Politics aside, private markets in many areas of the economy have substantive advantages over a government program. They create competition, which leads to innovation and lower prices. But private markets in medical care tend to be more complicated and less successful.

And government health care programs turn out to be very popular, among both Democratic and Republican voters. Medicare is a huge success. Medicaid also works well, and some Republicans have defended it in recent weeks.

So if voters like government-provided health care and Republicans are going to undermine private markets, what should Democrats do? When they are next in charge, they should expand government health care.

They should expand Medicaid further into the working class. They should open Medicare to people in their early 60s. They should add a so-called public option to the private markets. They should push the United States closer to single-payer health insurance. It will take time and involve setbacks, but they are likely to succeed in the long run.