In the end, Democrats in the House of Representatives answered the call of history, as their president put it. Not since 1965, when Medicare and Medicaid were created, has a chamber of Congress passed a measure to vastly increase medical coverage. Universal healthcare, the centrepiece of Barack Obama's first term as president – and everyone is assuming there will be another – looks like becoming a reality. There were breathtaking compromises on the way, such as an amendment that prohibits the public option, the government-run healthcare programme, from covering abortion, except in cases of rape, incest or if the mother's life is threatened. There could be more hard decisions to come: allowing states to opt out of the public option, whether to require employers to provide coverage for their workers, whether to tax the rich.
But healthcare reform, like other issues, demands a clear judgment: is Mr Obama betraying in power the principles on which he ran for it? Or is this president a shrewd and pragmatic leader? This has not been an easy year for those who danced