Luke A. Barnes is a postdoctoral researcher at the Sydney Institute for Astronomy. His university medal from the University of Sydney helped him earn a scholarship to complete a PhD at the University of Cambridge. He has published papers in the field of galaxy formation and on the fine-tuning of the Universe for life. He has been invited to speak at the 2011 and 2015 St Thomas Summer Seminars in Philosophy of Religion and Philosophical Theology, the University of California Summer School for the Philosophy of Cosmology, and numerous public lectures. His book with Geraint Lewis, “A Fortunate Universe: Life in a Finely Tuned Cosmos” is available from Cambridge University Press.

For seven years Republicans have complained that the Affordable Care Act makes health insurance unaffordable for millions of Americans. The two primary drivers of those high health insurance prices were (1) abandoning actuarial standards and (2) requiring people to have very expensive, comprehensive coverage. The Republican bill addresses the second problem but ignores the first.

President Obama and the Democrats do not believe a health insurer should be allowed to decline coverage to applicants in the individual (i.e., non-group) market, even if that person has a costly medical condition. Nor could insurers charge more for that condition. So Democrats imposed those provisions in Obamacare.

But they were warned that doing so would encourage individuals to remain uninsured until they need medical care, and then drop that coverage after their condition is treated. So Democrats included the mandate to have health insurance to keep people from gaming the system. However, it didn’t work because the penalties were fairly low.

Many of us warned at the time that young and healthy people would likely stay out of the insurance market until they needed care. And if you’ve followed Obamacare’s travails, you know that’s exactly what happened.

In his February 28 address to the Joint Session of Congress, President Trump called the Affordable Care Act (ACA or "Obamacare") an "imploding disaster."

His references to soaring premiums, contracting choices, and market collapse are all spot on. And of course everybody wants "reforms that expand choice, increase access, lower costs, and at the same time, provide better Healthcare." Trump wants Americans to be able to choose "the plan they want, not the plan forced on them by the government."

But what must we do "first" and "second"? From a physician’s perspective, "first" is to make the diagnosis. "Second" is to remove the cause of the ailment if possible. And that means to drain the swamp.

Unfortunately, Trump’s "first" is to "ensure that Americans with pre-existing conditions have access to coverage" and "second" to "help Americans purchase their own coverage, through the use of tax credits…."

These "popular" ideas emanate from the swamp, percolating up through lobbyists, think tanks, and congressional "leadership." Correctly translated, these mean to abolish true insurance — and the only reason for buying it when healthy — and to force healthy or higher-income people to pay more than their fair share. A "refundable tax credit" is a disguised subsidy, courtesy of present and future taxpayers.

If you want to see political malpractice in action, you don’t have to read Donald Trump’s latest tweet — just look at the mess Republicans have made of repealing and replacing Obamacare. Given seven years ...