Amid a protracted rollout, the real-world evidence keeps mounting: the Affordable Care Act (Obamacare) is too costly to finance, too difficult to administer, too burdensome on doctors, and too disruptive of health care arrangements that Americans prefer. The need to replace it has never been stronger, yet full repeal is unviable in the short-term. The long-term task for reformers is to lay out a convincing case, not for a return to the former status quo, but for the kind of patient-centered health care system only a market-based model can deliver. But what policy changes would that entail? And what would they mean for patients and providers? American Enterprise Institute resident fellow Tom Miller answers these and other questions.