Any plan that “replaces” obamacare will be single-payer or will be a worse disaster on the way to single payer. The concept of market medicine is the one prohibited consideration. The power and inherent corruption entailed by socialized medicine of some sort is the guide to what will come from the COngress, the courts, and the president, primarily the president because he has already established that obamacare and by extension whatever health arrangements exist will be altered and manipulated with no limits by him. Congress will only complain and will not actually do anything that he does not ordain Congress to do.
This would be a valid point, but it's not relevant to any discussion about modern health care in the U.S. The whole idea of "market medicine" is destroyed once you introduce any third party into the payment process -- regardless of whether that third party is a government or an insurance company.
Let's face it ... There are very few Americans who can afford to pay for their own health care if "market medicine" was adopted here.
We have not had a free market in physician and hospital services since 1964.
The central problem, the one which must not be named, is Medicare. Medicare is the reason most GOP elected officials support Obamacare, or at least will oppose its removal by any means other than symbolic and ineffective gestures.
In 1965, the government promised to pay, without limit, for all useful or potentially useful medical procedures for persons over 65, and some others who qualified by reason of disability or having a politically favored disease.
To the socialists who passed Medicare, this seemed like a small promise - after all, in 1964, persons over 65 and their families were not paying much for medical services, since those outlays had to compete with other family needs and priorities.
Using typical socialist static analysis, the pro-Medicare forces promised expenses in 1990 would not exceed $8 billion, when in fact they were over $100 billion and skyrocketing.
What the socialists of 1965 did not recognize was that a promise to pay, without limit and with other people's money, combined with our capitalist health industries, would create a 50-year boom of inventions, therapies, and technologies, which very few over-65s of 1964 would have paid for voluntarily and out of pocket, but which now, fueled by OPM and a post-Christian attitude about suffering and death, would soon consume all tax revenue if not stopped.
Step one was the Great Compromise of 1986. Tip O'Neill and Ronald Reagan agreed that the GOP could cut taxes, as long as the Democrats could continue to fund Medicare by printing money and borrowing. Step two, largely ineffective, was the attempts to limit spending through the HMO model(s) and disease-specific payments (DRGs).
Now, our ability to create money for social spending out of thin air is threatened, and all political attempts to curtail Medicare have failed.
Hence "Obamacare". They all hoped, foolishly as it turns out, that passing a vague and unconstitutional "law" turning Medicare (and all the rest) over to "experts" like Ezekiel Emmanuel and David Blumenthal would solve the payment without limit problem, somehow, while letting individual Congressthings off the hook.
Of course, it's a disaster, with much worse to come.
But the system as it existed after 1965 was doomed anyway. For one thing, the government cannot have a real budget if medical services are covered without limit.
If you want a free market, which, on most days, seems like the best solution to me, it is Medicare, not Obamacare, which must be repealed.