In October 2004, in a D.C. hotel ballroom crowded with ambitious politicos, George W. Bush’s campaign manager Ken Mehlman was at the podium, shouting and gesturing like a televangelist. 

His message was that the 2004 election was the most important of our generation. It was important because, otherwise, evil things and evil times awaited us.  But his histrionics did little to impress.  My hope is that I can do a better job at impressing upon you that our current election is, rather, the most important of our generation. 

America has a great inner strength that transcends what any single politician can do.  But there are times when that strength can be tested, and the direction of the country changed.  Both conservatives and liberals point to the transformative presidencies of Franklin Roosevelt and Ronald Reagan.

President Barack Obama, in his own way, is trying to be a transformative president, but the nation isn’t buying his change agenda -- the Republican gains in the off-year elections of 2010 proved that.  Further, it seems that Obama’s change agenda contains warmed-over stuff from decades past, instead of focusing on the real, basic need of Americans today: more jobs.

Let’s take Obama’s “green jobs” initiative for example, which, looking at Solyndra, appears to be a repeat of an error of a former presidency. (Readers of a certain age may recall President Jimmy Carter’s Synfuels fiasco, which was supposed to lower gas prices by offering federal subsidies to create new fuels.) It’s not hard to see that Obama’s Solyndra is just a remake of the Carter program.  If it were a movie, we could conceivably call it “Son of Synfuels.”

But Solyndra is small potatoes compared to the brass-ring prize of health care reform.  Obama worked his early-administration trifecta (a Democratic House, Senate and White House) hard and produced a law that, if it goes fully into effect, will inject the government deeply into a major sector of the American economy.

The health care law is so huge and complex there is no way to predict all of its unintended consequences -- and hidden extra costs for providers as they struggle to comply with the law.

Remember the medical records privacy act passed in 1996, known by its initials as HIPAA?  Medical records privacy, we all agree, is a good thing.  But when my mother was in a nursing home in another state and I tried contacting the home to find out how she was doing, I was told that HIPAA prevented them from discussing her situation. For me to find out about her status, I would have to take time off of work to travel to the home and have a discussion with the home’s HIPAA privacy officer.  

I called a Congressional staffer who had worked on the HIPAA legislation to complain about the paranoia reigning in medical facilities, including my mom’s nursing home.  He shamefacedly admitted they had never considered the possibility of overreaction, or how difficult it would make it for children to get updates on a parent in a care facility.  And then he shrugged. 

Who knows what unintended consequences lurk in that big blob of so-called health care reform?  Bureaucratic boards will merrily churn out decisions, and if your health costs go up, or you can’t get treatment because you don’t fit a certain profile, you can expect to deal with more bureaucrats (called appeals boards) -- and more shrugs. 

What particularly worries me is that you can bet there is an unknown ugly quirk buried somewhere in the law that will cause more burdens and hurt more families.  Plus you can bet the response will be: “Well, we wrote that law in a hurry, so sorry (shrug), can’t fix it now.”

Happily we have the power to end this nightmare in just a few days.  Mitt Romney has made it very clear he will stop Obama’s health care law on Day One.  I get the sense Romney is really determined to do this. He knows the nation wants to end Obamacare and replace it with a more sensible approach to health care reform.

Turning to the jobs issue, it’s clear the president has been dusting off more old solutions  -- let the government “stimulate” jobs. But what happens when the stimulus money goes away?  Think of all those teachers’ aides funded with stimulus funds who were subsequently laid off when the money ran out.  And remember how Obama was shocked to find out there were no “shovel-ready” jobs thanks to endless rounds of governmental reviews of environmental impacts?

The best stimulus is one that encourages enterprises to create jobs.  I’m not talking about cash infusions to the favored few, but simple, sensible and reliable tax policies coupled with a trade policy that actually focuses on America’s job needs instead of America’s overseas image.  Romney gets this.

As I see it, the decision is this: more jobs, more opportunities, and more certainty with sensible health care reform or stagnant unemployment coupled with an uncertain health care future.  The question is: Do we want that impact to be positive or negative?  I want a better future for our nation, not four more years of the same old, same old.

Now you know why Romney’s got the momentum to win on Nov. 6.  It is this election that really matters, and America knows it. (Sorry Mr. Melhman, but you were wrong in 2004.)  

What happens on Nov. 6 will have an impact on all Americans, including generations not yet born, and as voters we have a grave responsibility to cast a vote that will strengthen our nation for the rest of this century.

The goofy sideshows of the primary season are over.  It’s the final scene of the final act in this election drama.  How it all works out is up to you.

Joanne Butler is a graduate of the Kennedy School of Government at Harvard University and a former professional Republican staff member at the U.S. House of Representatives Ways and Means Committee.