USA, February 26, 2010: After more than seven hours of back and forth in the refined surroundings of Blair House, Republicans and Democrats went their separate ways - each side convinced that they were still right.

No-one had really expected anything else.

President Obama had hoped Congress would sign off on health reform last summer, but the issue goes to the heart of the ideological differences between the two parties, and even between liberal and moderate Democrats.

Politicians on the left want more government involvement to ensure that healthcare is available to all. Those on the right say keep the government and the lawyers out, and let the market decide.

Public opinion goes back and forth.

Reading all the various polls available, you get the clear picture that Americans are generally happy with the healthcare they have but most would be unhappy if no reform was passed this year.

They don’t much like the bill Congressional Democrats are pushing - its too expensive and too complicated - but they like its component parts and they trust the president and his party more than Republicans to solve the problem.

In the face of such ambivalence about healthcare reform, there is plenty of room for politicians of every stripe to try to control the debate.

Whatever the outcome of this political process, it will fuel campaigning for the mid-term elections in November.

Republicans will use it as evidence that Democrats are ready to tax and spend America into an unpayable debt, while failing to give patients better coverage.

Democrats will portray Republicans as “the party of No”, unwilling to take tough choices to give a healthcare safety net to millions of uninsured Americans and tackle a looming budget crisis.

So alongside the millions of uninsured Americans there are hundreds of politicians who have an important stake in whether - or what - healthcare reform gets to the president’s desk.

Quite apart from the fact that he thinks it is the right thing to do, healthcare reform would help Barack Obama shore up his presidency too.

Besides his efforts to re-vitalise the economy, reforming healthcare is the central plank of his domestic agenda and he badly needs something to show for the sizeable majorities he has had in the House and Senate for the past year.