“On Tuesday, Americans will go to the polls to choose whether or not to nationalize their health-care system. The choice for president will have numerous other consequences. But in most cases we will be choosing between tendencies shrouded in uncertainty. The candidates have staked out positions and made some explicit promises—but how these work out in practice will depend on many future contingencies, and many an earnest campaign promise has been confounded or even reversed in the past. The health-care choice is singular not only for its importance but for its certainty.”