Various conservative health-care experts and policymakers have offered up various formulations of the kind of approach that should replace Obamacare, many of which have involved some combination of transforming Medicare and Medicaid into defined-contribution programs and turning the tax exclusion for employer-provided insurance into a tax credit for all. But somehow a lot of these formulations have lacked coherence, or at least a clear and accessible explanation of why this is the way forward, how this would all work as a whole, and how we might get there.
That’s why this new paper from Jim Capretta (my colleague at the Ethics and Public Policy Center) and Tom Miller (of AEI) is so important. More than anything else I have seen, it offers a coherent and concrete answer to the question “replace with what?”—especially when combined with the essay Capretta and Miller co-authored about how to address the problem of pre-existing conditions earlier this year.
Be warned: the paper is long and fairly complicated. But it is important. If conservatives get a chance to do health-care reform their way, and if they are able to get it right when they do, it will look a lot like this.






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