Replacing Obamacare

President Trump promised to replace Obamacare, but so far has  only suggested modifying it.   He should replace the Obama approach to health care.  

Medical costs cause the price of health insurance to be too high for some to afford.    Obamacare attempted to deal with high insurance rates by forcing healthy people to buy health insurance. 

A better  approach would recognize that it isn't practical for profit-making insurance programs to pay for expensive to treat chronic disorders such as those associated with alcohol or tobacco use.   Special programs could be set up to cover such disorders. 

Taxes on alcohol and tobacco should be used to fund programs for alcohol and tobacco related medical disorders.   For example, a per gallon tax on alcohol products would go into a fund for treatment of alcohol related disorders.   A doctor would certify that a person has an alcohol related disorder and health care providers would send health care bills for the patient to the alcohol fund in the same way bills are sent to insurance companies for payment.   To simplify payment procedures all medical problems of a patient with an alcohol related medical problem would be paid by the fund because alcohol can reduce the body's ability to handle problems.  The fund would also cover medical costs of those who suffer injuries because  of the actions of someone under the influence of alcohol even if the injury involved a preexisting condition.  A police report that one of the drivers in a traffic accident was under the influence of alcohol would trigger payment from the alcohol fund even if the courts wouldn't consider the drinking driver to be at fault.

Under the current insurance system people who never use tobacco or alcohol help pay for the medical treatment of those who have tobacco or alcohol related medical problems.  Under my proposal only those who use alcohol and tobacco  products would pay to treat  medical problems related to alcohol and tobacco use.  

Another type of health care fund would involve specific disorders, such as heart trouble or specific cancers that may be caused by various factors other than tobacco or alcohol.   Government would use general taxes to finance treatment and conduct research.  Other funds might come from non-profit organizations.  Government might encourage non-profit funds by offering to match what they raise.    

Each fund would operate in part as a research project.  Paying for all treatments from a single fund would allow researchers to monitor and compare the success rate of various different treatments.   Insurance companies are reluctant to fund experimental treatments because they can't expect to benefit from them, but the federal government could benefit from knowing what doesn't work as well as knowing what does work.