Mike, which utopia is that?
What will really happen: no further reform will be possible, and
the whole of the existing reform will not be affected. In other words, single payor will have all the might of the 18% of GDP arrayed against it, business interests will drown out anything else... and the other aspects of the current law will either face Supreme Court challenges, or become impossible to implement due to the lack of sufficient insurable population.
The end result is that those of us who have insurance will pay more for it, and forego future pay increases for it. Those who do not will continue to free load on the rest of us, though this free loading is seemingly OK because it is
private sector freeloading.
In case the political polarization happens to flip towards Republicans, they will be emboldened to replace Medicare/Medicaid with a voucher system, so the old people will be screwed. In case the polarization flips towards the Dems, those spineless bastards will simply try to patch whatever they can without extending their necks out one inch.
I watched the Dan Rather report on this upcoming decision, and the analysis seemed to be that the opponents had to sway 4 Justices while the proponents had to sway just 1 to get a majority. The sole Justice solidly against? Clarence Thomas, the only non RINO in the bunch