Could Obamacare Fail?

How Obamacare Could Fail

One of my non-scientific methods of gauging the current state of the health care system is by the requests I receive for writing and editing.

For example, I have recently received four requests to write about failed electronic medical records systems (no surprise there).  Others include the progress of accountable care organizations (ACOs), the future economics of physician groups, compensation models for physicians, hospital/physician relations and new regulatory issues for nursing homes.

So all of this gets me thinking; what could happen to create a catastrophic failure of Obamacare?  My thoughts….

Accountable Care Organizations:  ACOs could fail to work as hoped by the feds, this could collapse the foundations of Obamacare

Failed integration efforts: hospitals and systems are integrating multiple services, creating much larger and much more complex organizations, not  all of them will work

Exchanges:  the shopping experience becomes a confusing mess (high probability IMHO)

Payment Innovations:  innovations such as fee bundling fail to be feasible

Employer meltdown:  employers engage in wholesale dumping to the exchanges (not impossible in such a weak economy)

So, what are the odds of catastrophic failure?  50% - 50% in my opinion.

Tom