By the beginning of this year, success looked close. The House passed its version of a health bill in November. The Senate followed just before Christmas. All that was required when Congress returned last month was for the two bills to be combined so that a joint version could be passed by each chamber again. But on January 19th Scott Brown, a Republican, captured the old Kennedy seat in Massachusetts, bumping the Republicans in the Senate up to 41 and destroying the Democratic supermajority at a stroke. The very next week Mr Obama went to Capitol Hill and pleaded with Congress not to walk away from reform when it had got so close. But the whole plan may now be dead.

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