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CPBJ Extra Blog

When the superhero stumbles

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The thing is, government was supposed to be the superhero on health care.

The villain? Let's say nebulous, though that's arguable. But the crisis? Clear. And government was going to avert it, even though the actual work to be done involved a lot of other parties. Because it was leading the charge, bringing the change, and how.

Lately we've been seeing the feds signal that they will take an even more active role in determining, for example, what plans offered on the Obamacare Marketplace must contain and what assessment criteria will be posted to them. This also fits nicely into the superhero schema.

You know what doesn't? The fact that the implementation problems so far have not come from the hospitals or the insurers or the brokers or the medical manufacturers. The not meeting deadlines, the rough rollouts — I'm trying to think of non-governmental examples, and coming up empty. Except for the electronic health record vendors, whose handiwork is, um, not garnering entirely raving reviews — and who, after all, are being used so widely now because government told providers they had to.

In short, the problems so far have been government problems, albeit state government in the case of some non-federal Marketplaces. And, to be sure, many of the Obamacare delays and modifications have been presented expressly as smoothing the transition for the other parties involved. But still, the actual problems we have seen so far are government problems.

Does that portend inexorable doom? Nope: That's a really high bar to clear.

But it does raise little peals of dissonance in my head each time the administration decides that doubling down on government involvement is the best approach.

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