For now, let’s drop the talk about wanting a liberal America or a conservative America. What we truly need is a modern America. No country can be modern spending twice what its rich competitors do on health care while leaving millions without any coverage.

If the U.S. Supreme Court declares the essential “individual mandate” in the federal Affordable Care Act unconstitutional — or Republicans throw out the reforms — then it’s back to the past, back to the economy-dragging health care mess we’ve been calling a “system.”

Republicans say that Americans don’t want top-down government control of their health care. But what we have now is top-down corporate control of health care. Insurers, drugmakers, sellers of expensive equipment, hospital executives, labs, home-health-care services and others unnamed prosper by exploiting the chaos in our health care system.