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Obamacare’s win-win strategy

By Jay MacDonald ·
Tuesday, October 8, 2013
Posted: 6 am ET

One of the many perks of my job is the opportunity to interact with insurance professionals who are passionate about their work. I've come to doubly appreciate this benefit while covering the difficult birth of Obamacare, where the thoughtful voice of public health experts often goes unheard amid the din of political hyperbole.

So it was my pleasure to bump into yet another voice of reason last week when health policy professor Richard Palmer of Florida International University in Miami agreed to be my fellow guinea pig on opening day of our Florida state health insurance marketplace.

Like many Americans, we spent the morning watching whirling screen clocks spin on the site. Neither of us gained access to the health plan pages that day, and while that wasn't a huge surprise, Palmer sensed beforehand exactly how it would go.

Expert had a hunch about rough launch

"I do medical research, and what I find interesting is the marketplace set-up is similar to some of the functions that I have to use when I register with the National Institutes of Health," Palmer says. "It has that same very bureaucratic feel to it."

Like most health experts I've interviewed these past four years, Palmer applauds the insurance reforms in the Affordable Care Act: no-cost preventive care, guaranteed insurance for those with pre-existing conditions, the end of lifetime benefit limits, no more rate discrimination against women, and so forth.

But also like many of his colleagues, Palmer is dubious at best that a federal marketplace program that attempts to enlist states in imposing market dynamics on private insurers can deliver the universal coverage we need, especially in states that adamantly oppose the forced marriage.

"The federal government just isn't a consumer-driven entity; it's pretty much bureaucrats in D.C. trying to dictate health policies to states. And as we know, if your state is not very supportive of the ACA, you're going to have a lot of clashing ideas," he says.

Florida is a case in point

Palmer says the Sunshine State is a perfect example of how the marketplace experiment could falter.

"It is the federal government's intention that the states will eventually take control of their own exchanges. That's going to be a most interesting experience here in Florida," he says. "Unless the (Republican-controlled) legislature or the political officers change, this state doesn't want anything to do with affordable care."

Still, like so many other health policy experts, Palmer predicts this win-win scenario for Obamacare: If the online marketplaces work, great. If they don't, America will be halfway to a single-payer "socialized medicine" model that's commonplace throughout the rest of the world and inevitable here, in the view of many health policy experts.

"This is a first good step to universal health care, but it just doesn't go far enough," Palmer says of Obamacare. "Unless we put health care in the tax base and control costs that way, there will never be universal health care for everyone, and ultimately, average American taxpayers will always have to be the safety-net providers for the uninsured in this country."

I'd welcome your thoughts, perhaps while you watch your state's marketplace clocks spin.

Follow me on Twitter: @omnisaurus.

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Jay MacDonald is a Bankrate contributing editor and co-author of "Future Millionaires' Guidebook," an e-book by Bankrate editors and reporters.

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October 16, 2013 at 11:12 am

Obamacare - win/lose. 45% of us who are legally employed will pay through our taxes for the care of ourselves and the other 55%. So, some will win and some will pay! That doesn't sound American, or win/win. Our country has not been built on that principle. Let me suggest that those who receive the free benefits of Obamacare, do some community service for those benefits. Give us 10 hours a week of community service, please. If you are sickly, give us 10 hours of service that is appropriate to your condition. Give us something in return for the free benefits that you receive. That sounds more American to me. What do you think?

Bob Furr
October 11, 2013 at 11:19 pm

You do a great disservice by misrepresenting "Single Payer" as socialized medicine. It is of course socialized insurance, but that is a very different thing.

Steve Ward
October 09, 2013 at 9:53 am

I just received a letter from Florida Blue informing me that my $142 per month insurance policy that I've had for about 4 years will no longer be offered as a result of the "Affordable" Care Act. In it's place they offered me a $726 per month policy. The high cost is the result of me having to carry maternity, pediatric care and other coverage. I'm 58, already paid for my children's care, have ZERO interest in paying for others.
Yes, I really can't wait for single payer CUBAN STYLE (and quality) health care. Right. Actually I could care less, all of you grifters and freeloaders can all go to he(double hockey sticks). I already bought a place in Costa Rica where most of the decent physicians in South Florida are opening practices.

Greg Wetzel
October 08, 2013 at 9:04 pm

If socialism will be so good for this country and the economy; why not make everything socialist. Then we can enjoy life like Russia, China and how about Italy were gas is $14,00 per gallon; it's working so well for them, only 40% unemployment, waiting years to get a surgery, your physician does not care the best for his/her patient, only to check off the protocol list the government requires. Why are you living here; other countries are just waiting with their doors open; O' I'm sorry they are not!

Ron Trent
October 08, 2013 at 5:03 pm

I believe that sometime in the future, we will have a one(1) payer health care system. The current healthcare system is unsustainable. The American people cannot contime to spend a vast amount of our GNP on healthcare. This is the only way to curb prices and profits of the healthcare industry. Everyone (most)will complain and say we are being taken over by
socialists and controled by the government, but will eventually also see that is the best way to go.