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There’s no doubt the ACA is finished. It’s bankrupt; it doesn’t work; its killing coverage; the coverage afforded is basically unusable; doctor’s are fleeing; insurance companies are abandoning entire states; and, of course, it’s found nowhere in the Constitution outside the overactive imagination of John Roberts (not that that one matters). The question is how will it go out. And what will take it’s place?

President-elect Trump dropped some hints as to his coming answers:

President-elect Donald Trump said in a weekend interview that he is nearing completion of a plan to replace President Obama’s signature health-care law with the goal of “insurance for everybody,” while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid.

Trump declined to reveal specifics in the telephone interview late Saturday with The Washington Post, but any proposals from the incoming president would almost certainly dominate the Republican effort to overhaul federal health policy as he prepares to work with his party’s congressional majorities.

Trump’s plan is likely to face questions from the right, after years of GOP opposition to further expansion of government involvement in the health-care system, and from those on the left, who see his ideas as disruptive to changes brought by the Affordable Care Act that have extended coverage to tens of millions of Americans.

In addition to his replacement plan for the ACA, also known as Obamacare, Trump said he will target pharmaceutical companies over drug prices.

“They’re politically protected, but not anymore,” he said of pharmaceutical companies.

One wonders how “insurance for everybody” will be paid for. Trump is likely to face a greater fight from his own party than from the opposition. The Democrats should technically be okay so long as continued coverage for the “poor” is promised (no-one cares about delivery, it’s the thought that counts in D.C.). And the GOP has murmured about changing the law but keeping those dreadful taxes – even as they contemplate mind-blowing debt increases in the near years to come.

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NBC News.

Another huge problem will be the insurance industry and the medical community. They will not go away quietly. And they will join forces with the big-pharma racket. Nothing about repealing or replacing this monster will be easy. But change has to come. Barring massive, massive subsidies, the program as is, is finished.

Fred Reed recently mused on the fact that the much-maligned, socialist single-payer system found in some other countries is preferable to what we have now. And he’s right. Single-payer would cost less overall and would likely deliver much better results. But, recall that delivery doesn’t matter in D.C. Due to the stigma, the potential loss of control and profits for the insurance cabal, etc., and the lingering collective remembrance of freedom, socialized medicine is not going to happen in America. No time soon, at least.

The Austrian, the anarchist, and the capitalist in me fully believes that a completely unregulated, free-market system is by far the best alternative. It’s one we used to have and is still found in a few small places around the world. It worked – too well for the government and their corporate handlers. It will never return.

So “free” medicine, the best solution, and socialized medicine, a distant second-best, are off the table. That leaves things in between them and what we have now. And what we have now is the worst possible in the developed world. It’s really little better than no care at all in many cases. In some cases, it’s actually worse.

What we’re probably going to end up with is a compromise. Something dead in the middle that will last a few years or decades and then need another massive overhaul. I wish Trump (and all of us) well but I remain optimistically pessimistic.

As is, I’ll try to stay healthy and avoid any contact with any medical system. That’s what I recommend for everybody.

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