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Repealing Obamacare is all but a certainty. It’s the "replace" part that has everyone hung up. Democrats hilariously claim if Republicans “break it, they’ve bought it.” That’s like accusing someone of breaking the picture on a jigsaw puzzle.

Still, the matter of replacing this abomination presents Republicans with serious problems, not the least of which is the concept of government interference in health insurance has long been ceded.

Were this a pre-Obamacare world, implementation would be easy to stop – people can’t miss what they never had. But it was implemented, and millions of people are used to what Obamacare has “given” them.

This is particularly true of the millions of people who’ve been put on the Medicaid rolls.

Medicaid was supposed to be a program to help the poor – the real poor, not those who have to postpone the purchase of a new 70-inch TV until they find a better sale price. Since its inception, what qualifies as “poor” for the purposes of Medicaid has been creeping up. Obamacare accelerated that trend.

Republicans now have to figure out what to do with a family of four that makes $80,000 but still suckles the government teat by taking health insurance designed for people who are incapable of obtaining it for themselves. What do you tell them?

Calling them losers won’t win any votes, but anyone firmly in the middle class who is comfortable with leeching off taxpayers so they don’t have to address their personal responsibility is unlikely to vote Republican anyway.

Whatever Republicans eventually coalesce around will arm Democrats with people who have no qualms leaching off the government and are more than happy to be trotted out as examples of people “suffering” under the cruel GOP action. So what?

Republicans have to focus on getting the policy right, or as right as they can on an issue with which government never should have gotten involved.

Getting it right means getting the government out of it as much as possible. Republicans can’t concern themselves with who “wins” or “loses,” or if there will be “pain.” Frankly, there has to be pain. Pain should be a cornerstone of what is proposed as a replacement.

The solution to replacing Obamacare isn’t to cobble together a different big government solution, it’s to empower individuals to make the best choices for themselves and get the hell out of the way of everything else.

Among the many changes, there likely will be competition across state lines for health insurance, which will be good and drive competition. And tax credits to buy it. All well and good. But there has to be consequences for choosing not to do so.

The individual mandate must be repealed. The federal government has no business forcing the Americans people to purchase something they don’t want. But there should be serious consequences for not at least buying some catastrophic coverage.

It’s usually young people who don’t buy health insurance. They are least likely to need it and end up essentially subsidizing wealthier older people anyway. They should be free to opt out of that pyramid scheme.

But if, God forbid, someone 37 years old get sick after they’d chosen not to buy insurance, they should not be absolved of the ramifications of that choice.

I’m not saying they should die on the streets. They should get treatment. But they should have to pay for it. Maybe not all of it, but a significant portion. If they own a house, they should have to sell it. Their wages should be garnisheed until a significant but fair portion of their tab is satisfied.

They would have made a bet and lost, and they shouldn’t get to walk away from a bet just because they lost.

Significant pain, or potential for it, would encourage people to do the right thing while affording them the option not to. Family, friends, communities could take up collections and help people who gambled and lost settle their debts, but not taxpayers as a whole. We need to restore the concept of responsibility as we restore liberty. Replacing one big government program with another does neither.

In modern America, the idea of consequences is almost as dead as Latin. The importance of returning them to all areas of life is crucial, particularly in health care. Americans should be free to gamble, to roll the dice. But if it comes up snake eyes, well, the house needs to be paid. If someone wants to risk it to save on premiums for something they don’t think they’ll need, knock yourself out. Just don’t come running to taxpayers if you do get knocked out.