Let’s straighten out what actually happened at the Supreme Court. By refusing to reject President Obama’s healthcare reforms, the Supremes opened a clear pathway that leads in time to what right-wingers like to call “socialized medicine.” This is not what Chief Justice John Roberts had in mind. Nor what the president himself had proposed. But that is the true subtext for what the court decided, the real reason why right-wing frothers threw everything in their fevered imaginations at the liberal object for their scorn.

A line was crossed in the artful reasoning concocted by the Chief Justice. Or rather the door was opened for continuing invention and evolution toward what eventually will be recognized as nationalized healthcare, American style. Like it or not, Roberts explained, Obama’s scheme is not unconstitutional and the Court has no right to stand in the way.

The Chief Justice’s logic effectively confirms the open-ended process of discovery Obama has launched. The president’s strategy disappointed those of us who had wanted a more aggressive and coherent solution. His cautious approach means many more years of pushing and pulling between private interests and public needs. But the private sector—from doctors to drug companies and hospitals—is already trying to adjust, anxious to shape big changes in store for them.

This much has been settled. The federal government does indeed have expansive powers to reorganize the healthcare sector in whatever ways that will work for people and the broad public interest. In a backhanded way, the Court’s determination essentially secures the right to healthcare for everyone and on terms that everyone can afford. That is what Franklin Roosevelt envisioned back in 1944 in his “Second Bill of Rights” speech. Reformers who disparaged Obama’s hesitant approach should now celebrate his victory and make the most of it.

The shift in political boundaries is a huge accomplishment though, given the current ideological hysteria, neither Obama nor Roberts have much to gain by claiming full credit. The right will no doubt froth on. But the right lost the argument big-time. It created legal-eagle word games and pretended to be spouting constitutional principle. But the real motives are deeply cynical. The Republican party is playing crash-and-burn politics over this and other issues, insisting that all people want is “smaller government.” What people really want is a governing system that works for them. Those of us who argued with Obama’s caution now have a vast field of play in which to make their case, state by state, for stronger, more comprehensive solutions. Can Vermont or Oregon create an equivalent of single-payer healthcare? Will backward state governments punish their poor citizens by refusing to take the federal money for Medicaid? These are animating political issues that will test the half-baked claims of small-government conservatives.

My take on things probably sounds wildly over-optimistic. I do not suggest that reformulating healthcare in incremental ways will be free or easy, much less quick. These are knotty economic matters in which government decisions are tested in real time and mistakes will be immediately clear and costly. Nevertheless, I think the Roberts-Obama concordant has great promise and reshapes the future.

Two things of lasting impact occurred with the Supreme Court’s green light. Conservative illusions of ideological supremacy popped like a soap bubble. The major media have been under this spell for years—taking cues from Fox News or nasty talkers like Limbaugh—but the Supreme Court decision is a major, major embarrassment for pundits and reporters. How could they be so wrong with their confident predictions of doom for Obama?

It will take a while for the right-wingers to grasp this same point—maybe a couple of election cycles—but the GOP has committed itself to the loser position. If Obama should fail to win re-election, the Republican dilemma will swiftly become obvious. What does the GOP intend to do with government? Less and less? If you listen to its leaders and presidential nominee, that is their program. Romney sounds like he is full of Mitt.

The larger reason why healthcare reform will remain a driving force in politics is the necessities of our new economic condition as a nation. The free-spending days of easy credit and lopsided inequalities are squeezing folks from every side. Libertarians have no answer except to say, Get over it. Politicians, however, will be driven to find answers, even half-baked answers, or else cash out their careers. It is not that “big government” has found the answers for the national scandal of healthcare. It is that “small government” doesn’t even want to look.