right the nations health care system.

It was very interesting because the sentiment I got on both sides was that the law was going to be found unconstitutional, Uva said.

Even though Congress called it a penalty, not a tax, Roberts said, The payment is collected solely by the IRS through the normal means of taxation.

Stocks of hospital companies rose after the decision was announced, while shares of insurers fell sharply. Shares of drug makers and device makers fell slightly.

The justices rejected two of the administrations three arguments in support of the insurance requirement. But the court said the mandate can be construed as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness, Roberts said.

The court found problems with the laws expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states entire Medicaid allotment if they dont take part in the laws extension.

Although they said certain elements of the law such as not having pre-existing conditions and allowing students to remain on their parents insurance until age 26 were steps forward, Uva and Morgan also found problems with many of its components.

Independent advisory boards with no accountability and cuts to Medicare in particular were a sticking point for Uva.

Its going to be very hard to practice now in private practice, he said.

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Health care overhaul gets mixed reactions locally