Five years since its passage, the Affordable Care Act (“Obamacare”) remains mired in controversy. Despite its lofty goals, the law imposes costly mandates, overpromises benefits, and hurts labor markets at a time of tepid wage and employment growth. And while Republicans have offered various alternatives, the GOP remains sharply divided over how to best repeal and replace the law—even with the Supreme Court poised to rule on the legality of federal exchange subsidies.

In his penetrating new book A Better Choice: Healthcare Solutions for America, John Goodman, senior fellow at the Independent Institute and the “father of health savings accounts” (Wall Street Journal), proposes four reforms to undo the most damaging elements of Obamacare: replace mandates and subsidies with a universal tax credit; replace medical savings accounts with a Roth Health Savings Account; allow Medicaid to compete with private insurance; and  deregulate the exchanges and require them to institute change-of-health-status insurance. “The result,” writes Goodman, “would be a healthcare system that would be unquestionably more equitable than what you see in either Britain or Canada and a lot more equitable than what we will experience under the Affordable Care Act.”

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