It is clear at this point that Obama care has been a failure. The health of Americans has declined precipitously and premiums have skyrocketed. There’s a lot of pressure on President Trump to come up with an Obama care replacement this time around. My recommendation would be for something like the universal catastrophic healthcare plan proposed by scholars at the Niskanen center:
Universal catastrophic healthcare makes health insurance more like automobile or home insurance. Rather than being highly prescriptive and covering all services including preventive and routine care, universal catastrophic healthcare would only cover expenses that are unexpected, extreme, and beyond the ability of the average person to afford. In other words, it would be a true risk pool like automobile insurance.
I haven’t really given any thought as to whether it would be best handled through the private insurance market or something like Medicare for all. Shifting the focus of universal healthcare to catastrophic care would address the most pressing issue, which is people being driven into bankruptcy and poverty through unexpected Illness and accident. This would push the rest of healthcare into the free market where the natural principles of competition and innovation would likely drive down prices and improve health outcomes.