The Affordable Care Act does a lot of things. It takes some money out of Medicare and puts a bunch in to Medicaid. It requires chain restaurants to post calorie counts on their menus and funds a pilot program for nurse home visits for low-income mothers. But for the nonretired middle class American, it does two big things. One is that over time, it phases out the existing tax subsidy for employer-provided health insurance and phases in a new system where Americans will choose a health plan on an individual basis in a regulated exchange, with the level of subsidy based on objective financial need.

Now here’s David Brooks, who rightly thinks there’s a lot that’s wrong with the basic way health care is delivered in the United States:



Liberals tend to argue that major structural changes can be made within the framework of Obamacare. Republicans tend to believe that the perverse incentives can only be corrected if we repeal Obamacare and move to a defined-benefit plan — if we get rid of the employer tax credit and give people subsidies to select their own plans within regulated markets.

In other words, Brooks wants to repeal Obamacare and replace it with … Obamacare. Or rather with a more vigorously implemented version of Obamacare.