There are a couple of things that jump out at me about the process. First, Obama has expended huge amounts of political capital on the bill. A president who came to office promising to do many things has had to drop that approach and concentrate pretty much solely on healthcare. He even postponed an overseas trip to lobby in favour of it. Obama also looks far more vulnerable in terms of the 2012 presidential race than most people expected he would in January 2009. But, as David Frum notes, this bill is almost certainly going to become law and not be repealed anytime soon. This means that this bill is, I fear, going to act as a major drag on US economic growth; something that is bad news for all of us who want to see a strong America that is engaged in the world.