Obama’s great achievement is not any one element of the health-care reform law — not even the now-upheld “individual mandate,” which compels individuals to have health insurance or pay a fine. The important thing is the law’s underlying assumption that every American, rich or poor, should have access to adequate health care. …

The result — the Patient Protection and Affordable Care Act — is a huge, complicated, unwieldy piece of legislation. I would have loved to see the president try for something simpler and more elegant, perhaps a “Medicare for everyone,” single-payer system. Maybe that’s where we’ll end up someday.

But despite all the rhetoric we’ll hear from Romney and the GOP until Election Day, health-care reform is here to stay. Provisions such as guaranteeing insurance coverage to those with preexisting conditions are too consumer-friendly to be taken away, and once these measures take effect, which happens in 2014, insurance rates would rise sharply — and unacceptably — without the individual mandate.