I write this from Vancouver where everyone has health care.
Canada also has the most conservative government it has had in decades. Yet when I ask Canadians around here if the Harper government is threatening to repeal Canada's popular single payer system, they express surprise. Not a chance, they say. It would be political suicide.
The law that the U.S. Supreme Court upheld today is not a single-payer system on the Canadian model. Rather, it's a set of compromises, a weaving together of provisions that were politically feasible in the U.S. at that time to try to get us to more or less the same place. It was our best answer to the moral issue of forty million Americans without health insurance. It's not perfect, but it's pretty damn good.
My guess is that, if the law survives past the next presidential election, it won't be an issue at all in 2016. By then all of the laws major provisions will have kicked in and the polls show that people like them. A lot.
Stopping insurance companies from denying coverage for pre-existing conditions, or canceling a policy because a person becomes ill? Almost 90% of Americans support that.
Creating health insurance pools to give small businesses the same leverage and advantages of big corporations? Eighty percent support it.
Requiring companies with more than 50 employees to provide their employees with health insurance? Seventy-seven percent in favor.
Increasing the Medicare payroll tax for those earning more than $250,000? That's got the support of 72%.
And allowing young people to stay on their parents' insurance plan until age 26? That gets the nod by two out of three Americans.
But because, incongruously, the overall "Obamacare" law is wildly unpopular, this is now likely to become the centerpiece of the fall elections with Mitt Romney now saying that his election is the only way this scourge can be overturned. What's worse, most of the most popular provisions won't go into effect until 2014.
So, it's not over by a long shot. Now, the president and his team need to do what they haven't done since the law passed: sell it.
The Democrats need to explain what's actually in the law, but do so in an environment where the law's major benefits are still two years in the future. Not an easy job.
But if they pull it off, and Obama and the law survive to 2014, than even a conservative president elected in 2016 wouldn't dare touch it.
Just like Canada.