	Wilensky also gives suggestions on how to reform these shortcomings in the Affordable Care Act. “Value practicing” over “volume practicing” is necessary to reduce the costs of healthcare while improving the quality of care received. Value practicing refers to good medical procedures to ensure that patients become healthy quickly after they become ill. Volume practicing refers to maximizing patients accommodated at any one time to maximize profits. Individuals must also have proper medical knowledge to make informed decisions on the type of care that they wish to receive. Allowing “market-friendly” reform does not undermine the current reform of expanding medicine to all American citizens. It does, however, give wealthier seniors the ability to purchase more expensive care if they choose to do so and pay these fees out of their pocket.
	McClellan is generally approving of the Affordable Care Act. He approves of the principles behind the creation of the bill and sees many promising features of the bill. This includes the provider payment reforms, which are meant to create cheaper coverage for Americans. In particular, McClellan finds the reforms that incentivizes physicians and hospitals when they provide superior care at a lower cost promising. The bill does not provide any methodology on how to reach this point, but it is promising to see support for more efficient healthcare practices.
	McClellan also finds that the Affordable Care Act lacks in specific areas. He says that adding a reform of the medical liability system and reforms for consumers would improve the quality of care. He also stresses the importance of health education, as the best prevention of increasing costs is to avoid medical procedures in the first place.
	Butler argues that the Affordable Care Act is unconstitutional due to individual mandates. Individual mandates force citizens to get health insurance or pay a small fee every year to compensate for their lack of insurance. This was included in the act to incentivize Americans to purchase health insurance. He previously supported individual mandates in the 1990s, when he attempted to prevent the Clinton Administration from creating a form of universal healthcare in the United States at that time. He believed that individual mandates were once necessary in a universal healthcare system to prevent insurers avoiding bad risks and healthy people declining coverage due to not needing it at the time.
	The reason that an individual mandate would work in Butler’s proposed healthcare system in the 1990s is due to three critical assumptions. Butler assumed that healthcare coverage was not primarily acquired to protect the consumer, but instead to protect others around the consumer. This was necessary to prevent hospitals and individuals footing the bill for someone who did not purchase health insurance in the event that they did require medical attention. A large portion of the funding in Butler’s reform would come from the money saved from other aspects of his health reform, and not out of the consumer’s pocket. Finally, Butler’s version of the individual mandate was not a mandatory requirement. It was designed to be an incentive (through tax breaks instead of a penalizing fee) for people to get health insurance.
