As the argument over the legality of the Affordable Care Act mandates the requirement of all Americans to carry health insurance or face financial penalties continues. Some Medical Leaders believe the potential for better quality, diminishing cost of care and overall increase in relationship between patient and physicians have been ignored.

According to the commentary in the Journal of the American Medical Association, the individual mandate would have measurable benefits for the relationship between patients and physicians.

Authors Edward D. Miller, M.D., dean/CEO of Johns Hopkins Medicine, and Scott A. Berkowitz, assistant professor of medicine and medical director for Accountable Care from Johns Hopkins, wrote that the mandate would strengthen the patient-physicians relationship, increase access to health insurance without the intention of just covering the cost of care. And stabilize premiums, also would target the "free rider" problem because many do not pay for the care.

"It should be clear to objective observers that the manner in which our nation has historically dealt with health care insurance coverage is unfair, inequitable and unsustainable," says Miller. "Ensuring that the maximum number of people possible have health insurance is crucial in improving access to, and the quality of, care."

The authors point out that by increasing the number of insured individuals, the mandate should reduce the cost of healthcare services that are routine and provide financial security from potentially devastating healthcare cost.

"The potential positive impact of the individual mandate on the patient-physician relationship is underappreciated," says Berkowitz. "We know from research that patients with insurance are more likely to have physicians routinely involved in coordinating their care, are more apt to receive regular screening and preventative services, and have an increased life expectancy."

The mandate will address the chronic problem in the US healthcare system where estimated yearly cost of $73 billion in uncompensated heath care was provided, resulting in $1,000 increase in annual cost for health insurance premiums. The authors believe individual mandate would reduce the level of uncompensated care and the resulting need to pass these cost on for those who have insurance.

The authors also note that the individual mandate addresses the issue of fairness, pointing out that the health care market is unique in that while virtually everyone will require medical care during their lives, many do not pay for that care.

"For those individuals for whom health coverage is unaffordable, there is a societal obligation to create remedies. On the other hand, for those who could afford to purchase coverage, yet choose not to, it should be made clear that 'free riding' cannot be sanctioned," says Berkowitz.

"In the end, the health of patients relies on the health of the system providing their care, so it is imperative to get it right, and the individual mandate is an important step in that direction."