On Sunday 21 March the House of Representatives passed a healthcare bill that had been promoted for a year and brokered in many particulars by Barack Obama. This marked a victory for a substantial piece of social legislation, the first of its kind in more than three decades; and the result appears to have given the president and his party fresh confidence in their efforts at comprehensive reform. Whatever may happen now, it was plain the defeat of healthcare would have been a death-blow to the Obama presidency; its passage has given him time to discover the means for a renewal of presidential energy. Yet the bill passed without a single Republican vote, and its revisions, augmentations and delays, many of them prompted by Obama in a vain search for bipartisan support, made the process a textbook example of 'winning ugly'. When the president launched his proposal last spring, two-thirds of Americans approved the idea of national healthcare. By the time it passed the number had shrunk to a third.

LRB 13 May 2010 | PDF Download