"The policy upheld in Thursday’s Supreme Court ruling is a rough approximation of the Republican Party’s 1993 federal proposal for insurance reform and of then-Gov. Mitt Romney’s bipartisan insurance reforms in Massachusetts five years ago. It’s fun to denounce it as socialism or the “end of America” or whatever, but in reality the Affordable Care Act is a small-c conservative reform that preserves the private insurance system. Without reform, that system has produced outcomes that no one should have been satisfied with — compared with other well-off industrialized countries, we’ve been getting lousy outcomes, for twice the price, with tens of millions of Americans left out of the system altogether. Scuttling Medicare isn’t going to fix that system, nor is doing nothing. But these reforms might. Beyond the bloodthirsty partisanship that is so desperate to deny this president anything that looks like a victory, I think history will view this ruling, and this policy, as simple affirmations that the country can and ought to use policy to try to come up with practical solutions to even our big, complicated problems."