Wish granted, mission accomplished. Obama has failed — that is, if you judge by his tanking poll numbers. But does this collapse in approval have to mean that the last best chance for expanding health care for millions of Americans must fail as well?

Does this mean we throw in the towel, and return to a status quo in which insurance companies routinely cancel policies, deny health care to people with pre-existing conditions and have their own death panel treatment for patients who reach a cap in medical benefits?

The Republican plan would do just that, because they have no plan but to crush the nation’s fledgling experiment. Sometimes they bring up vouchers, or tort reform, or some combination of catchphrases. Here was Sarah Palin, who is to articulate reason what Mr. Magoo is to vision, on the Republican alternative, as she told Matt Lauer:

“The plan is to allow those things that have been proposed over many years to reform a health care system in America that certainly does need more help so that there’s more competition, there’s less tort-reform threat, there’s less trajectory of the cost increases. And those plans have been proposed over and over. And what thwarts those plans? It’s the far left.”

Yes, it is a big and legitimate news story, for a presidency built on technical expertise, that the federal exchange is not working as promised. Ditto Obama’s vow that people could keep their bottom-feeder health care policies.

But where were the news conferences, the Fox News alerts, the parading of people who couldn’t get their lifesaving cancer treatments under the old system? Where was the media attention when thousands of people were routinely dumped once they got sick? When did Republicans in Congress hold an oversight hearing on the leading cause of personal bankruptcy — medical debt?

All of that is what we had before. And all of that is what we will return to if some version of the Affordable Care Act is not made workable. Republicans have a decent chance, in next year’s elections, of killing the dream of progressive presidents going back to Teddy Roosevelt. But they shouldn’t count on it. What’s going against them, or any party invested in failure, is that Americans are inherently optimistic. That alone may be enough to save Obamacare.