So they're going to pass some version of health care reform. Like any big legislative initiative, nobody really knows how it will interact with reality once it takes effect. Most political partisans seem pretty unimpressed with it; which is weird, since the final bill will be very impressive... politically speaking. I haven't seen this kind of belief in the power of government to make positive change in the lives of average Americans in my lifetime. In recent decades, Americans have voted for (and seemingly preferred) a government that has not only abdicated its charge to work in the interests of civic good, but has actively set about dismantling every institution of collective betterment. I wouldn't go so far as to declare the era of Laissez-faire governance over, but I do think that we're moving in the right direction for the first time in a long, long time.
This is the real reason that the Republicans have united in opposition to the health care bill: it represents an ideological shift away from official neglect and towards participatory activism. The specifics of the bill never really mattered to those that opposed it. The "public option," abortion provisions, "death panels," Medicare buy-ins... all of these contentious provisions were resolved with deference to the preferred solutions of hardline conservatives, and they still opposed the bill unanimously. The truth is that they simply don't believe that the government can play a useful regulatory role... in anything. The defeat of congressional conservatives herein represents a defeat of that worldview; this may not be the next "New Deal," but it's a great deal more hopeful and progressive than anything we've seen make it's way through the legislative process since the days of LBJ.
Contrary to the incessant whine from committed leftist ideologues, this really is the change we voted for. It's not fast, it's not pretty, it's not perfect, and it's far from being done... but if we keep at it we can, over time, become a more equitable and a more just country. Yes we can.
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