Repeal (what?) and replace (with what?).

• Position: Your Life

The Republican "repeal and replace" slogan sounds simple and appealing, but gets very complicated when you get to the next step. "Repeal" generally means "repeal ObamaCare," which often is qualified immediately with "except for the parts we like." The problem is that the parts you like depend on the parts you, or your fellow Americans, do not like, stresses Jane M. Orient, executive director of the Association of American Physicians.

For instance, she points out, you may like not being denied coverage because of preexisting conditions, but you may not like having to pay more to cover other people's preexistings. You might like the "free" contraceptives, but not like the mandates that force you to pay for "free" care for other people's children.

"Then what do we replace it with?," she asks. "Republicans have a bunch of competing ideas. Each would replace the ObamaCare centrally planned system of subsidies, thresholds, and mandates with a different system of government dictates. The Republican mandates might be milder, at least at first--call it ObamaCare Lite.

"We've seen them do it before. We already have ClintonCare Lite: the so-called Health Insurance Portability and Accountability Act. That was supposed to solve the problem of preexistings and insurance cancellation. It didn't. What it did accomplish is to establish a pervasive web of Federal controls over medical practice that becomes more expensive and onerous every year."

Republicans, Orient reminds us, might use a different term, such as "refundable tax credits" instead of "subsidies," but it still is forced redistribution of wealth. The cut-off points (thresholds) constitute a cliff where marginal tax rates leap upward, punishing those who increase their income, and thus creating a poverty trap.

Orient, a clinical lecturer in medicine at the University of Arizona, Tucson, continues: 'The basic problem is this: medical care costs too much. The basic solution is to get the Federal government out of medicine, and replace the third-party payment system with the only honest ways of paying for medical care: cash, catastrophic insurance, and charity. Simple--but extremely difficult."

ObamaCare did not create the problem, Orient points out; it just made it a whole lot worse by destroying much of the system that people depended on and creating vast new dependencies.

Moreover, some estimate that at least 40%--possibly much more--of the 2.7 trillion dollars poured into the "health care system"...