If President Barack Obama is re-elected, ObamaCare’s controls over doctors, hospitals, pharmaceutical firms and other providers of medical care will be tightened, and the operations of private insurance companies will be progressively restricted. Everyone involved will know where the process is going—to a single-payer system or one with a few chosen insurers subject to national public-utility controls—and will negotiate the best possible accommodations to it. Within a few years, a new political equilibrium will be in place, making the system irreversible and subject to only marginal adjustment.
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For tactical reasons, neither President Obama nor Gov. Romney has emphasized the election’s special, referendum-like importance for the future of American health care and politics. But it truly is a moment of We the People sovereignty—so the more of us who realize what we are doing, the better.