Tom Price for Health & Human Services

For health secretary, Trump has chosen a House representative who has drafted a complete replacement of the Affordable Care Act (ACA), leaving no doubt that he is allied with Senate Majority Leader Mitch McConnell who says, "I can tell you where we're going to start" the new term. "With a process to repeal and replace Obamacare".

Trump's choice is Tom Price, an orthopedic surgeon from Georgia, who has received $734,900 in campaign contributions from health, drug and insurance companies. His view of the passage of the ACA was "a dark day for America…our founders are weeping". The Act was not to make people protect themselves with health insurance, "the true desire of those on the left is to gradually and enticingly move all Americans to Washington-controlled bureaucratic health care", he said on the House floor in 2007 before Obamacare was enacted.

His solution is to upend the healthcare act with "free-market solutions" set out in his bill called the "Empowering Patients First Act", which translates to leaving people to find and buy insurance only if they choose to do so and on their own. That eliminates the mandate — the requirement that people buy insurance or pay a penalty — and replaces subsidies with a mix of tax credits and tax-free savings accounts (applicable, however, only to people who have money enough to set aside). The federal government would offer funding to the states for "high risk pools" to help pay for the more seriously ill. That's what income from the mandate was intended to pay for, so the cost would merely be shifted to taxpayers by a different route.

Companies with over 100 employees will not be required to buy insurance for employees in Price's plan. Medicaid infusions from the government to the states would be cancelled. The Congressional Budget Office has made no estimate of the plan's, so its claims of cost savings are blue sky.

With possible but uncertain exceptions — there are already plans to attach strings to coverage for pre-existing conditions — conservatives will thus turn the clock back eight years to restore much the same tangled health system that governments since Truman have tried to fix.

Recognizing that pulling the rug from under the over 20 million people who now have insurance under the ACA will cause howls, the Republican plan is to repeal but delay execution for two years until after the mid-term elections of 2018. That ruse is to hide from the public what is to come that could cost them their seats, but their real hope is that Obamacare's growing premium costs will bring about their avidly wished for "death spiral" that will cause it to implode on its own. Having had no hand in it (and refusing to entertain any repairs), the Party will just successfully blame its failure on the Democrats.