For a better experience, click the Compatibility Mode icon above to turn off Compatibility Mode, which is only for viewing older websites.

Professor Robert Field Offers WHYY Listeners an Update on Affordable Care Act; Philadelphia Inquirer Reviews his New Book

Robert I. Field Mother of Invention

December 02, 2013

The public-facing components of the website have improved, but questions remain as to the Affordable Care Act’s long-term prognosis, Professor Robert Field said during an interview on WHYY’s Radio Times on Dec. 2.

“The front end is vastly improved,” Field said, referring to upgrades federal government contractors made to the online health insurance exchange that unsuccessfully launched in October.  

Field said, however, that the ultimate test of Obamacare will come next year, when insurers who need information about patients’ coverage begin receiving claims.

“The real risk is January 1st,” Field said. “Are people going to get claims denied because the insurance companies don’t think they have a policy?”

Several factors contributed to the troubled roll-out of the government’s health insurance marketplace, Field told Radio Times host Marty Moss-Coane. 

“There were many moving parts,” Field said, citing the unexpected burden the federal government faced in creating a system that would work in 36 states.

Beyond the political opposition that hampered implementation of the Affordable Care Act, the process of creating the health exchanges was poorly managed, Field said.

“There were no clear lines of authority.  Contractors didn’t know who to report to, and the authorities put a lot of stock in the contractors.” Field said.

Despite the technical issues in the launch of the health exchanges, Field and Washington Post reporter Sarah Kliff agreed, there was scant political support for creating a government-based system.

While critics of Obamacare criticize government involvement in health care delivery, Field said private providers from doctors to hospitals, pharmaceutical companies and insurers are massively indebted to the government.

“If the government weren’t in our health care, we wouldn’t have most new drugs, because the (National Institutes of Health) funds the basic research,” Field told Moss-Coane. “We wouldn’t have well equipped new hospitals, because Medicare pays for a lot of their new equipment.  We wouldn’t have medical specialists that we do now, because Medicare funds their training, and we wouldn’t have these private insurance companies.”

Field explores the theme closely in his new book, “Mother of Invention: How the Government Created ‘Free-Market’ Health Care,” which was published by Oxford University Press in November and reviewed by the Philadelphia Inquirer on Dec. 1.

The book has drawn other favorable reviews, with James Morone, the John Hazen White Professor of Political Science and Public Policy at Brown University, describing it as “elegant, thoughtful, creative, meticulous, unsettling, irresistible, and required reading for both scholars and citizens.“

This is Field’s second book with Oxford University Press, which published “Health Care Regulation in America: Complexity, Confrontation and Compromise” in 2006.

On Jan. 22, the law school will host a 5 pm book-signing with Field, and his colleague, Professor Barry Furrow, director of the Health Law Program and the lead author of “Health Law – Cases, Materials and Problems,” which is now in its 7th edition.

Field directs the JD-Master of Public Health Program and holds a joint appointment as professor of health management and policy at the Drexel University School of Public Health.