#38 Why Obamacare Might Collapse: Megan McArdle: How Do We Fix It?

For its opponents, Obamacare is a disaster - a classic example of over-reach by an Administration that wants to expand the size and scope of the Federal government.

Supporters say The Affordable Care Act is a triumph, benefiting countless millions of Americans, while reducing the threat of personal bankruptcies in medical emergencies crippling healthcare costs.

"We have decreased the rate of the uninsured by about a third," says our guest Megan McArdle, a columnist at Bloomberg View. But Obamacare poses a potentially fatal threat.

"What people are doing is they're gaming the system." Some with health emergencies, who have inadequate medical insurance are "signing up for a few months, using a ton of services and then dropping it again."

Several large insurance companies say they are losing money on the government-run exchanges. UnitedHealth, the nation's largest health insurance firm, warned it would have to pull out if market conditions didn't improve. Exchange enrollments are lower than the government had forecast. 

Is Obamacare the victim of "an adverse death spiral"?  Are costs rising faster than expected?  Do Americans have unrealistic expectations that would doom any attempt to provide better coverage?

We debate the arguments from different points of view and suggest a fix that could involve consumers more directly in cost decisions, while putting a ceiling on heath care costs for each household.

Megan McArdle is the author of "The Upside of Down: Why Failing Well Is The Key To Success."