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 in the streets last year. With unemployment the highest in nearly three decades, seven of the 10 states with the highest rates are Democratic, and three of those – Nevada, Florida and North Carolina – switched sides to vote Obama last year. If anyone is struggling to keep faith, it is the people responsible for putting Mr Obama in office. And what about those promises to take bold action on the banks? We got caution rather than boldness, a government of Goldman Sachs by Goldman Sachs, the belated introduction of caps on bonuses and no restructuring of finance.
Those who believed Mr Obama's commitment to wipe away the stain of Guantánamo and all that went on inside it have also been struggling with the National Defense Authorization Act (NDAA) which he has just signed into law. Congress made significant improvements on a truly horrific law, but military commissions will remain as a second-class form of justice circumventing both the US constitution and the Geneva conventions, and they will only exist for non-US citizens. Many of the deepest problems of Guantánamo, like indefinite detention, may simply be continued in other, though less obvious, forms.
These are significant blips, but none in themselves constitute a reason for losing faith. Most of what is going wrong now – the banking crisis, the war in Afghanistan, the stagnation of the Israeli-Palestinian peace process, failure over climate change – was going wrong a year ago. Some things, such as the atmosphere in talks between the US and Russia have changed, and could well result in an agreement on strategic arms which will replace the Start-1 agreement next month. But even if the current talks with Iran are doomed to failure, who would be foolhardy enough to damn the new era of constructive engagement which Mr Obama has brought in? The failures are manifest. It is easy to see how the realities of power betray the hopes of a year ago. It is harder to stick with the vision, but that is what we should all do.