I guess nobody should be surprised that American conservatives are boiling over with rage right now. You know how they can get. Irrational. “Death panels,” “the antichrist,” birtherism and stuff. They freak out. I know.

But still. Don’t they see that this is the best possible outcome for them? It was either this individual mandate-driven reform involving the private insurance system or it was going to be Medicare-for-all. Period. This is the most marketiest, least governmentiest way this could have ended. If you look around the world, I don’t think you can find any other civilized nation on earth that has a smaller role for government and a larger role for private insurance companies in their solution. You do find quite a few more government-heavy ones, though.

And, come on. The current system is so awful. It’s hard to imagine it being worse. Tens of millions with no insurance? People with insurance getting dropped when they become ill? People who have been ill blacklisted from future coverage? Even children? Come on. The only people who had any kind of security in their health care at all would be those who already had government insurance: those on Medicare, Medicaid, military or VA. The rest of us paid through the nose, often for poor coverage. And we never were sure it was going to be there when we needed it, anyway. Even the best-insured could be devastated by one serious illness in the family. Retirement gone, home gone. Tens or even hundreds of thousands in debt. Bankruptcy. Financial ruin. For the insured!

So things were bad. Terrible. And getting worse every year. Solutions presented themselves from all over the world. This was the least government-heavy one out there. In fact, it was a policy advocated by American Republicans for nearly twenty years–right up until the time Democrats said “ok, we’ll do it your way.” Then they pretended like they’d never heard of it, this strange new plan to kill all liberty.

I guess what I’m trying to say to American conservatives is: this is about the best you could have reasonably hoped for. You got the least government-heavy solution out there. You managed to forestal any kind of solution at all for many decades beyond other civilized nations. You managed to make the law unpopular, even though Americans like the provisions of the law. You even managed to get the Supreme Court to hand you ammunition for the post-game squabble: it’s a “tax.” (Heaven forfend!)

What more did you really think you were going to get? Another decade of descent into horribleness? By then we’d be living The Hunger Games, for Christ’s sake.

I shouldn’t ask such a reasonable, reality-based question of people who think “death panels” was a meaningful contribution to the health care debate. But I want to ask it anyway, even if I know I won’t get a rational response.