In his announcement speech on Monday, ophthalmologist turned GOP White House hopeful Rand Paul recounted his pro bono work performing eye surgeries in Guatemala. But in a speech that emphasized his medical background and commitment to "liberty" as his calling cards, Senator Paul made little mention of the Obamacare program he has long promised to repeal. That omission was probably for the best. After all, as he has made clear in the past, Dr. Paul's prescription for millions of previously uninsured Americans is to choose "freedom," just like those who shop for cosmetic surgery like Lasik.
But in his response to President Obama's State of the Union address in January, the junior Senate from Kentucky offered his diagnosis of the American health system and offered his own prescription to cure it:

Obamacare, at its core, takes away a patient's right to choose. Under Obamacare, patients are prohibited from choosing their doctor or their insurance...
Everyone knows our health care system needed reforming, but it was the wrong prescription to choose more government instead of more consumer choice and competition.
Obamacare restricts freedom and must be repealed!
I was asked recently how we would fix our healthcare system. I replied, "Let's try freedom again. It worked for over 200 years!"

But before Obamacare, "freedom" produced 50 million uninsured, another 25 million underinsured and employers rapidly shifting costs to workers. Leaving his fictions above aside, how would Dr. Paul propose replacing the Affordable Care Act which enabled over 30 million people to obtain health insurance and reduced the uninsured rate to its lowest level in twenty years (especially in Kentucky), all while helping slow the growth in health care costs? Like some other conservatives, Senator Paul in 2013 pointed to the miraculous wonder-working power of the market for Lasik surgeries:

"Insurance doesn't cover Lasik surgery, the surgery to get rid of glasses," Paul remarks. "So it started at about $2,000 an eye, maybe even $2,500 an eye, and it's down in some communities to under $500 an eye because competition works and people call on average four doctors to get the price and see how much it's going to cost."

Of course, choosing Lasik surgery over glasses or contact lenses is completely elective. In a free market, the seller has a lot less leverage when the buyer can simply walk away and choose to purchase nothing. Give that a try the next time you go for chemotherapy, kidney dialysis, get diabetes treatment or, say, rupture your spleen. As I documented last year in "Why the U.S. Should Treat Health Care Like a Utility, Not a Market":

But even if our American patient-as-consumer had access to transparent pricing information and knew everything doctors know about his or her treatment, health care would still not constitute a free market for a simple reason. In most cases, the transaction between the patient/buyer and the provider/seller is coerced. That is, when you're sick, you can't simply walk out of the market. You have to buy care from someone--or else. (Recent studies have the put the number of uninsured Americans who needlessly die each year as high as 45,000.) Worse still, because you can never know in advance about a bank account-draining illness or accident or condition that could require regular or lifelong care, insurance is the only path forward.

No large, modern industrialized nation has based its health care system on the medical equivalent of window shopping. (In fact, the experience in countries as diverse as Germany, Japan, the UK, France, Switzerland and Taiwan is to treat health care as a highly regulated utility in which rates for hospitals, insurance premiums, physician services and drugs are set by the government.) "There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn't work," Dr. Paul Krugman summed it up. "And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence."
As a quick glance at his web site shows, Rand Paul's plan to replace Obamacare with "freedom" is nothing new. Bullet points like selling insurance across state lines and supporting health savings accounts (HSAs) have been part of every GOP health care plan since Bill Kristol helped torpedo the Clinton initiative in 1993. As Dr. Paul's web site reads:

As your President, I will ensure that real free-market principles are applied to the American health care system so that it is responsive to patients, families, and doctors, rather than government bureaucracy.

If you believe that, you don't need your eyes checked; you need your head examined.