"Repeal and replace" is a misguided strategy for getting past the Affordable Care Act and moving toward a focus on health rather than insurance cards. It is hopelessly utopian, strategically suicidal, emotionally deadening, operationally hollow, and needlessly partisan. Here's why:
Utopian: Like the Affordable Care Act, "repeal and replace" assumes some enlightened Congress and president can muster the wisdom, altruism and ability to reinvent one-fifth of the economy. One new law would sweep away the old and fix the problems that preceded it.
Suicidal: A "repeal and replace" coalition would see no victories for years. Doing so requires a unified plan, House and Senate majorities, the presidency and the will to stave off lobbyists for years. An "repeal and replace" bill would require proponents to lay aside divergent philosophies and parochial interests. In reality, once announced, Affordable Care Act supporters and lobbyists would demagogue any such bill to death in a day’s time. "Repeal and replace" resembles the British during the American Revolution: bright red uniforms with shiny brass buttons, tight geometric groupings marching onto an open field and guerrillas behind trees cutting them to pieces.